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PATHOPHYSIOLOGY of ECTOPIC PREGNANCY

Coitus

Entry of spermatozoon in the


cervix then to the fallopian
tube

Union of ovum and


spermatozoon at distal 3rd of
fallopian tube

Predisposing Factors:

Beyond conceivable age Precipitating Factors:


Congenital anomalies in the
fallopian tube Tubal damage caused by:
Chronic salphingitits
Pelvic Inflammatory Disease
Use of IUD more than 2 years
Previous pelvic/tubal surgery
Previous ectopic pregnancy
Maternal cigarette smoking

Legend:
Obstruction/damage in the
Signs and tube
Symptoms

Diagnostic Narrowing of the fallopian tube


evaluation

Management Prevents egg from reaching the


uterus
Complication
s
Blastocyst implants outside the
Manifested endometrium of the uterus (6-
by the 12 wks)
patient
Fallopian tube:

Ampullary
Abdomen portion of the Ovary and Cervix
tube
Hysterect
Isthmic omy
Laparatomy
segment of the
tube Oophorect
omy
Fimbrae
Salpingec
Cornual and tomy
interstitial
portion of the Fimbraect
tube within the
Implantation omy
Amenorrhea
fallopian tube
Cornuecto
my

Co
Much higher BP Decreased Decreased
Limited muscle lining of
in tubal resistance to
decidual the tube
arteries than the invading
reaction
uterine arteries trophoblastic
tissue

Serum
pregnan Growing zygote
cy test ruptures the
shows slender Tearing and
Placental
HCG tube/trophoblast destruction of
dislodgement
cells break blood vessels
through with
Cauldoc
narrow base Tube
Progesterone entesis
ruptures
secretion stops
Ultraso
und
Uterine decidua
sloughs off

Bleeding/va
ginal
spotting

Sharp
stabbing
pain at L/R
Pain lower
radiating abdomen
to
Blood Conception
shoulder
accumulation products
Rigid in the expelled into
abdomen peritoneum pelvic cavity
Tachycard
ia Cullen’s
sign
Hct
Tachypne Hemorrhage
a Hgb

Hypotensi Shoc
on k
Lighthead
edness
Modified
Narrowed trendelenburg
pulse
pressure Fluid
resuscitation

O2
supplementatio
n

Blood
transfusion as
indicated