ECTOPIC PREGNANCY |
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DESCRIPTIONAn ectopic pregnancy is a pregnancy that develops outside the uterus. The most common site is in one of the narrow tubes (the Fallopian tubes) that connect the ovaries to the uterus. Other sites include the ovary itself or the area outside the reproductive organs in the abdominal cavity. The female reproductive system and abdominal cavity are involved. Ectopic pregnancies can affect women of childbearing age. Appropriate health care includes: physician's monitoring of general condition and medications; surgery (exploratory laparotomy) to remove the growing fertilized ovum and control internal bleeding; colposcopy; ultrasound examination; laparoscopy.
SIGNS & SYMPTOMS
Early stages:
Missed menstrual period or a heavy, painful period.
Unexplained vaginal spotting or bleeding.
Lower abdominal pain and cramps.
Pain in the shoulder.
Late stages:
Sudden, sharp, severe abdominal pain caused by the rupture of a Fallopian tube.
Dizziness, fainting, and shock (paleness, rapid heartbeat, drop in blood pressure, and cold sweats). These may precede or accompany pain (sometimes).
CAUSES
An egg from the ovary is fertilized and becomes implanted outside the uterus -- usually in the Fallopian tube. As the fertilized egg enlarges, the Fallopian tube stretches and ruptures, causing life-threatening internal bleeding.
RISK FACTORS
Use of an intrauterine device (IUD) for contraception.
Previous pelvic infections.
Adhesions (bands of scar tissue) from previous abdominal surgery.
PREVENTING COMPLICATIONS OR RECURRENCEInstructions for your sexually active daughter:
Use a contraceptive method other than an IUD.
Obtain prompt treatment for any pelvic infection.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory studies, such as a pregnancy test and blood count.
Surgical diagnostic procedures, such as laparoscopy and culdocentesis (See Glossary for both).
Ultrasound to outline the fetus (See Glossary).
POSSIBLE COMPLICATIONSShock and death from internal bleeding.
PROBABLE OUTCOME
An ectopic pregnancy cannot progress to full term or produce a viable fetus. Rupture of an ectopic pregnancy is an emergency requiring immediate hospitalization and surgery. Full recovery is likely with early diagnosis and surgery. Subsequent pregnancies are usually normal.
TREATMENT
HOME CAREInstructions for your daughter after surgery:
You may wash normally over the stitches in your incision.
Use heat to relieve pain. Apply a heating pad or hot-water bottle to your abdomen or back.
Hot baths also relieve discomfort and relax muscles. Sit in a tub of hot water (106F to 110F or 41.1C to 43.3C) for 10 to 15 minutes. Repeat as often as needed.
MEDICATION
Medicine usually is not necessary for this disorder.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
Your daughter can resume normal activities, including sexual relations, as soon as possible.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?After recovery from surgery.
CALL YOUR DOCTOR IF
Your daughter has symptoms of an ectopic pregnancy, especially a rupture. Call immediately. This is an emergency!
The following occurs after surgery:
-- Excessive vaginal bleeding (soaking a pad or tampon every hour).
-- Signs of infection, such as fever, chills, headache, dizziness, or muscle aches.
-- Increased urinary frequency that lasts longer than a month. This may be a sign of bladder irritation or infection resulting from the surgery.
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