Pregnancy burst or ruptured | Ectopic Pregnancy-How is it managed?-Dr.Nidhi Agrawal |Doctors' Circle

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So ectopic the word itself means which is not right in its place. So what is ectopic pregnancy normally. We all know that pregnancy should be in the mother's womb the uterus. So when the pregnancy elsewhere we call it an ectopic pregnancy. It can be in the fallopian tube it can be in the ovary. It can be somewhere in the abdomen. So all these locations would come under one umbrella that's ectopic pregnancy. But the commonest ectopic pregnancy is the tubal pregnancy in fact even the fallopian tube is divided into like you know four parts. So there also is illary pregnancy which is the commonest. So why should one get a ectopic pregnancy is the problem lies in the alter mobility of the fallopian tube and the concerns were that does it need immediate surgery. So it really depends upon the presentation of the patient if a patient presents to at five to 6 weeks here or very early. Once she's diagnosed she's pregnant we do a scan and it just comes out that there's a ectopic pregnancy. In those cases we really have options if the mother is stable if her beta hCG is low. The baby has not developed a heartbeat the size is less she is stable we can plan her for a expectant management or a medical management. But if the patient has presented to us with a ruptured ectopic pregnancy what do you mean by ruptured ectopic that the fallopian tube has ruptured and the fallopian tube is a very vascular structure in our body so if it ruptures the mother bleeds and the patients present to us with the hemoperoneum. What's a hemoperitoneum? There's a all blood in the abdominal cavity and the patients vitals are low. Sometimes they are sinking. So in those cases those are not the candidates for any sort of expectant or medical management and they are the utmost urgency in obstetric we immediately just do their vitals arrange blood and take them to OT the stabilization and the surgery they go hand in hand and this surgery is a life-saving surgery the moment we just get hold of that bleeding end the patients vitals start improving. So in those cases definitely surgery is needed and it should be done in immediately and in the well selected cases we do give expected management or give medical management and keep the patient under observation with all the risks explained after the ectopic surgery depending upon if the patient came to us in a really bad state in very low hemoglobin then she would need transfusion of blood and blood products and there the recovery would be a little slow because the patient has lost a lot of blood and there will be weakness in those cases where the patient came in just in time the recovery is very good and in all the cases the patient is discharged on third day of the surgery and nowadays with the advent of laparoscopy. We no more do open surgeries for ectopic even if it's a rupture disc. We always go laparoscopically. So in a week patient is up and above and she can start all her office or household work except for the heavy work. So the recovery is not a problem it's just that the general health has to be taken again.
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