Embarazo

Ectópico
Breakthrough
R1 MC Xaviera Arreguín García
Revisó: Dr. Juan Pedro Chávez

Illustration by Smart-Servier Medical Art

 Objetivos

Definición Definir el embarazo ectópico

Epidemiología Incidencia , prevalencia y sitios de implantación

Factores de riesgo Factores de riesgo asociados a embarazo ectópico tubarico

Fisiopatología Fisiopatología de la implantación extrauterina

Diagnóstico Algoritmo diagnóstico del embarazo ectópico tubarico

Tratamiento Manejo del embarazo ectópico en UCI

 Contenido

01 02 03
Introducción Fisiopatología Abordaje
diagnóstico

04 05 06
Results Discussion Conclusion
 01
Introducción
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 Definición

Implantación del
blastocisto fuera de
la cavidad
endometrial.

Mann L. Kreiser, Trends in ectópico pregnancy diagnosis. Maternal and child journals, 2020/213-221.
 Epidemiología
9-14%
1-2 %
5-10%
De todos los embarazos, son ectópicos Todas las muertes relacionadas con el
embarazo

75% 3.8
Muertes maternas en el primer trimestre Muertes por cada 10,000 casos

18%
Urgencias

Overview of ectópico pregnancy diagnosis management and innovation, Women s Health 19:1-13;2023
 Epidemiología

20-24

3.5
4.4

15-19
2.8 35-39
9.9 Más en > 35 años

40-44
75%25-29
7.4
9.8

Po L. Management of pregnancy of unknown location and tubal and non tu al ectópic, Journal of obstetrics and ginecological 2021 43-54.
 Epidemiología

TRA
1/100 FIV , 2.1-8.6%

1/7000 IDO

Overview of ectópico pregnancy diagnosis management and innovation, Women s Health 19:1-13;2023
 Localización

Po L. Management of pregnancy of unknown location and tubal and non tu al ectópic, Journal of obstetrics and ginecological 2021 43-54.
 02
Fisiopatología
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 Histopatología

Problem statement
Ausencia de la capa submucosa facilita
el acceso del óvulo fertilizado al epitelio
y facilita la implantación dentro de la
pared muscular.
 Inflamación
Alteración del movimiento ciliar, se genera señal favorecedora de implantación.

Infecciones recurrentes, Chlamidya Trachomatis:

Inflamación intraluminal
Depósitos de fibrina con cicatrización tubarica
Aumento de interleucina 1
 Tabaco

Problem statement
El receptor canabinoide (CB1) cuya
acción está mediada por las señales
endocanabinoides altera el movimiento
ciliar.

Exposición crónica a la nicotina

modifica las concentraciones de
endocanbinoides y causa disfunción
ciliar de las trompas de falopio.
 Cirugías previas

Problem statement
Se produce una regulación positiva de
citocinas proinflamatorias secundarias al
daño y cicatrización de la trompa.

Alteración en movilidad
Implantación
Invasión
Angiogénesis
 Factores de riesgo

Po L. Management of pregnancy of unknown location and tubal and non tu al ectópic, Journal of obstetrics and ginecological 2021 43-54.
 Abordaje diagnóstico

25% presenta sangrado y dolor

en el primer trimestre

Mujer en edad fértil

Amenorrea
Dolor pélvico
Sangrado transvaginal
+/- síntomas de embarazo
Historia clínica e interrogatorio

Interrogatorio dirigido
Factores de riesgo
FUM
Antecedente de embarazo ectópico previo
Embarazos previos
Cirugías o procedimientos tubaricos
Sangrado uterino anormal
Enfermedad pélvica inflamatoria
Semiología del dolor
Infecciones recurrentes
Uso de técnicas de reproducción asistida
Tabaquismo activo
 Signos y síntomas

