ectopic pregnancy in obstetric and gyanaecology

ectopic pregnanacy in obstetric and gynecology in pregnancy

1. Shri shankaracharya college of nursing Seminar on Subject : gyaneciology Topic: ectopic pregnancy Date: Guide, Madam Mrs. Elsy varhese Presenting by, Ms.Priti Masih

2. INTRODUCTION Ectopic pregnancy still contributes significantly to the cause of maternal mortality & morbidity. The incidence of ectopic pregnancy is an the rise .

3. definition An ectopic pregnancy is one in which fertilized ovum is implanted & develops outside the normal uterine cavity  D.C. DUTTA

4. SITES OF IMPLANTATION Implantation sites Extra uterine uterine Tubal ovarian abdominal Cervical Angular Cornual 1.Ampulla 2.Isthmus 3.Infundibulum 4.Interstial Primary Secondary Intraperitoneal Extraperitioneal

5. tubal pregnancy Frequency:- The incidence has increased because the prevalence of chronic pelvic inflammatory disease. ETIOLOGY:-  Factors preventing the migration of the fertilized ovum to the uterine cavity .  Factors facillitating of the fertilized ovum in the tubalmucosa

6. mode of termination TUBAL MOLE The encysted bld so collected in the pouch of douglas is called pelvic haematocele TUBAL ABORTION If implantation occurs in the ampulla / in fundibulum prior to abortion . The ovum may be converted into a mole/ a living ovum is aborted.The expulsion may be complete / in complete

7. Product of tubal pregnancy

8. cont…… TUBAL RUPTURE It may be, common in isthmic & interstital implantation .As the isthmic portion is narrow & the wall is less distensible TUBAL PERFORATION Secondary abdominal pregnancy Secondary broad ligament pregnancy CONTINUATION OF PREGNANCY RARE

9. CLINICAL FEATURES 3 TYPES Acute Un ruptured Chronic /Old

10. diagnosis

11. X-RAY OF ECTOPIAN PREGNANCY

12. USG

13. LAPROSCOPY

14. INTERSTIAL PREGNANCY It is associated with the massive intra peritoneal hemorrhage due to its combined vascularisation by the uterine & ovarian arteries.

15. management ACUTE:-  Anti shock treatment  Ringer solution  Blood transfusion  Laparatomy  Salphingectomy CHRONIC  Observation  Investigation  Laparatomy  Salphingectomy  S alphingestomy

16. SALPHINGECTOMY

17. unrupture tubal pregnancy Management Expectant Conservative Salphingectomy

18. abdominal pregnancy Primary :- Both the tubes & ovarian are normal without evidence of recent pregnancy secondary:- Abdominal pregnancy is always secondary SYMPTOMS Nausea vomitting constipation pain

19. ovarian pregnancy Tube on the affected side must be intact The gestation sac must be in the position of the ovaries salphingo-oophorectomy is done

20. cornual pregnancy pregnancy occuring in rudimentary horn of a vicornuate uterus is called cornual pregnancy

21. cervical pregnancy when the implantation occur in the cervical canal / below the internal os is called cervical pregnancy.

22. CONCLUSION

23. THANK YOU