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Ectopic Pregnancy: Definition: An Ectopic Pregnancy Is One in Which The Fertilized Ovum Is

An ectopic pregnancy occurs when a fertilized egg implants and grows outside the uterus, usually in the fallopian tubes. Symptoms include abdominal pain, vaginal bleeding, and feeling unwell. Signs include pallor, abdominal tenderness, and no uterine mass on examination. Diagnosis is suggested by history and confirmed through blood tests, ultrasound, laparoscopy or laparotomy. Differential diagnoses include incomplete abortion, pelvic infection, appendicitis, or ovarian cyst issues.

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Suhas Ingale
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276 views4 pages

Ectopic Pregnancy: Definition: An Ectopic Pregnancy Is One in Which The Fertilized Ovum Is

An ectopic pregnancy occurs when a fertilized egg implants and grows outside the uterus, usually in the fallopian tubes. Symptoms include abdominal pain, vaginal bleeding, and feeling unwell. Signs include pallor, abdominal tenderness, and no uterine mass on examination. Diagnosis is suggested by history and confirmed through blood tests, ultrasound, laparoscopy or laparotomy. Differential diagnoses include incomplete abortion, pelvic infection, appendicitis, or ovarian cyst issues.

Uploaded by

Suhas Ingale
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd
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ECTOPIC PREGNANCY

Definition : An ectopic pregnancy is one in which the fertilized ovum is


implanted and develops outside the normal uterine cavity.

Implantation sites

Extra uterine Uterine


Ampulla (55%) Cervical

Isthmus(25%) Angular

Infunditulum Cornual
(18%)

Intestinal
(20%)

Primary
Inteperitoneal(common)

Secondary

Extra Peritoneal
(Brood Ligament)

Clinical Features:
A. Acute Ectopic
B. Unruptured
C. Sub-acute or chronic or old
Acute Ectopic :
An Acute Ectopic is less common and is associated with rupture or abortion
with massive intraperformed haemmorhage.
Patient :Between 20-30 yrs of age usually nullipa
Mode of Onset : Acute with persistent unilateral uneasiness.

Symtoms :
 A short period of amenorhea.
 Abdominal pain
 Vaginal Bleeding
 Feeling of nausea, vomiting
 Fainting even syncope

Signs :
 Patient is quite, conscious , looks blached.
 Pallor
 Features of shock
 Abdomen – tense, tumid, tenders
 Muscles guard absent
 Bimanual examination – extreme ,tenderness, no mass felt through
formia, uterus float as if water

B. Unruptured Ectopic :
Symptoms :
 Presence of delayed period or spoting features suggestive of
pregnancy.
 Uneasiness on are side flants.
Signs :
 Bimanual examination – Uterus smaller than the period of
amenorrhoea.
 A pulsative small mass may be felt through one fernix separated from
the uterus.

C. Chronic Or Old Ectopic


Symptoms :
 Amenorrhoea of short period.
 Lower abdominal pain
 Vaginal Bleeding
 Symptoms of bladder irritation.

Signs :
 Patient looks ill.
 Varying degree of pallor
 Increase pulse nate
 Features of shock absent.

Abdominal Examination : Tenderness and muscle guard on lower abdomen


esp. affected side.
Cullen’s sign – dark bluish discoloration around umblias.

Bimanual Examination is painful and Reveals – Vaginal Mucosa (Pale)


 Uterus seems to be normal
 Extreme tenderness on movement of cervix.
 An ill defined, boggy and extremely tendes mass is felt through
bostesolateral folnix to pouch of Douglas.

Diagnosis Of Ectopic Pregnancy :


A. Acute : The classical history of acute abdominal catastiophe with fainting
attack and collapse associated with features of intra-abdominal haemorrhage
in a woman of child bearing age points to diagnosis of ectopic pregnancy.

B. Subacute and chronic :


 Blood examination – leucocytosis, increased ESR
 Culdocentesis
 Estimation of HCF
 Laparoscopy
 Rilatation and Cureltage
 Serum Progesteron
 Laparotomy

Differential Diagnosis ;
 Incomplete abortion in retroverted uterus
 Salphingitis
 Appendicitis
 Twisted ovarian tumor
 Ruptured Chocolate cyst.

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