ECTOPIC PREGNANCY

OBJECTIVES
At the end of this presentantion learners should be
able to;
 Define ectopic pregnancy
 Discuss the incidence and mechanism of ectopic
pregnancy
 Outline causes of ectopic pregnancy
 Identify signs and symptoms
 Discuss the management and care
 Identify complications of ectopic pregnancy
 DEFINITION
An ectopic pregnancy is a condition where the
fertilised ovum is embedded outside the uterus,
as it failed to reach the uterus before
implantation took place.
The pregnancy therefore develops in the
fallopian tube or extremely rare cases in the
abdomen(an extra uterine pregnancy or
abdominal pregnancy)
 INCIDENCE
The majority of cases are in the ampulla and
isthmus of the fallopian tube but unusual sites
of implantation include the fimbriated ends of
the fallopian tubes, the interstitial portion of the
fallopian tubes, the ovary and the abdominal
cavity.
 MECHANISM
The ovum only implants when the zona
pellucida (the membrane surrounding the
ovum)is completely or almost completely shed.

The implantation may occur at any point along

the tube.
 CAUSES
Congenitally narrowed fallopian tube
Pelvic inflammatory condition
Chronic salpingitis
Endometriosis
Tuberculosis
Tubal surgery
Intrauterine contraceptive device
 Signs and symptoms
 Amenorrhoea
 Lower abdominal pain (occasional sharp,stabbing
pain)
 Vaginal bleeding
 Nausea and vomiting
 Sudden ,excruciating abdominal pain
 Fainting
 Signs of shock which include pallor,cold, clammy
skin,tachycardia,and vomiting
 MANAGEMENT AND CARE
Immediate management
 Take blood for cross matching, start iv fluids
and arrange for immediate laparotomy
 Do not wait for blood before performing
surgery
 Auto transfusion may be considered if
significant haemorrhage occurs and the blood
is fresh and free from infection
 SUBSEQUENT MANAGEMENT
 Schedule follow up visit 4 weeks
 Anti-D administration where applicable
 Nutritional and dietary counseling
 Correct anemia with haematinics
 COMPLICATIONS

Haemorrhage ,shock
Anaemia
Pelvic adhesions ,chronic pelvic pain
Secondary infertility
Increased risk of repeat ectopic pregnancy