Ectopic pregnancy

Ectopic pregnancy, often called a tubal pregnancy, is a dangerous complication in pregnancy and a life-threatening medical emergency requiring immediate surgery.

In a normal healthy pregnancy the fertilised egg moves down to the uterus and settles into the prepared uterine lining, where it has plenty of room to divide and grow. In an ectopic pregnancy the egg attaches itself to the wall of the fallopian tube instead (or very rarely to other locations such as the cervix or ovary). As the embryo grows, the tube becomes stretched and inflamed and the person experiences extreme pain. An ectopic pregnancy must be removed surgically as soon as it is detected or the fallopian tube will burst, immediately causing gynecologic hemorrhage and endangering the life of the mother.

A case in Montreal in August 2003 in which a fetus in an ectopic pregnancy was successfully carried to term and delivered by Caesarean section is an example of a very rare medical event, possible only when the site of implantation is outside the fallopian tube - in this instance, the abdominal surface of the uterus. The woman and her doctors were unaware of her condition until she was delivered. There are only a dozen or so known cases of this in the world. [1]

Table of contents

1 Causes 2 Diagnosis 3 First Aid 4 Field Care (for EMTs) 5 Clinical Treatment 6 References 7 External Links

Causes

Diagnosis

Ectopic pregnancy should be suspected in any woman of childbearing years (12 to 60) with sudden, deep and excruciating abdominal pain clearly on "one side" of the lower abdomen, especially if she has missed one or more menstrual cycles.

First Aid

Questioning of the patient about the nature and location of the pain and their recent menstrual cycle(s) is appropriate. Nothing useful can be determined by a layperson's examination.

Call for help and arrange for immediate transport to advanced medical care. Also see gynecologic hemorrhage.

In wilderness first aid, suspected ectopic pregnancy calls for immediate evacuation by the fastest means available, including MEDEVAC if available. The patient will be unable to walk.

Field Care (for EMTs)

Transport immediately to a hospital with advanced OB/GYN facilities, not a community hospital without a surgical service. "Load and go." Provide supportive care including oxygen therapy.

Clinical Treatment

Immediate surgery by an OB/GYN specialist is required.

References

gynecologic hemorrhage medical emergency

External Links