An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, usually in a fallopian tube. Common symptoms include missed period, abdominal pain, vaginal bleeding, nausea and fainting. Diagnosis involves blood tests, ultrasound and laparoscopy. Treatment depends on factors like size and location of ectopic pregnancy, and may involve surgery like salpingostomy or salpingectomy, or medication like methotrexate. Risk factors include prior pelvic infections, IUD use, tubal surgery or damage from endometriosis. Managing ectopic pregnancies helps preserve fertility whenever possible.

2. Definition
Implantation sites
Clinical Features
Diagnosis
Different types
And its
Management

4. “An ectopic pregnancy is the one in which
the fertilized ovum is implanted and
develops outside the normal uterine cavity”

9. Amenorrhea
Abdominal pain
Vaginal bleeding
Feeling of nausea
Vomiting
Fainting attacks

10. Delayed periods
Spotting
Uneasiness with colicky pain in one side
Amenorrhea

11. Amenorrhea
Lower abdominal pain
Vaginal bleeding
Dysuria
Frequency of micturition
Rise in body temperature

12. 1. Blood examination:
routine hemoglobin, ABO and RH grouting and
total white cell count.
2.Sonography:
3.Laproscopy:
4.Laprotomy:

17. 1. Factors preventing or delaying migration
Pelvic inflammatory disease (PID)
increases the risk of ectopic pregnancy.
Selected contraception failure.
Use of intrauterine device.
Tubal surgery increase the risk of tubal
pregnancy.
Intrapelvic adhesion following pelvic
surgery.
Prior induced abortion significantly
increases the risk.

18. Conti….
2. Factors facilitating nidation in the
tube –
Early resumption of the
trophoblastic activity is probably
due to premature degeneration of
the zona pellucida.
Increased decidual reaction.
Tubal endometriosis.

19. Affected side of the
tube is intact
The gestation sac
connected with the ovary
Salpingo-oophorectomy
is the better option as
treatment surgery

20. Implantation of the fertilized ovum in
the
Peritoneum
Both tubes and ovary are normal
Primary abdominal pregnancy
Primary site may be tubes, ovary or
uterus
and then gets implanted in the abdomen
Secondary abdominal pregnancy

21. Pregnancy occuring in the horn of the bicornuate
Uterus is called the cornual pregnancy.

23. MANAGEMENT

25. •Salpingostomy
–Used to remove a small pregnancy
usually <2 cm in length and located in
the distal third of the fallopian tube
–A 10-15 mm linear incision is made
immediately over the ectopic pregnancy,
and is left unsutured to heal by
secondary intention
–Readily performed through a laparoscope
–Gold standard surgical method used for
unruptured ectopic pregnancy

26. Salpingotomy
Procedure is the same as salpingostomy
except that the incision is closed with a
suture
Surgical Resection & Anastomosis
Sometimes used for an unruptured
isthmic pregnancy

27. Medical Management:
METHOTREXATE
An anti-neoplastic drug that acts as a folic
acid antagonist, and is highly effective
against rapidly proliferating trophoblasts
Success is greatest if
The gestation is <6 weeks
The tubal mass should be <3.5 cm in
diameter
The fetus is dead

28. •Contraindications
for methotrexate
Intra-abdominal hemorrhage
–Breast feeding
–Immunodeficiency
–Alcoholism
–Liver or renal disease
–Blood dyscrasias
–Active pulmonary disease
–Peptic ulcer

29. Risk factors:
IUD
PID
previous ectopic pregnancy
endometriosis
tubal ligation
tubal surgery
smoking
…