ECTOPIC PREGNANCY || ETIOLOGY || MANIFASTATION || DIAGNOSIS || TREATMENT ~ Medical diseases and trems ,symptoms causes TREATMENT

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ECTOPIC PREGNANCY || ETIOLOGY || MANIFASTATION || DIAGNOSIS || TREATMENT



DEFINITION 

                      It is a condition when implantation occur other then normal site ,Both extra uterine and intra uterine . maximum time it involve fallopian tube so it known as tubal pregnancy.

                    Highest incidence in ampulla .

                    Maximum survival in Interstitial prat of fallopian tube.

ETIOLOGY 

          1. Most common cause pelvic inflammatory disease .

          2. Most common PID is salpingitis .

                                           cause 

                                         ↙       ↘

                           Tubal defect          Endometrium defect 

                                 ↓                                   ↓  

                 clinical damage                        OCP

                 ↙          ↘                               ↙            ↘

           PID           Smoking          Endometritis       Endometriosis

ENDOMETRIOSIS

                               It is over growth of endometrium layer of uterus.

MENIFESTATION 

                * Most common complain is lower abdominal pain .

                * Cause of bleeding is damage of decidua after the death of embryo .

                * Decidua do not contain villi .

                * sign of rupture include 

                                   - shock { BP Low, HR high , Hematocrit low}.

                                   - CULLAN SIGN - It is periumblical blues discoloration.

                                   - Shoulder pain  - it is referral pain originate from pelvic .

Area stela reaction - it explain as glandular cystic hyperplasia { This is cyst formation in the endometrium due to unavailability of fetus} .

TERMINATION OF ECTOPIC PREGNANCY

   1. TUBAL MOLE - Termination occur during celluar stage . The complete material is absorb .

   2. TUBAL ABORTION - Termination occur after the growth commonly involve ampulla and                                                infundibulum.

   3.TUBAL RUPTURE - It involve peritoneal bleeding or pelvic haematocele.

DIAGNOSIS 

            PVS + LEPROSCOPY { Ideal method }

         - Serum progastron level 5ngm 

        - HCG hormone increase but not up to  the maximum .

TREATMENT 

   Medical management                                                   Surgical management

 1. unruptured                                                             1. ruptured

 2. mild                                                                       2. severe

 3. acute                                                                      3. chronic 

Target of medical management is to immediate to stop pregnancy.

Drug of choice is methotrexate .

In the surgical management basic intervantion involve oxygen IV  fluid BT .

 Name of surgery 1 SALPINGOPLASTY 

                             2 SALPINGECTOMY.


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