DEFINITION:

An ectopic pregnancy is one in which the fetus is implanted

outside the uterine cavity.
TUBAL PREGNANCY:
Tubal pregnancy develops when the transport of the fertilised ovum into the
uterine cavity is interfered with.Implantation can occur at any point along the
tube,although the ampulla is the common site.
CAUSE OF TUBAL PREGNANCY
Congenital abnormalities of the tube such as hypoplacia,and tubal diverticula.
Previous infection such as post-abortal sepsis, puerperal sepsis and
tuberculosis.
OUTCOMES OF TUBAL PREGNANCY
 Tubal abortion
 Tubal mole
 Tubal rupture
 Abdominal pregnancy
CLINICAL PRESENTATION
 Ammenorrhoea
 Pelvic pain
 Acute lower abdominal pain
 Dizziness,
 Nausea, and vomiting
 Shoulder pain,
 Bleeding into the perineal cavity,
 Severe pallor,faintness
 Rapid and thread pulse ,tachypnea and low blood pressure.
 Abdominal examination will show lower abdominal tenderness,
rebound tenderness, guarding and shifting dullness due to ha
emoperitoneum.

DIAGNOSIS
 Missed period and or a positive pregnancy test.
 Abdominal pain which occurs on one side only and is situated low,
down in the abdomen.
 Vaginal bleeding which starts after a bout of lower abdominal pain.
 Those with an IUD (Coil) in place are taking the progestogen only
pill or PID.
  An ultrasound showing a gestational sac with fetal heart in the
fallopian tube is clear evidence of ectopic pregnancy.

TREATMENT FOR ECTOPIC PREGNANCY:

Ectopic pregnancy may be treated in several ways depending on whether the
fallopian tube has ruptured or not, the development level of the pregnancy, and
the mother's hormone levels. Treatments may include:
• medications - such as methotrexate can be used for some very early
ectopic pregnancies in mothers who are asymptomatic.
• surgery (possibly including laparoscopy with salpingostomy or
salpingectomy) - a surgical procedure to make a small opening in the
fallopian tube and remove the pregnancy. If the tube is damaged, total or
partial salpingectomy may be necessary - the removal of all or a part of
the fallopian tube.
In rare cases, a laparotomy may be necessary. This is a surgical procedure in
which an incision is made in the mother's abdomen to remove the ectopic
pregnancy or damaged fallopian tube.

NURSING PROCESS

ASSESSMENT
Sharp localised pain in lower abdomen
Syncope and referred shoulder pain
Irregular vaginal bleeding
Abdominal rigidity and distention
Shock-decreased blood pressure increased heart rate.
Disorientation and lack of cooperation due to severe pain.

NURSING DIAGNOSIS

Risk for foetal injury

Risk for infection
Ineffective airway clearance
Actual /risk for aspiration
Anxiety
IMPLEMENTATION

Provide pain relief

Manage shock
 Administer oxygen intravenous fluids
 Type and cross-match blood.
Prepare for surgery, laparotomy with removal of the ectopic pregnancy,
and perhaps the affected fallopian tube.
Provide post operative
• Give routine post operative care
• Assess vaginal bleeding
• Offer emotional support
SUBMITTED TO: MS SUBHASHINI G.
HOD OBG NURSING
P.I.O.N

SUBMITTED BY: MS DIMSEY.R.MARAK

MSC NURSING 1ST YEAR
P.I.ON