Síntomas Signos
AMENORREA 95.8% SENSIBILIDAD ABDOMINAL 68.1%

DOLOR ABDOMINAL 62.2% SENSIBILIDAD PÉLVICA 44.5%

SANGRADO TRANSVAGINAL INESTABILIDAD HEMODINÁMICA

41.2% 11.8%

MAREOS Y LIPOTIMIAS 11.8% TUMOR ANEXIAL 5%

45%
 Exploración física
SV.
Datos de abdomen agudo y sangrado
activo

Estabilidad Inestabilidad
hemodinámica hemodinámica
Continuar con abordaje, ABCDE, gasometria, Bh,
interrogatorio, exploración tiempos, Eco FAST, abordaje
física , USG, laboratorios quirúrgico.
Exploración física dirigida
 Pruebas de laboratorio

B-HGC

BH
EGO
GASOMETRIA
PFH
TIEMPOS
TELE DE TORÁX
 Pruebas de laboratorio
Current
landscape
Highlight the current challenges
and limitations in the medical
field that require a
breakthrough. Describe the
healthcare problems, diseases or
conditions that need innovative
solutions
Emerging
trends
Focus on emerging medical
trends, technologies, or
scientific discoveries that
present an opportunity for a
breakthrough. Discuss the
potential benefits, such as more
accurate diagnostics or
preventive measures
Breakthrough
vision
Outline a visionary goal for the
breakthrough, such as curing a
disease or revolutionizing
procedures. Highlight the
broader impact on healthcare
and global quality of life
Definición

Implantación del blastocisto fuera de la cavidad endometrial

● Represents a significant advancement in the field of
medicine
● Challenges conventional medical practices
and beliefs
● Holds the potential to revolutionize treatments,
improve patient outcomes and save lives

In summary, a medical breakthrough can revolutionize

medical care and improve patient lives

Current
landscape
Highlight the current challenges
and limitations in the medical
field that require a
breakthrough. Describe the
healthcare problems, diseases or
conditions that need innovative
solutions
Background
Emerging
trends
Focus on emerging medical
trends, technologies, or
scientific discoveries that
present an opportunity for a
breakthrough. Discuss the
potential benefits, such as more
accurate diagnostics or
preventive measures
Breakthrough
vision
Outline a visionary goal for the
breakthrough, such as curing a
disease or revolutionizing
procedures. Highlight the
broader impact on healthcare
and global quality of life
 Methodology

Study design Data collection

Outline the research design for the medical Explain the methods and tools used for data
breakthrough. Describe the type of study, collection, including patient records or
sample size, inclusion criteria and ethical examinations. Emphasize data accuracy and
considerations patient privacy

Data analysis Results validation

Describe the approach for analyzing the Discuss the steps taken to validate the results.
collected data. Explain the statistical methods Explain how the findings will be reviewed,
or qualitative analysis techniques used to confirmed or peer-reviewed for scientific rigor
derive meaningful insights

Data analysis
Present the analyzed data from
the study. Describe the
methods used for analysis and
highlight key findings and
trends
Comparison
Compare results with existing
literature or previous studies.
Highlight similarities,
differences, and novel insights
for knowledge
Results
Quant. results
Focus on numerical results
derived from the analysis.
Present percentages, means or
correlations and use visual aids
Limitations
Acknowledge study
limitations. Discuss challenges
faced during data collection,
analysis and interpretation
Qual. results
Discuss qualitative findings
from interviews or surveys.
Present themes, patterns and
include examples
Conclusions
Summarize the findings and
their implications. Discuss the
impact on medical practice,
patient care or future research
 10x faster
It’s a treatment 10 times faster than
previous treatments

50% 85%
Reduction in complications Success rate for the breakthrough
 95%
Use percentages in your breakthrough presentation to
quantify and communicate the frequency or
proportion of an important finding

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 Column chart

Understanding
the numbers
Use this slide to present data on the
outcomes of patients who have
received treatment for a particular
condition or disease. A column chart
can be an effective way to illustrate
changes in patient outcomes over time.
Consider including data from clinical
trials or real-world patient populations
to showcase the impact

