Wednesday, March 20, 2019

Management of Ectopic Pregnancy | Ectopic Pregnancy Treatment | Ectopic Pregnancy Diagnosis

Definition of Ectopic Pregnancy:
An ectopic pregnancy is that in which the fertilized ovum becomes implanted in a site other than the normal uterine cavity. When the fertilized egg attaches itself in a place other than inside the uterus then an ectopic pregnancy occurs. 
Ectopic pregnancy
Fig: Ectopic pregnancy
Almost all the ectopic pregnancies happen in the fallopian tube. That is why it is sometimes called tubal pregnancies. It should be noted here that, the fallopian tubes are not designed to hold a growing embryo; thus, in a tubal pregnancy, the fertilized egg cannot develop perfectly and must be treated. For 1 out of 50 pregnancies, an ectopic pregnancy occurs.

What is the Management of Ectopic Pregnancy?
Management process for ectopic pregnancy have described in the following:
  • Immediate hospitalization,
  • Two large bore intravenous cannulas,
  • An indwelling catheter placed to monitor urine output,
  • Blood is sent for grouping and cross-matching,
  • IV fluid infusion (Hartman solution),
  • Blood transfusion if needed generally 4-8 bags blood should be kept ready,
  • Analgesics,
  • Antibiotics,
  • Sent the patient to operation theater room as soon as possible,
  • Laparoscopy,
  • Laparotomy under G/A (after resuscitation),
  • Anti D immunoglobulin in RH (negative) mother (within 72 hours).
Complications of Ectopic Pregnancy:
Common complications of ectopic pregnancy have pointed out in the below:
  • Maternal death due to hemorrhage of untreated or mistreated ruptured ectopic,
  • Chronic salpingitis,
  • Sterilityinfertility- who have undergone surgery,
  • Intestinal obstruction,
  • Fistula.
Surgical Preparation of Patient of Rupture Ectopic Pregnancy:
After immediate hospitalization, the patient should be prepared in the following way if the patient is hemodynamically unstable then-
  1. Open I/V channel and IV infusion should start,
  2. Immediate analgesia by Inj. Pethidine 10mg/IM,
  3. Catheterization of the patient,
  4. Start appropriate antibiotic,
  5. Inform the party about the need for blood transfusion and tell them to manage 4 bag blood.
Treatment of Unruptured Tubal Pregnancy:
In the case of unruptured tubal pregnancy, there are two options of treatment.


1. Waiting for spontaneous resolution:
In this case, when the pregnancy test is negative, symptoms are mild and subsiding gynecologists prefer to wait for the spontaneous resolution to take place.

2. Surgery:
In this case, doctors don’t want to take the risk and they prefer to go for surgery and the choice is unilateral salpingectomy or salpingo-oophorectomy.

Differential Diagnosis of Ectopic Pregnancy:
All the differential diagnosis of ectopic pregnancy has pointed out in the following:
  1. Acute appendicitis,
  2. Renal colic,
  3. Torsion of an ovarian cyst,
  4. Torsion of a pedunculated leiomyoma,
  5. Acute or subacute salpingitis,
  6. Abortion complicated by salpingitis,
  7. Retroverted gravid uterus,
  8. Rupture of an endometriotic cyst,
  9. Dysmenorrhea,
  10. A reaction of an intra-uterine contractive device,
  11. Intraperitoneal hemorrhage.
More questions related to this article:
  1. What is an ectopic pregnancy?
  2. What is tubal pregnancy?
  3. What are the treatment options for ectopic pregnancies?
  4. How do they remove an ectopic pregnancy?
  5. Can ectopic pregnancy resolve on its own?
  6. Mention the management process of ectopic pregnancy.
  7. What are the major complications of ectopic pregnancy?
  8. How will you manage a case of ectopic pregnancy?
  9. Describe the management of acute rupture ectopic pregnancy.
  10. How will you prepare a case of ruptured ectopic pregnancy for laparotomy?
  11. How will you treat a case of unruptured ectopic pregnancy?
  12. How to prevent ectopic pregnancy?
  13. What is the differential diagnosis of ectopic pregnancy?