Your SlideShare is downloading. ×
Ectopic Pregnancy Lecture at 1nurses.Com
Upcoming SlideShare
Loading in...5

Thanks for flagging this SlideShare!

Oops! An error has occurred.

Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Ectopic Pregnancy Lecture at 1nurses.Com


Published on Here's an ectopic pregnancy lecture at Grab more free nursing resource materials. Here's an ectopic pregnancy lecture at Grab more free nursing resource materials.

Published in: Education, Health & Medicine

1 Comment
  • how can i downloD THIS ONE ?
    Are you sure you want to  Yes  No
    Your message goes here
No Downloads
Total Views
On Slideshare
From Embeds
Number of Embeds
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

No notes for slide


  • 1. Nursing Lecture Brought to you by:
  • 2.
    • Occurs when the site of implantation is outside of the womb.
    • It can occur in several places
        • Ovary
        • Abdomen
        • Cornua
        • Cervix
        • Fimbria
        • Fallopian tube
    • Pregnancy can even occur in both the womb and the tube at the same time (heterotopic pregnancy), but this is rare (about 1/10,000 pregnancies).
  • 3.  
  • 4.
    • Any mechanism that interferes with the normal function of the fallopian tube during this process increases the risk of ectopic pregnancy.
    • The mechanism can be:
      • Anatomic – scarring that blocks transport of the egg
      • Functional – impaired tubal mobility
  • 5.
    • Pelvic Inflammatory Disease
      • the most common risk factor for ectopic pregnancy
      • 8x increased risk
      • infection causes scar tissue adhesions in the tube and may damage the cilia.
    • Previous ectopic pregnancy
      • the chances of another one in the same Fallopian tube and in the other tube are increased.
      • 5x increased risk
  • 6.
    • Tubal ligation in the past 2 years
    • Previous tubal surgery
    • Intrauterine device in place
    • Prolonged infertility
    • Diethystilbestrol (DES) exposure in utero
      • This is a drug that was once used during pregnancy
      • Female babies of women who used it were at risk of developmental abnormalities of the genital system.
      • Their tubes are more likely to be abnormal and predispose to ectopic pregnancy.
  • 7.
    • After the fertilization of the ovum, its transport to the uterine cavity is arrested.
    • The growing egg burrows through the tubal mucosa with subsequent implantation in the muscular layer.
    • Meantime, the proliferating trophoblast invade the muscularis and maternal blood vessels.
    • Blood accumulates into the spaces within the trophoblasts or between it.
  • 8.
    • The natural progression of tubal pregnancy is either of three ways:
      • Expulsion from the fimbriated ends (tubal abortion)
      • Involution of conceptus
      • Tubal rupture
  • 9.
    • Once an ectopic is diagnosed, there are several different treatments.
    • It is not possible to take the pregnancy from the tube and put it into the womb.
    • The options are as follows:
  • 10.
    • A proportion of all ectopics will not progress to tubal rupture, but will regress spontaneously and be slowly absorbed.
    • This may be appropriate if the level of hCG is falling and a woman is clinically well.
  • 11.
    • With a drug called methotrexate, which is given by injection.
    • This makes the ectopic pregnancy shrink away by stopping the cells dividing.
      • Methotrexate – a folic acid antagonist that is metabolized in the liver and excreted in the kidney
  • 12.
    • salpingiectomy
    • salpingotomy
    • salpingostomy
  • 13.
    • The most common symptoms and findings of ectopic pregnancy are:
      • an overdue period (suggesting pregnancy)
      • positive pregnancy test
      • lower abdominal pain
      • fainting
      • sharp pain in the abdomen or pelvis
      • signs of early pregnancy
      • vaginal bleeding
      • tender abdomen
      • dizziness or fainting and generally not feeling well
  • 14.
    • Any of the following additional symptoms can suggest an ectopic pregnancy:
      • vaginal spotting or bleeding
      • dizziness or fainting (caused by blood loss)
      • low blood pressure (caused by blood loss)
      • lower back pain
  • 15.
    • Amenorrhea
    • Abdominal pain
    • Abnormal vaginal bleeding
  • 16.
    • The diagnosis of an ectopic pregnancy can be difficult.
    • Your doctor may perform some tests to help confirm suspected ectopic pregnancy.
    • These tests include:
        • Pelvic exam
        • Blood tests
        • Ultrasound
  • 17.
      • Culdocentesis
          • determines if there is blood in the space behind the uterus
      • Laparoscopy
          • a telescope is inserted through a small incision in the woman’s abdomen
          • this allows the doctor to see the fallopian tubes and other organs
          • this takes place in an operating room with anesthesia
  • 18.
    • Failure to identify risk factors is cited as a common and significant reason for misdiagnosis
    • A proper history and physical examination remain the foundation for initiating an appropriate work-up that will result in the accurate and timely diagnosis of an ectopic pregnancy
    • Identification of risk factors can raise the index of suspicion and lend significance to otherwise minor physical findings
  • 19.
    • Monitor the mother’s vital signs, heart rate and rhythm, blood pressure, and effectiveness of breathing.
    • Monitor the fetal heart tones and assess fetal movement.
    • Monitor blood loss volume.
    • Monitor therapy closely for the patient’s therapeutic response
  • 20.
    • Monitor closely for the development of adverse reactions to therapy
    • Keep the patient, family, and caregivers well informed of the plan of care and the remaining time anticipated before disposition.
  • 21.
    • Monitor the patient’s laboratory and x-ray results and notify the physician of critical abnormalities.
    • Notify the physician when all diagnostic results are available for review.
    • Ask for establishment of a medical diagnosis and disposition.
  • 22. Thank You!
    • For More Nursing Resources go to
    • Nursing care plans
    • Nursing Continuing Education Units
    • Nursing news
    • Nursing Community