Ectopic pregnancy

1. ‫الرحيم‬ ‫الرمحن‬ ‫هللا‬ ‫بسم‬
َ‫ل‬ َ‫ك‬َ‫ن‬‫ا‬َ‫ح‬ْ‫ب‬ُ‫س‬ ْ‫ا‬‫و‬ُ‫ل‬‫ا‬َ‫ق‬‫آ‬َ‫ن‬َ‫ل‬ َ‫م‬ْ‫ل‬ِ‫ع‬ّ‫ل‬ِ‫إ‬
ُ‫م‬‫ي‬ِ‫ل‬َ‫ع‬ْ‫ال‬ َ‫ت‬ْ‫ن‬َ‫أ‬ َ‫ك‬ّ‫ن‬ِ‫إ‬ ‫آ‬َ‫ن‬َ‫ت‬ْ‫م‬ّ‫َل‬‫ع‬ ‫ا‬َ‫م‬
ُ‫م‬‫ي‬ِ‫ك‬َ‫ح‬ْ‫ال‬
‫العظيم‬ ‫اهلل‬ ‫صدق‬
‫سورة‬‫البقرة‬‫أية‬32
Thursday, April 5, 2018 Dr. Soad Abd El salam Ramdan 1

2. High risk pregnancy
Thursday, April 5, 2018
Dr. Soad Abd El salam Ramdan 2

3. 3
• Chairman of obstetrics &woman health
nursing department
• Pre. Vice of dean for students &Education
Affair
Faculty of nursing
Benha University
Thursday, April 5, 2018 Dr. Soad Abd El salam Ramdan

5. Learning objectives:-
 Describe causes of bleeding in early pregnancy.
 Apply nursing care plan for woman with
bleeding in late pregnancy.
 Enumerate types of associated medical
problems during pregnancy.
 Describe the nurses responsibilities in relation
to various types of associated medical problems
during pregnancy.
Thursday, April 5, 2018 Dr. Soad Abd El salam Ramdan 5

6. Bleeding during pregnancy
Bleeding
Late
pregnancy
Accidental
hge.
Placenta
previa
Early
pregnancy
Abortion
Ectopic
pregnancy
Vesicular
mole
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7. 1- Bleeding
in early pregnancy
Thursday, April 5, 2018 Dr. Soad Abd El salam Ramdan 7

8. 1-Bleeding In Early Pregnancy
(Before 20 weeks Gestation)
Causes:-
 Abortion.
 Vesicular mole.
 Ectopic pregnancy.
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9. Related to pregnant state
 Abortion
 Ectopic pregnancy
 Molar pregnancy
Bleeding in early pregnancy
abortion ectopic Vesicular
mole
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10. 3- Ectopic Pregnancy
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11. Ectopic Pregnancy:-
 Ectopic pregnancy is defined as
pregnancy occurring outside the
normal uterine cavity.
 ◘ It is an abnormal implantation
of the fertilized ovum that occurs
outside the uterine cavity.
 Approximately 2% of
pregnancies are ectopic.
 Second most frequent cause of
bleeding.
Thursday, April 5, 2018 Dr. Soad Abd El salam Ramdan 11

12. Sites of ectopic pregnancy
implantation:
1. The surface of the ovary
2. Cervix
3. Fallopian tube (95% ): 80% occur in the
ampullar
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13. Ectopic Pregnancy Incidence
increase with:
 Smoking.
 Intrauterine devices (IUDs).
 In vitro fertilization.
 History of ectopic pregnancy (10%-20%).
 Pelvic inflammatory disease.
 History of previous pelvic operations such as
D and C, tuboplasty, tubal sterilization,
ovarian surgery.
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14. Causes:-
 Obstruction, such as an adhesion of the fallopian
tube.
Causes of adhesions:
1. Previous infection.
2. Congenital malformations.
3. Scars from tubal surgery.
4. Uterine tumor.
 Impaired tubal ciliary action.
 Impaired tubal contractility.
 Decreased sperm mobility.
 The use of intrauterine contraceptive device.
Thursday, April 5, 2018 Dr. Soad Abd El salam Ramdan 14

15. Signs and Symptoms :-
 Short periods of amenorrhea.
 History of infertility, tubal surgery, induced
abortion.
 Sudden/recurrent severe, colicky abdominal
pain in one iliac fossa or entire lower
abdomen.
 Dizziness and fainting attacks.
 Blood stained vaginal discharge.
 Diffuse tenderness on lower abdomen.
 Signs of shock.
 Dyspareunia.
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16.  Management
 Once the diagnosis of ectopic pregnancy has
been made, the pregnancy should be evacuated
immediately.
 Salpingectomy is preformed.
 Provide emotional support to the patient.
 Prepare for emergency surgery.
 Monitor the patient for shock. Follow-up is
needed.
 Family planning should be discussed.
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17. THANKYOU
Thank you
Thursday, April 5, 2018 Dr. Soad Abd El salam Ramdan 17