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Factors | Tubal Pregnancy
| Clinical Features | Diagnosis
| Management
Introduction
Ectopic pregnancy is one in which the fertilized ovum (egg) is implanted
and develops outside the uterus. The most common site is tube. Normally
fertilization occurs in the tube and the fertilized ovum moves into
the uterus. But in tubal pregnancy the ovum remains in the tube.
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Factors
The factors causing this are-
- Chronic inflammatory diseases of the tube.
- Developmental defects of the tube.
- Distortion of the tube.
- Iatrogenic.
- Tubal spasm.
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Tubal Pregnancy :
The tubal pregnancy ends in following way-
- Formation of some thing called a tubal mole
- Tubal abortion through fimbrial end (one end of the tube).
- Tubal rupture.
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Clinical
Features :
- It could be acute (recent) or chronic (old) acute is associated
with tubal rupture or tubal abortion causing severe bleeding inside
the abdomen..
- The four important symptoms are-
- Ammenorrhoea (no periods) of short duration.
- Severe abdominal pain.
- Vaginal bleeding.
- Nausea, vomiting and fainting attacks.
- On examination
- Patient is extremely pale, features of shock are
present. Abdomen is tense and painful to touch. Internal examination
is painful.
- Chronic or old ectopic-
- May be of slow onset. Symptoms of-
- Ammenorrhoea of short duration.
- Abdominal pain may have been an severe initially, from which
patient recovers and has dull aching pain.
- Scanty bleeding from vagina.
- Other symptoms like frequency of urine, fever etc.
- On examination patient looks sick, varying degree of paleness
is present, features of shock are not there, rise of temperature,
abdomen is painful to touch. On internal examination a mass is
felt.
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Diagnosis
:
- Diagnosis is done by the above sign & symptoms. Investigations
done are-
- Sonography to confirm the diagnosis. Others like blood examination,
immunological
test for pregnancy, Laproscopy.
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Management
:
- The principle in the management of acute ectopic is resuscitation
and surgery done at the same time. Blood transfusion is done if
required. A quick surgery stops the bleeding and improves the
patients condition.
- In chronic ectopic also surgery is the treatment. Laproscopic
surgeries are done in urban centres.
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