2/21/2011 DEFINITION Ectopic pregnancy :- Ectopic: this term's derived from Greek ‘word ‘ektopor” which means pregnancy out of place, in ather words, a pregnancy in which th ‘embryo is implanted and develops outside the| endometrial lining of the uterus w= PATHOPHYSIOLOGY « Ina normal preanancy, the fetid ess enters the uterus and setts ft the uterine ing whe tehas plenty of room tadide and gro ‘Theol any mechanical or functional facto thot prevent or taterfere with the pasoge of tho fertiized ovum to the Uterine eaiy mey be aetiological factors of eetepte presnancy CLASSIFICATION he 9 carte apn ues ol a tmpamavon ate vara i, hy ont pt ‘ite mse peroneal ng ‘ese pty seins SonTubal pregnai ‘in ectopic pregnancies in recent yers. isk ofan ctopie pregancies increases about 7-fal Sitter woman slr acute peli infection. Infection may lead to 4 -Bestruction ofthe tubal epithelium with eduction or ls of etary current 2-tntretubal adhesions resulting in partial tubal (struction 5 -eritubal adhesons resulting io restricted tubal Nosy ‘rall these situation, scting alone orn Combination, can sow the passage ofthe ea lich eves time to implant ist nthe tube 2/21/2011 "Incidence of tubal pregnancy by location HIGH-RISK FACTORS. ‘Prior itor of PID .g.chlamydia or sonorthea anencas RISK FACTORS tory of cD.RISK FACTORS ‘8 Congenital abnormalities of the fallopian tubes or the uterus, HOW IS AN ECTOPIC PREGNANCY DIAGNOSED? The diagnosis of ectope pregnancy ts made by: 2-Physical examination Laboratory tess, and ultrasound CLINICAL PRESENTATION * Aatat258 tub part eer 1 sete abdomen 2 cariovascilr elapse opi pulse ypsterin stating attache al 2: Tp eer to soe 8 ‘Abd. Pain| ae ita fossa) delayed menstruation, Bepizader of vaginal bleeding, Peritoneal tation sigs les markedLABORATORY TESTS AND ULTRASOUND me * SSfnueaenns pesca brane pater Oe Tow eget een, ch abet ran saparoteopy> the gold standard to Dx ectopic s208C> sbeance of chorion vi «Culdocentest: not useful n detecting early ‘ectopic pregnancy Laparoscopy should be considered in women ‘ath nee above the dzerminatery lovel & fbsence of intrauterine G3 on ule MANAGEMENT 3 pS AA FO TTT =TORTE ‘emery tht ppenrsrauray mang {Sete 5 Rogan mona ed v2 (eet i fine MANAGEMENT SELES RS EY ae DIFFERENTIAL DIAGNOSIS ‘Aborton (complet incomplete, neviabe, missed) «Threatened appendiiss Acute dyemonorea Tacenta previa {Shock (hemorhagi hypovolemic) ‘Ruptureseorpustuteumeyst {Adnexaltorion {Comuaimyomacr abscess SOvarantumor ‘sCorvealeancor 2/21/2011