An ectopic pregnancy is when the fertilized egg (zygote) attaches, or implants, and begins to grow in an area other than the uterus. This most often occurs in the fallopian tube, but can be in other areas as well such as the cervix, ovary or abdominal cavity. An embryo cannot grow and survive outside the uterus, and parts like the fallopian tubes are unable to support such a pregnancy and must be treated immediately. Often, a woman may not be aware she is pregnant and symptoms may be vague. Blood test and ultrasound are the best ways to diagnose ectopic pregnancy.
An ectopic pregnancy happens when the egg, traveling from the ovary to the uterus, gets stuck. This may be due to endometriosis, scar tissue from previous abdominal surgeries, inflammation or infection such as chlamydia, use of an IUD, or following IVF treatments. If the pregnancy occurs in the fallopian tube (tubal pregnancy), it may cause the tube to rupture and is considered a medical emergency.
Patient will be free from pain and complications
Assess vital signs:
If an ectopic pregnancy occurs in the fallopian tube that ruptures, the patient may go into shock and will have rapid heart rate, rapid breathing and low blood pressure.
Assess for signs of dehydration; skin turgor, mucous membranes, cap refill
Excessive blood loss and vomiting may cause hypovolemia and dehydration.
Position patient for comfort and assist with movement as needed
Patient should be positioned lying flat on the bed to reduce movement, stabilize vitals and promote comfort.
Assess for abdominal pain and tenderness
Monitor blood loss and administer blood products as necessary
Vaginal bleeding may range from spotting to heavier than a normal menstrual cycle
Monitor intake and output; administer fluids as appropriate
To maintain renal function, especially in the case of shock.
Administer medications as appropriate and monitor for adverse reactions
Prepare patient for surgery:
If the fallopian tube has ruptured, surgery to remove part or all of the tube may be the best option. Surgery may be performed laparoscopically or a laparotomy may be necessary.
Provide patient education of ways to prevent future ectopic pregnancies
Educate patient of risk factors and lifestyle changes to avoid future ectopic pregnancies:
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