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Factors |
Tubal Pregnancy |
Clinical Features |
Diagnosis |
Management
Introduction
Ectopic pregnancy is one in which the fertilized ovum
(egg) is implanted and develops outside the uterus. The most common
site is tube. Normally fertilization occurs in the tube and the
fertilized ovum moves into the uterus. But in tubal pregnancy the
ovum remains in the tube.
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Factors
The factors causing this
are-
- Chronic inflammatory diseases of
the tube.
- Developmental defects of the tube.
- Distortion of the tube.
- Iatrogenic.
- Tubal spasm.
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Tubal Pregnancy :
The tubal pregnancy ends in following
way-
- Formation of some thing called a tubal
mole
- Tubal abortion through fimbrial end
(one end of the tube).
- Tubal rupture.
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Clinical Features :
- It could be acute (recent) or chronic
(old) acute is associated with tubal rupture or tubal abortion
causing severe bleeding inside the abdomen..
- The four important symptoms are-
- Ammenorrhoea (no periods) of short
duration.
- Severe abdominal pain.
- Vaginal bleeding.
- Nausea, vomiting and fainting
attacks.
- On examination
- Patient is extremely pale, features
of shock
are present. Abdomen is tense and painful to touch. Internal
examination is painful.
- Chronic or old ectopic-
- May be of slow onset. Symptoms of-
- Ammenorrhoea of short duration.
- Abdominal pain may have been an
severe initially, from which patient recovers and has dull
aching pain.
- Scanty bleeding from vagina.
- Other symptoms like frequency of
urine, fever etc.
- On examination patient looks sick,
varying degree of paleness is present, features of shock are not
there, rise of temperature, abdomen is painful to touch. On
internal examination a mass is felt.
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Diagnosis :
- Diagnosis is done by the above sign
& symptoms. Investigations done are-
- Sonography to confirm the diagnosis.
Others like blood examination, immunological
test for
pregnancy, Laproscopy.
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Management :
- The principle in the management of
acute ectopic is resuscitation and surgery done
at the same time. Blood transfusion is done if required. A quick
surgery stops the bleeding and improves the patients condition.
- In chronic ectopic also surgery is the
treatment. Laproscopic surgeries are done in urban
centres.
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