INTRODICATION

Mechanism of pregnancy involves a

pair of healthy female and male who
have normal reproductive systems.
For pregnancy during a sexual
INTRODICATION

intercourse male provides a sperm

to females awaiting egg(ovum)
and if the sperm fertilizes the
ovum the result is pregnancy. It
.happens like this
INTRODICATION

Ovulation is a process when one or more eggs

are released from one of females ovaries. This
is the most fertile time of her menstrual cycle,
Eggs mature inside the ovaries. The ripest egg
is released into the pelvic cavity and swept into
the fallopian tube. To become pregnant
,naturally
:ECTOPICPREGNANCY

is when a fertilized egg implants

itself outside of the uterus,
usually in one of the fallopian
tubes
:ECTOPICPREGNANCY

Ectopic means "out of place." In a normal

pregnancy, the fertilized egg implants and
develops in the uterus. In most ectopic
pregnancies, the egg settles in the fallopian tubes.
This is why ectopic pregnancies are commonly
".called "tubal pregnancies
:ECTOPICPREGNANCY

The egg can also implant in the ovary,

abdomen, or the cervix, so it also might see
these referred to as This means the egg will
not develop into a baby, which can be
.devastating to the pregnant woman
.cervical or abdominal pregnancies
:ECTOPICPREGNANCY

Ectopic pregnancies affect 2% of all pregnancies, -

and approximately 10% of individuals with first
trimester bleeding
Ectopic pregnancy is the leading cause of first -
.trimester mortality
RISK FACTORS

A major risk factor for ectopic pregnancy is .1

previous incidence of pelvic inflammatory
disease
Current use of an intrauterine device (IUD), a .2
form of birth control
Sexually-transmitted diseases such as chlamydia .3
and gonorrhea
RISK FACTORS

4. Congenital abnormality (problem present at

birth) of the fallopian tube
A previous history of ectopic pregnancy .5
Surgery on fallopian tube .6
Infertility problems or medication to stimulate .7
ovulation
.Woman who are over (35years old) .8
CAUSES

One cause of an ectopic pregnancy is a

damaged fallopian tube that doesn't let a
fertilized egg into the uterus, so it implants
.in the fallopian tube or somewhere else
SYMPTOMS

 1. Light vaginal bleeding

 2. Nausea and vomiting with pain
 3. Lower abdominal pain
 4. Sharp abdominal cramps
 5. Pain on one side of your body
SYMPTOMS

 6. Dizziness or weakness
 7. Pain in your shoulder, neck, or rectum
 8. If the fallopian tube ruptures, the pain and
bleeding could be severe enough to cause
fainting.
DIAGNOSING

1. Finding of physical examination

2. Blood test
Ultra sounds .3
TREATMENT

If an ectopic pregnancy is detected at an early -

stage, a medication called methotrexate is
sometimes needed to stop the egg developing.
The pregnancy tissue is then absorbed into the
.woman’s body
TREATMENT

However, methotrexate is not always needed – in

around half of cases, the egg dies before it can
.grow
Ectopic pregnancies detected at a more advanced -
.stage will require surgery to remove the egg
TREATMENT

**If an ectopic pregnancy is left to develop,

there is a risk that the fertilized egg could
continue to grow and cause the fallopian
tube to split open (rupture), which can cause
life-threatening internal bleeding.
:SIGNS OF A RUPTURED FALLOPIAN TUBE

 sudden, severe, sharp pain

 feeling faint and dizzy
 feeling or being sick
 diarrhea
 shoulder tip pain
:NURSING INTERVENTION

Monitor maternal vital signs .1

Monitor for presence and amount of vaginal .2
bleedin
Monitor for increase and pain and abdominal .3
distention and rigidity which is may indicates
rupture and possible intra abdominal hemorrhage
:NURSING INTERVENTION

Monitor complete blood count (CBC) to .4

.determine the amount of blood loss
Provide comfort measure like backe rubs, deep .5
breathing Instruct in relaxation or visualization
. exercises
Give analgesia as prescribed to decrease pain .6
HYDATIDIFORM MOLE

