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    Ectopic Pregnancy

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    milka agustina
    1) An ectopic pregnancy occurs when a fertilized egg implants somewhere other than the uterus, usually in the fallopian tubes. 2) Tubal pregnancies account for 98-99% of ectopic pregnancies and occur most often in the ampulla of the fallopian tube. 3) Risk factors include a history of pelvic inflammatory disease, tubal surgery, IUD use, previous ectopic pregnancy, infertility treatments, smoking, and abdominal surgery.

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    Ectopic Pregnancy

    Uploaded by

    milka agustina
    64 views14 pages
    1) An ectopic pregnancy occurs when a fertilized egg implants somewhere other than the uterus, usually in the fallopian tubes. 2) Tubal pregnancies account for 98-99% of ectopic pregnancies and occur most often in the ampulla of the fallopian tube. 3) Risk factors include a history of pelvic inflammatory disease, tubal surgery, IUD use, previous ectopic pregnancy, infertility treatments, smoking, and abdominal surgery.

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    1) An ectopic pregnancy occurs when a fertilized egg implants somewhere other than the uterus, usually in the fallopian tubes. 2) Tubal pregnancies account for 98-99% of ectopic pregnancies and occur most often in the ampulla of the fallopian tube. 3) Risk factors include a history of pelvic inflammatory disease, tubal surgery, IUD use, previous ectopic pregnancy, infertility treatments, smoking, and abdominal surgery.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    64 views14 pages

    Ectopic Pregnancy

    Uploaded by

    milka agustina
    1) An ectopic pregnancy occurs when a fertilized egg implants somewhere other than the uterus, usually in the fallopian tubes. 2) Tubal pregnancies account for 98-99% of ectopic pregnancies and occur most often in the ampulla of the fallopian tube. 3) Risk factors include a history of pelvic inflammatory disease, tubal surgery, IUD use, previous ectopic pregnancy, infertility treatments, smoking, and abdominal surgery.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 14

    ECTOPIC

    PREGNANCY
    “ A fertilized ovum implants in
    an area other than the endo-
    metrial lining of the uterus “
    Classification
    Sites of ectopic pregnancy
    • Tubal (98-99%)
    • Ovarian pregnancy (0,5%)
    • Adominal (~1/15.000 pregnancies)
    • Cervical implantation
    • Intraligamentous
    • Heterotropic pregnancy
    • Bilateral ectopic
    Tubal pregnancy

    • Ampullary (55%)
    • Isthmic (25%)
    • Fimbrial (17%)
    • Interstitial (angular,cornual) (2%)
    Risk factors
    a.Pelvic inflammatory disease
    b.Previous tubal surgery
    c.Use of intrauterine contraceptive
    devices
    d.Previous ectopic pregnancy
    e.In vitro fertilization
    f.Smoking
    g.Previous abdominal surgery
    Symptoms & Signs
    A.Symptoms:
    • 1.Pain (pelvic or abdominal pain) (100%)
    • 2.Bleeding (abnormal uterine bleeding)
    (75%)
    • 3.Amenorrhea (50%)
    • 4.Syncope (1/3 – 1/2 case)
    • 5.Decidual case (5 – 10%)
    B.Signs :
    • Tenderness
    - Diffuse or localized abdominal
    tenderness (> 80%)
    - Adnexal and/or cervical motion
    tenderness (75%)
    • Adnexal mass
    • Uterine changes
    Special Examination
    1.Ultrasound
    2.Laparoscopy
    3.D & C
    4.Laparotomy
    5. Culdosentesis
    Differential Diagnosis
    * Appendicitis
    * Salpingitis
    * Ruptured corpus luteum cyst
    * Ruptured ovarian follicle
    * Abortion
    * Ovarian torsion
    * Urinary tract infection
    Treatment
    Divided into two catagories:

    1.Ruptured ectopic pregnancy and/or active


    bleeding

    2.Unruptured ectopic pregnancy


    (do not have active bleeding)
    Emergency treatment
    • Hospitalize the patient
    • Insert a large-bore IV into large vein
    • Obtain hemogram,clotting panel,and blood of
    type and crossmatch
    • Administer antishock measures as indicated:
    - IV crystalloid
    - blood vcomponent trasnfusion
    - give oxygen
    Surgical treatment

    • a.Salpingectomy
    • b.Partial salpingectomy
    • c.Salpingostomy
    • d.Fimbrial expresssion
    Medical treatment
    • Medical therapy is increasingly utilized for
    unruptured ectopic gestations with minimal
    bleeding
    • Medical therapy is most safe and effica-cious in
    ectopic gestations with following:
    * beta hCG < 5000 IU
    * hematosalpinx < 3 cm
    * peritoneal fluid < 300 CC
    * patient is capable of complying with the
    necessary follow -up
    Medical therapy
    • Mehotrexate
    • Given intramuscularly, 50 mg/m2 on day 1
    • Repeat hCG is performed on day 4 and 7
    1) if hCG level declines < 15% between day
    4 and 7, a second dose methotrexate is
    given
    2) if hCG level declines > 15% between day 4
    and 7,the hCG titers arefollowed weekly until
    titer is < 15 ml IU/ml
    • Mean time to resolution is 35 day

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