Ectopic Pregnancy Flashcards
What is an ectopic pregnancy?
This is a pregnancy in which the fertilised egg implants outside the uterus.
Is an ectopic pregnancy life threatening? Why
Yes because the ectopic pregnancy can’t survive outside the uterus it would cause sever bleeding and potentially death.
What causes it?
Most times it’s conditions that slow down or block the movement of the egg down the Fallopian tube to the uterus
What conditions slow down egg movement?
- Scar tissue, adhesion or inflammation prior to pelvic surgery
- irregularly shaped Fallopian tube
- growth in the tubes
Sites of implantation
- Ampulla
- ovarian
- Abdomen
- Fimbrial
- isthmic
- intraligmentous
- cervical
- intramural
What is the most common site of implantation?
Along Fallopian tube
What are the symptoms ?
Vaginal bleeding
Pain in lower abdomen, lower back and pelvis
If it ruptures expect:
Dizziness or weakness
Fainting
Shoulder pain
Low blood pressure
Rectal heaviness
What factors could increase chances of one developing an Ectopic pregnancy?
- A previous ectopic pregnancy
- history of pelvic inflammatory disease
- Tubal ligation
- history of infertility
- sexually transmitted infections
- IUD- Intrauterine device
- history of smoking tobacco
- increase age >35
An ectopic pregnancy is more common in what situations?
People who find out their pregnant when they still have an IUD in and and have a history of tubal ligation.
What are the complications of an ectopic pregnancy?
The uterus is the only organ able to facilitate a foetus and as it grows, it’s able to stretch along with the neonate, but when one has an ectopic pregnancy, the foetus grows elsewhere where it can’t be taken care of and that area is weak and isn’t flexible enough and would result in it bursting and damaging any near by organs and causing severe bleeding that if not treated immediately would potentially lead to death.
what tests would you carry out in order to diagnose?
- urine test which involves peeing on a test strip.
- blood test which will show the levels of HCG which will be low in ectopic pregnancy and high during normal uterine pregnancy.
- Ultra sound exam.
what is the treatment plan?
- Medication: use of Methotrexate, it eliminates the growth and development of the ectopic pregnancy, basically killing it.
- Surgery: Laparoscopy is done when the pregnancy erupts.
what are the two types of Laparoscopic surgeries?
- salpingostomy, this involves the removal of the ectopic pregnancy while preserving your fallopian tubes.
- Salpingectomy, this involves removing the entire fallopian tube that contained the pregnancy.
what questions would you ask a patient presenting with an ectopic pregnancy?
Did you have abdominal pain, absent or irregular periods, vaginal bleeding with or without clots?
Were there any of these features: pain in the abdomen, pelvis or vaginal area?
Did you have a pregnancy test and if so, when?
Have had any pelvic surgeries before?
had any pain when urinating or passing stool?
experienced dizziness lately?
how would a patient with an ectopic pregnancy present?
they would present with early signs of pregnancy, breast tenderness, nausea, missed periods and the like. The best way to know is by carrying out tests, a patient may come in bleeding via the vagina and that could give you an idea.