Hydatidiform mole (H.mole) or molar

:pregnancy

is a rare mass or growth that forms inside the

.uterus at the beginning of a pregnancy
PATHOPHYSIOLOGY

A hydatidiform mole results from over-

production of the tissue that is
supposed to develop into the placenta.
The placenta normally nourishes a fetus
during pregnancy
PATHOPHYSIOLOGY

Instead, these tissues develop into a

mass. The mass is usually made up of
placental material that grows
uncontrolled. Often, there is no fetus at
.all
PATHOPHYSIOLOGY

About 80% of hydatidiform moles are not

cancerous and disappear spontaneously.
About 15 to 20% invade the surrounding
.tissue and tend to persist
PATHOPHYSIOLOGY

Of these invasive moles, 2 to 3% become cancerous

and spread throughout the body; they are then
called choriocarcinomas. Choriocarcinomas can
spread quickly through the lymphatic vessels or
.bloodstream
: TYPES

There are two types:

 Partial molar pregnancy: There is an

abnormal placenta and some fetal

development.
 Complete molar pregnancy: There is an

abnormal placenta but no fetus.

RISK FACTORS:

1.Maternal age. A molar pregnancy is more likely

for a woman older than age 35 or younger than
age 20
2.Previous molar pregnancy
3. Some ethnic groups. Women of Southeast Asian
descent appear to have a higher risk of molar
pregnancy
CAUSES
The cause is not completely understood.
: Potential causes may include
,defects in the egg
abnormalities within the uterus, or
nutritional deficiencies
SYMPTOMS

 Abnormal growth of the womb (uterus)

 Excessive growth in about half of cases
 Smaller-than-expected growth in about a third of
cases
 Nausea and vomiting that may be severe enough
to require a hospital stay
 Vaginal bleeding in pregnancy during the first 3
months of pregnancy
SYMPTOMS

Symptoms of hyperthyroidism
Heat intolerance
Loose stools
Rapid heart rate
Restlessness, nervousness
Skin warmer and more moist than usual
Trembling hands
Unexplained weight loss
SYMPTOMS

Symptoms similar to preeclampsia that occur in the

1st trimester or early 2nd trimester -- this is
almost always a sign of a hydatidiform mole,
because preeclampsia is extremely rare this early
in a normal pregnancy
High blood pressure
Swelling in feet, ankles, legs
DIAGNOSTIC TEST:

A pelvic examination may show signs similar to a .1

normal pregnancy, but the size of the womb may
be abnormal and the baby's heart sounds are
absent. There may be some vaginal bleeding
Ultrasound: A pregnancy ultrasound will show an .2
abnormal placenta with or without some
development of a baby
DIAGNOSTIC TEST:

:Another tests may include .3

 HCG blood test

 Chest x-ray
 CT or MRI of the abdomen

 Complete blood count

 Blood clotting tests
 Kidney and liver function tests
TREATMENT:

If your doctor suspects a molar pregnancy, .1

a suction curettage (D and C) may be
performed
TREATMENT:

A hysterectomy may be an option for .2

older women who do not wish to
.become pregnant in the future
TREATMENT:

After treatment, serum HCG level will .3

be followed. It is important to avoid
pregnancy and to use a reliable
contraceptive for 6 - 12 months after
.treatment for a molar pregnancy
TREATMENT:

This allows for accurate testing to be sure that

the abnormal tissue does not grow back.
Women who get pregnant too soon after a
molar pregnancy have a high risk of having
.another molar pregnancy
POSSIBLE COMPLICATION:

Lung problems may occur after a D and-

C if the mother's uterus is larger than 16
.weeks gestational size
POSSIBLE COMPLICATION:

Complications of molar pregnancy include:

 Preeclampsia
 Thyroid problems
 Molar pregnancy that continues or comes back
POSSIBLE COMPLICATION:

Complications related to the surgery to remove a

molar pregnancy include:

 Excessive bleeding
 Side effects of anesthesia
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