WELCOME TO RNTU

INSTITUTE OF
NURSING
SUBJECT -: MIDWIFERY AND GYNAECOLOGY
NURSING
TOPIC -: ECTOPIC PREGNANCY
SUBMITTED TO-: SUBMITTED BY -:
MISS MAMTA AMARGHADE MISS UPASNA SINHA
NURSING TUTOR R.N.T.U BSC NSG 4TH YEAR
ANATOMY AND PHYSIOLOGY
 The fallopian tubes are muscular tubes that
sit in the lower abdomen/ pelvis alongside the other
reproductive organs.
There are two tubes one on each side that extend from
near the top of the uterus run laterally and then curve
and over and around the ovaries
The open ends of the fallopian tube lie very near the
ovaries but they are not directly attached. Instead the
fimbrie of the fallopian tubes sweep ovulated eggs into
the tubes and towards the uterus
CONT….
In an adult the fallopian tubes are around 10 to 12 cm
long although this can very substantially from person
to person
They are generally considered to consist of four
sections
Interstitial section
Isthmus
Ampulla
Infundibulum
FUNCTION..
The primary function of the fallopian tubes is to
transport eggs from the ovary to the uterus .the eggs are
picked up by the fimbriae and then swept towards the
uterus.
This movement is directed both by the beating of the
cilia and by peristalsis which is rhythmic condition of
the muscles of the tubes .
When fertilization occurs it is generally in the fallopian
tubes. The sperm travel from the uterus into the tubes
where they may encounter and fertilize an egg
CONT…..
The fertilized egg then continues pts movement
towards the uterus if a fertilized egg implants in the
uterus. And continues to develop it becomes a uterine
pregancy
INTRODUCTION .
The term comes from the greek “ektopic’ meaning
displacements .
Ek- out +topos = place = out of place
Any pregnancy where the fertilized ovum gets
implanted and develops in a site other than normal
uterine cavity
DEFINITION
Development of product of conception outside uterine
cavity body of uterus is know as ectopic pregnancy
Pregnancy grow outside uterine cavity ectopic
pregnancy
NORMAL CONDITION -: inside uterine cavity is
also know as endopic pregnancy
CONT….
INCIDENCE -: 1 IN 200 pregancy
TYPES OF ECTOPIC PREGNANCY
There are seven types of ectopic pregnancy
(1) interstitial pregnancy
(2) isthmic pregnancy
(3) Ampullary pregnancy
(4) Abdominal pregnancy
(5) Cervical pregnancy
(6) ovarian pregnancy
(7) Fimbrial pregnancy
CAUSES AND RISK FACTOR
Pelvic inflammatory diseaes most common cause
Previous ectopic pregnancy
Chalmyidial infection
Nesisseria gonorrhea
Previous uterine scar
Grand muitigravida
Old gravida (>40 year)
Endometeriosis
Intra uterine device
CONT….
Infertility
Smoking
Congenitial anomolies
Multiple sexual partners
SIGN AND SYMPTOMS
Abdominal pain
Lower abdomen pain
Radiatie thigh back and left shulder
Severe knife like pain
Vaginal bleeding
Amenorrhea
Hypovolemia
Tachycardia
Nausea and vomiting
CONT..
Cullen sign – ( bluish discolration around umblicus )
Turner sign ( Bluish discolration in flank region )
DIAGNOSTIC EVALUATION
History collection
Physical examination
USG
Trans vaginal sonography
Trans Abdominal sonography
B-HCG (lower than P.O.G)
Progestrone decereasa
Laproscopy
MANGEMENT
Pantop. 40 mg
Inj. Metrogyl 500 mg
Inj. Voveron 75 mg
Inj. methotraxate
SURGICAL MANAGEMENT
CONSERVATIVE MANAGEMENT –
 Linear salphingostomy -: crete surgical opening
in fallopian tube remove ectopic product of
concepation
NON CONSERAVATIVE MANAGEMENENT -:
 Salpingectomy -: removal of fallopian tube
NURSING MANAGEMENT
Provide comfortable position to mother
Provide psychological support to mother
Check vital signs
Check fetal heart rate
Proper bed rest
Administer medication on time
Provide healthy diet of mother
COMPLICATION
Hemorrhage and Hypovolemic shock
Infertility
Rupture of membrane internal bleeding
Unusual bleeding
Abdominal discomfort pain
Bowel bladder problems
Missed late period


HEALTH EDUCATION
Advices mother to take medicine on time
Advices mother to take healthy diet
Advices mother to maintain personal hygine
Advices mother to avoid sexual inter course
Advice mother to take proper rest
Advice mother for regular checkup and follow up care