ECTOPIC

PREGNANC
Y
 ECTOPIC PREGNANCY
Implantation of a fertilized ovum
outside the uterine cavity, most
commonly in the fallopian tube. The
baby (fetus) cannot survive, and
often does not develop at all in this
type of pregnancy.
 Causes
An ectopic pregnancy is often caused by a
condition that blocks or slows the movement
of a fertilized egg through the fallopian tube
to the uterus. This may be caused by a
physical blockage in the tube by hormonal
factors and by other factors, such as smoking.
Most cases of scarring are caused by:
• Past ectopic pregnancy
• Past infection in the fallopian tubes
• Surgery of the fallopian tubes
Some ectopic pregnancies can be due to:
• Birth defects of the fallopian tubes
• Complications of a ruptured appendix
• Endometriosis
• Scarring caused by previous pelvic surgery
The following may also increase the risk of
ectopic pregnancy:
• Age over 35
• Having had many sexual partners
• In vitro fertilization
In a few cases, the cause is
unknown.
Ectopic pregnancy is also more likely in women
who have:
• Had surgery to reverse tubal sterilization in
order to become pregnant
• Had an intrauterine device (IUD) and became
pregnant (very unlikely when IUDs are in
place)
 Symptoms
• Abnormal vaginal bleeding
• Amenorrhea
• Breast tenderness
• Low back pain
• Mild cramping on one side of the pelvis
• Nausea
• Pain in the lower abdomen or pelvic area
 Exams and Tests
• Culdocentesis
• Hematocrit
• Pregnancy test
• Quantitative HCG blood test
• Serum progesterone level
• Transvaginal ultrasound or pregnancy
ultrasound
• White blood count
Other tests may be used to confirm the
diagnosis, such as:
• D and C
• Laparoscopy
• Laparotomy
 Treatment
Treatment for shock may include:
• Blood transfusion
• Fluids given through a vein
• Keeping warm
• Oxygen
• Raising the legs
• If there is a rupture, surgery (laparotomy) is
done to stop blood loss.

• In some cases, the doctor may have to

remove the fallopian tube.
 If the doctor does not think a
rupture will occur, a medicine
called methotrexate may be given
and monitored. There may have
blood tests and liver function
tests.
HYDATIDIFORM
MOLE
(H-MOLE)
 Hydatidiform mole
A hydatidiform mole is a rare a mass or growth
that forms inside the uterus at the beginning
of a pregnancy. It is a type of gestational
trophoblastic disease (GTD).
 Causes
A hydatidiform mole, or molar pregnancy,
results from over-production of the tissue
that is supposed to develop into the
placenta. The placenta normally feeds a fetus
during pregnancy. In this condition, the
tissues develop into an abnormal growth,
called a mass.
Two Types:

• Partial molar pregnancy

• Complete molar pregnancy

 Partial Molar Pregnancy
there is an abnormal placenta and
some fetal development.
 Complete Molar Pregnancy
there is an abnormal placenta but no
fetus.
The exact cause of fertilization
problems are unknown.
However, a diet low in protein,
animal fat, and vitamin A may
play a role.
 Symptoms
• Abnormal growth of the womb (uterus)
• Nausea and vomiting that may be severe enough to require a
hospital stay
• Vaginal bleeding in pregnancy during the first 3 months of pregnancy
• Symptoms of hyperthyroidism
– Heat intolerance
– Loose stools
– Rapid heart rate
– Restlessness, nervousness
– Skin warmer and more moist than usual
– Trembling hands
– Unexplained weight loss
Symptoms similar to preeclampsia that occur in
the 1st trimester or early 2nd trimester -- this
is almost always a sign of a hydatidiform
mole, because preeclampsia is extremely rare
this early in a normal pregnancy
– High blood pressure
– Swelling in feet, ankles, legs
 Exams and Tests
• HCG blood test
• Chest x-ray
• CT or MRI of the abdomen
• Complete blood count
• Blood clotting tests
• Kidney and liver function tests
 Treatment
• If the doctor suspects a molar pregnancy, a suction
curettage (D and C) may be performed.
• A hysterectomy may be an option for older women who
do not wish to become pregnant in the future.
• After treatment, serum HCG levels will be followed. It is
important to avoid pregnancy and to use a reliable
contraceptive for 6 - 12 months after treatment for a
molar pregnancy. This allows for accurate testing to be
sure that the abnormal tissue does not return. Women
who get pregnant too soon after a molar pregnancy have
a greater risk of having another one.