Ectopic Pregnancy

• Ectopic pregnancy


  Implantation occurs outside the uterus
• Ectopic pregnancy

  Most common site: fallopian tube (tubal ectopic pregnancy)

  Non tubal: abdomen, ovaries, cervix
• Ectopic pregnancy

  Risk factors:

  • previous ectopic pregnancy
  • PID
  • IUD
• Ectopic pregnancy

  S/SX:

  • hallmark: severe, sharp stabbing knifelike abdominal pain (unilateral pain; if ruptured - bilateral pain)
  • vaginal spotting
  • rupture - (+) cullen's sign
  • can go to shock
• Ectopic pregnancy

  Management:

  • Combat shock - BT
  • Position: Elevate FOB or modified Trendelenburg (increase venous return = increase cardiac output)
  • DOC: Methotrexate
• Ectopic pregnancy

  Surgery:

  • Laparoscopic surgery - using of laparoscope to remove the ectopic pregnancy and repair or remove the affected fallopian tube.
  • Laparotomy - if ectopic pregnancy cannot be removed.