Follow the link in the graph to modify its data and then paste the new one here.
For more info, click here
 Milestones

Discovery Preclinical research Early phase Phase I clinical trial

clinical trial

Phase II clinical trial Phase III clinical trial FDA review Post-market monitoring
 Treatment options
Treatment option Efficacy rate Side effects Cost Availability

Medication A 80% Mild $$ Widely available

Medication B 70% Moderate $$$ Available only with prescription

Surgery 90% High $$$$ Requires specialized facilities

Radiation therapy 75% Moderate $$ Available in most hospitals

Immunotherapy 65% Moderate $$$$ Available only in select medical centers

Physical therapy 60% Mild $$ Widely available

 Clinical trial phases
Phase 1: safety and dosage
● Participants: 20-100 healthy volunteers
● Objective: determine safe dosage, identify side effects
● Duration: 6 months
● Success rate: 80% of participants completed the trial without
experiencing significant side effects
Phase 2: side effects
● Participants: up to hundreds of people with the condition
● Objective: determine effectiveness, evaluate safety
● Duration: 12 months
● Success rate: 65% of participants experienced a significant
improvement in symptoms

Phase 3: large-scale testing Phase 4: post-market monitoring

● Participants: from several hundred to thousands of people ● Participants: thousands of people with the condition who are
with the condition taking the drug
● Objective: to confirm effectiveness, monitor side effects, and ● Objective: to monitor long-term safety and effectiveness and
compare to standard treatments detect rare side effects
● Duration: 24 months ● Duration: ongoing
● Success rate: new treatment was better in 75% cases ● Success rate: no safety concerns identified in the two years
since the approval for market use
 Data and statics
Key performance indicator
Patients treated
Success rate
Average recovery time
Number Trend in patient outcomes
● Illustrate the trend in patient outcomes over time
2,500
● Highlight the impact of the medical breakthrough on
patient outcomes
95%
● Describe any significant changes or improvements
observed in the graph
3 days

● List the key performance indicators (KPIs) relevant to

the medical breakthrough
● Enter the values or metrics for each KPI in the table
● Discuss the significance of each KPI and its relation to
the breakthrough
● Highlight any notable achievements or milestones
reflected in the table
Follow the link in the graph to modify its data and then paste the new
one here. For more info, click here
 Implications
“It's been a true lifesaver for me. I can enjoy life again without any discomfort”

—Jane Smith, patient

“I've seen a significant improvement in patient outcomes. This breakthrough makes treatment
more efficient and personalized”

—Dr. John Doe, medical professional

“We are impressed with the safety and effectiveness of this breakthrough. It will greatly benefit
patients and healthcare systems”

—Susan Patel, regulatory body representative

 Key members
Mark Jones Sarah James
Use a sentence that describe their Use a sentence that describe their
job job

Role: Lead researcher Role: Clinical trial manager

Contributions: Contributions:
● You can enter a description of the contributions ● You can enter a description of the contributions
here here
● You can enter a description of the contributions ● You can enter a description of the contributions
here here
● You can enter a description of the contributions ● You can enter a description of the contributions
here here
 Results and conclusions
Background Conclusions
Briefly introduce the context of the investigation, such as the medical condition
or problem being addressed and the goals Briefly summarize the main findings of the
1 study or analysis
Study design
Discuss the implications of the findings and
Describe the design of the study, such as whether it was a randomized
controlled trial or observational study, the sample size and the inclusion and 2 how they relate to the original research
exclusion criteria
question

Findings
Summarize the main findings of the investigation, including statistical results
and any important trends or patterns observed
Impact
Discuss the implications of the findings for patients, healthcare providers and
other stakeholders. You could also mention any potential limitations of the
study or areas for future research
References
Include a reference page with the sources used in
your presentation. List the sources in alphabetical
order and include the author's name, the title of the
source, the publication date and the publisher or
URL
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