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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 SonTubal 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
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"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 markedLABORATORY 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
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