INTRODUCTION

I chose this case because I'd like to know the causes and treatment for ectopic pregnanacy. I also
want to know the possible signs and symptoms of the case so that it may help those women planning to
become pregnant. This study aims to expand knowledge about Ectopic Pregnancy
.
An ectopic pregnancy is a condition in which a fertilized egg settles and grows in any location
other than the inner lining of the uterus. The vast majority of ectopic pregnancies occur in the fallopian
tube (98%), however, they can occur in other locations, such as the ovary, cervix and abdominal cavity.
An ectopic pregnancy occurs in about one in 50 pregnancies.

The major health risk of ectopic pregnancy is rupture leading to internal bleeding. Before the
19th century, the mortality rate (the death rate) from ectopic pregnancies exceeded 50%. By the end of
the 19th century, the mortality rate dropped to five percent because of surgical intervention. With
current advances in early detection, the mortality rate has improved to less than five in 10,000. The
survival rate from ectopic pregnancies is improving even though the incidence of ectopic pregnancies is
also increasing. The major reason for a poor outcome is failure to seek early medical attention. Ectopic
pregnancy remains the leading cause of pregnancy-related death in the first trimester of pregnancy.

An ectopic pregnancy is commonly referred to as a tubal pregnancy because 95 percent occur in

a fallopian tube. An ectopic pregnancy needs to be treated immediately to avoid fallopian tube damage
or life threatening blood loss. When identified early, ectopic pregnancies are treatable with medication
that stops the pregnancy. If the pregnancy is further along, laparoscopy is usually performed to remove
the ectopic tissue and repair the fallopian tube. Currently, laparotomy is the preferred technique when
the patient is hemodynamically unstable, the surgeon has not been trained in laparoscopy, physical
facilities and supplies to perform laparoscopic surgery are lacking or technical barriers to laparoscopy
are present. If the ectopic pregnancy has ruptured or bleeding persists, salpingectomy is a very common
option. This procedure involves excision of segment of the Fallopian tube involved in the ectopic
pregnancy. The tubal segment to be removed is coagulated and cut off with bipolar forceps.

In the developed world, Ectopic Pregnancy occurs in about 1 in 250 pregnancies amounting to
approximately 70 000 cases annually, 5,833 per month, 1,346 per week, 191 per day, 7 per hour. In the
Philippines, unpublished reports have estimated the incidence to be just about 22, 194 each year.
PATIENT PROFILE:

• Ward: OB Ward, Bed 4

• Date of Admission: September 23, 2010 (7:40pm)
• Patient Name: Ms. VG
• Address: Makati City
• Age: 36 years old
• Gender: Female
• Birth Date: August 23, 1973
• Educational Status: College Graduate
• Religion: Roman Catholic
• Nationality: Filipino
• Civil Status: Married
• Occupation: Company Secretary
• Health Care Financing: PhilHealth
• Informant: Patient
• Reliability: 100%

Admission Data:

1. Chief Complaint: Pain in lower abdomen

2. Initial Diagnosis: 20 weeks, Ectopic Pregnancy G2P0
3. Final Diagnosis: 20 weeks, Ectopic Pregnancy G2P0
4. Attending: Dr. L. Morales
PATIENT HISTORY:

History of Present Illness

Patient VG is pregnant for her second baby. Her age of gestation is 20 weeks. She suffered
miscarriage on her first pregnancy and underwent dilatation and curettage. On her fourth month of
pregnancy, she noticed vaginal spotting and experienced slight pain in his abdomen but she didn't give
attention to her condition. No medications was taken to relive the pain. No other signs and symptoms
experienced by patient VG.
One week prior to admission, the patient experienced again pain in her lower abdomen. She also
added that while urinating and defecating she also experienced pain. No medications taken because she
thinks that it will cause abortion to her pregnancy.
3 days prior to admission, patient still have pain in lower abdomen increasing in severity. She
feels body weakness and loss of appetite due to the pain she is experiencing. She also noticed that the
vaginal spotting increases. The patient agree to be confined in Ospital ng Makati. Her age of gestation
upon admission was 20 weeks. Laboratory works were requested and the patient was diagnosed of
ectopic pregnancy and a stat Ex-Lap was ordered leading to Salpingectomy.
Past Medical History
The patient was born via normal spontaneous vaginal delivery. There were no complications or
abnormalities when she was delivered. She does not have any information about her immunization
status. According to her, she had a chicken pox when she was 9 years old. She does not usually get
cough or colds but experiences fever at times due to weather conditions.
During the first month of her pregnancy of her first child, she had bleeding. She sought for
medical help and it revealed that she had miscarriage. She underwent dilatation and curettage.

Personal and Social History

Patient is a non-smoker and non-alcoholic beverage drinker. She has no history of allergy to any
food or drinks.
Family Health History
Patient VG is a 36 years old female. She is the 2nd of 8 siblings. Her father died 5 years ago due
to cardiac arrest. On the other hand, her mother is still living and is hypertensive. Among her 7 siblings,
one is also hypertensive.
The family’s source of income is the husband who works as a construction worker. He has a
daily salary of P 350/ day or about P 7000/month. From this, the family can afford eating three times a
day. Their usual diet is composed of fish and vegetables since their son likes to eat vegetables. They
only cook meat once or twice a week. Sometimes, they also go to mall to have family bonding and time
for fun.

This is the first time in their family that an ectopic pregnancy occurred. However, it is noted that
her 2 siblings and 2 cousins have difficulty having a child