Adult Medical-Surgical Nursing

1
Adult Medical-Surgical Nursing

• Reproductive Health Module Ectopic Pregnancy

2
Ectopic Pregnancy Description

• Occurs in 1 of pregnancies
• Implantation of the embryo outside the uterus
• Mostly occurs in a fallopian tube
• May occur in the abdominal cavity, ovary or
  cervix

3
Ectopic Pregnancy Aetiology

• Longer than normal fallopian tubes
• Adhesions narrowing fallopian tube associated
  with
• Pelvic inflammatory disease
• Endometriosis (post laser or diathermy)

4
Ectopic Pregnancy Clinical Manifestations

• Amenorrhoea and positive pregnancy test
• Spotting per vagina
• Discomfort on the affected side
• If undetected the fallopian tube will rupture
  (around 8 weeks gestation) into the abdominal
  cavity ?
• Peritonitis
• Shock

5
Ectopic Pregnancy Diagnosis

• Patient history and clinical picture
• Positive pregnancy test
• Abdominal and pelvic ultrasound

6
Ectopic Pregnancy Management

• Surgery usually salpingectomy (removal of the
  fallopian tube including terminating the
  pregnancy)
• If undetected and ruptures
• Emergency resuscitation followed by surgery once
  stable
• IV antibiotic cover drain in situ initially
• NPO ? gradual resumption of fluids/ nutrition
  (await bowel sounds/ peristalsis)

7
Ectopic Pregnancy Nursing Considerations

• Early detection by midwife
• Emotional/ psychological support to patient and
  partner (pregnancy is not viable)
• Care in ICU if ruptured (shock)
• Monitoring of vital signs, fluid balance
• Aseptic technique observe wound and drainage
• Assess resumption of peristalsis