Oct. 25, 2010
As a layman when the fertilised ovum fails to attach to the uterine cavity for further development on the contrary adheres to some other tissue nearby the condition is medically known as an ectopic pregnancy. Though with rising technological advancements in the field of ultrasonography the situations are quite handy, early detectable and diagnosed but still prevails and add massively to the maternal morbidity and mortality.
The abnormal implantation sites include: tubal, ovarian and abdominal where the tubal one is the commonest with about 95 % incidences in total.
The risk factors that usually influence its existence include chronic pelvic inflammatory disorders, some tubal operations or else intra uterine contraceptive devices (IUCD’s). Here these factors directly affect on the motility of the fertilised ovum and delays its migration to the normal plantation site i.e. the uterine cavity. The clinical features usually don’t include a fulminating dramatic scenario rather she complains of a persistent unilateral uneasiness before the acute symptom array. Short termed amenorrhoea of about 6 to 8 weeks followed by abdominal pain and appearance of vaginal bleeding mark the situation triad. The pain is acute colicky in nature and the in between phases are agonising. The bleeding is slight, continuous and dark coloured. Feelings of nausea, vomiting and fainting attacks co exist even to the extent of syncope sometimes.
How to diagnose?
· Acute ectopic: In the acute ectopic pregnancy cases the classical history of abdominal pain and fainting attack collapse associated with features of intra abdominal bleeding in a woman of child bearing phase points towards the clinical detection. Here no time should be wasted and quick actions are to be adopted. There may be some conditions that simulate the acute ectopic such as acute appendicitis, peptic ulcer, disrupted ovarian tumour, ruptured cyst where a mistake can be made overlooking the ectopic pregnancy chances. A detailed history of the clinical features will help one judge much better and act wise. Where the confusing clinical conditions will show up the pain with their own set of signs and symptoms simultaneously.
· Chronic ectopic: it is rather difficult to detect with confusing features hovering and hiding the real diagnosis. The features that may leave one neglected towards a chronic ectopic pregnancy include: absence of amenorrhoea i.e. menstrual bleeding is there, absence of vaginal bleeding that is seen in acute ones following the pain, apparently normal general condition. Often these females do present with a positive history of a tubectomy operation or IUCD insertion.
Blood examination, ultrasounds, laparoscopy, HCG (human chorionic gonadotropin hormone) estimation with hormonal essays will indicate on the condition underneath.
Here there isn’t any conventional mode of action rather one has to act on the individual factors. Some may revert with just medications but some may need surgical interventions to withstand.
Here one needs to be vigilant ignoring things can be havoc at times. Pregnancy is joyous period, enjoy with health and under experienced hands to scrap off any odds. Also preconception counselling is integral, never hesitate to consult for your own good.