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class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Obstetrics_and_Gynecology/Ectopic_Pregnancy&veaction=edit&section=1" title="Edit section: Epidemiology" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Obstetrics_and_Gynecology/Ectopic_Pregnancy&action=edit&section=1" title="Edit section's source code: Epidemiology"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The <b>incidence</b> of ectopic pregnancy is increasing in the UK and currently stands at 1 in 100 pregnancies. </p><p>Risk Factors </p> <ul><li>Increased maternal age</li> <li>Smoking</li> <li>Previous tubal surgery</li> <li>Prior recurrent spontaneous miscarriages</li> <li>Prior surgical termination of pregnancy</li> <li>Pelvic inflammatory disease</li> <li>Previous use of an intrauterine device</li> <li>History of infertility</li></ul> <p>Prior oral contraception use can reduce the risk of ectopic pregnancy. </p> <div class="mw-heading mw-heading2"><h2 id="Etiology_and_Pathogenesis">Etiology and Pathogenesis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Obstetrics_and_Gynecology/Ectopic_Pregnancy&veaction=edit&section=2" title="Edit section: Etiology and Pathogenesis" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Obstetrics_and_Gynecology/Ectopic_Pregnancy&action=edit&section=2" title="Edit section's source code: Etiology and Pathogenesis"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>When the ovum is released by the ovary, it travels along the fallopian tube (where it is fertilized) in the direction of the uterus. The resulting embryo does not reach its destination, however, as it implants into the wall of the fallopian tube. The subsequents trophoblastic proliferation causes erosion and bleeding. Unlike the uterus, the fallopian tube's muscle layer does not undergo hypertrophy, so rupture into the lumen and peritoneal and retroperitoneal cavities occurs. </p> <div class="mw-heading mw-heading2"><h2 id="Clinical_Features">Clinical Features</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Obstetrics_and_Gynecology/Ectopic_Pregnancy&veaction=edit&section=3" title="Edit section: Clinical Features" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Obstetrics_and_Gynecology/Ectopic_Pregnancy&action=edit&section=3" title="Edit section's source code: Clinical Features"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>History </p> <ul><li>Severe lower abdominal colicky pain</li> <li>Vaginal bleeding after a missed period</li> <li>Shoulder tip pain</li> <li>Dysuria</li> <li>Shock</li></ul> <p>Examination </p> <ul><li>Signs of early pregnancy</li> <li>Mass on vaginal examination</li> <li>Soft, enlarged uterus</li> <li>Cervical excitation</li> <li>Abdominal tenderness</li></ul> <p>Investigations </p> <ul><li>Pregnancy test and serum β-hCG</li> <li>Ultrasound scan - trans-vaginal</li></ul> <p><br /> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Obstetrics_and_Gynecology/Ectopic_Pregnancy&veaction=edit&section=4" title="Edit section: Treatment" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Obstetrics_and_Gynecology/Ectopic_Pregnancy&action=edit&section=4" title="Edit section's source code: Treatment"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Treat these patients as resuscitation patients. Give oxygen and gain IV access. Cross-match blood and request Rhesus status. Surgery is avoided initially using IV methotrexate and hCG monitoring. If the pregnancy continues, surgical intervention is required. </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Obstetrics_and_Gynecology/Ectopic_Pregnancy&veaction=edit&section=5" title="Edit section: References" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Obstetrics_and_Gynecology/Ectopic_Pregnancy&action=edit&section=5" title="Edit section's source code: References"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>Why women die. Report on confidential enquiries into maternal deaths in the United Kingdom 1994-1996. Norwich: Stationery Office, 1998. The risk factors for an ectopic pregnancy are:</li> <li>Bouyer J et al. Risk Factors for Ectopic Pregnancy: A Comprehensive Analysis Based on a Large Case-Control, Population-based Study in France. <i>Am J Epidemiol</i> 2003 157;185-194</li> <li>O'Connor, J. Pathology 2nd ed. Mosby. Edinburgh. 2002.</li> <li>McCarthy, A & Hunter, B (2003) Master Medicine: Obstetrics and Gynaecology (2nd ed.) Philadelphia: Elsevier Saunder</li> <li><a rel="nofollow" class="external free" href="http://www.gpnotebook.co.uk">http://www.gpnotebook.co.uk</a></li></ul>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1&useformat=desktop" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikiversity.org/w/index.php?title=Obstetrics_and_Gynecology/Ectopic_Pregnancy&oldid=2688524">https://en.wikiversity.org/w/index.php?title=Obstetrics_and_Gynecology/Ectopic_Pregnancy&oldid=2688524</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Special:Categories" title="Special:Categories">Categories</a>: <ul><li><a href="/wiki/Category:Obstetrics_and_Gynecology" title="Category:Obstetrics and Gynecology">Obstetrics and Gynecology</a></li><li><a href="/wiki/Category:Emergency_Medicine" title="Category:Emergency Medicine">Emergency Medicine</a></li><li><a href="/wiki/Category:Reproductive_medicine" title="Category:Reproductive medicine">Reproductive medicine</a></li><li><a href="/wiki/Category:Human_pregnancy" title="Category:Human pregnancy">Human pregnancy</a></li></ul></div></div> </div> </main> </div> <div class="mw-footer-container"> <footer id="footer" class="mw-footer" > <ul id="footer-info"> <li id="footer-info-lastmod"> This page was last edited on 23 November 2024, at 15:19.</li> <li id="footer-info-copyright">Text is available under the <a rel="nofollow" class="external text" href="//creativecommons.org/licenses/by-sa/4.0/">Creative Commons Attribution-ShareAlike License</a>; additional terms may apply. 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