What is ectopic pregnancy?
Ectopic pregnancy is the development of fetus anywhere other than the uterine cavity. This occurs 1 in every 100 pregnancies.
What are the symptoms of ectopic pregnancy?
• Nausea, vomiting
• Excruciating abdominal pain
What causes ectopic pregnancy?
The causes are multifactorial Use of intra uterine devices History of pelvic inflammatory diseases History of previous tubal surgeries,Hormone intake.
If you had a history of ectopic pregnancy, you have higher chances of having an ectopic pregnancy again. Serial ultrasound monitoring is essential to ensure the gestation is within the uterine cavity.
How to diagnose ectopic pregnancy?
A urine pregnancy test should be first done to confirm pregnancy. An ultrasound can help differentiate a ruptured tube (an emergency) from an unruptured tube. This will help in further management.
How to treat ectopic pregnancy?
An ectopic pregnancy that is present towards the fimbrialend (the end closer to the ovary) and lesser than 3 mm in size (without cardiac activity), medical management can be tried. This involves alternating does of methotrexate and folic acid and monitoring progress for the next few weeks. Many times this results in a tubal abortion.
In cases of a ruptured tube or if the size of the ectopic mass is more than 3 mm then a laparoscopic management is needed.
How is laparoscopic ectopic excision performed?
Depending on the location of the ectopic mass, the surgical procedure may differ.
If the ectopic mass is present close to the fallopian tube, then efforts to deliver out the ectopic mass without affecting the tube will be made. If the ectopic mass is in the ampullary region (towards the middle) of the tube, then a small incision is made at the antemesenteric end and the ectopic mass is delivered out.