Ectopic pregnancy

Ectopic pregnancy

Implantation of a fertilized ovum outside of the uterine cavity is known as ectopic pregnancy. ectopic pregnancy mostly occur in fallopian tube(93-97%),which is called tubal gestation or pregnancy .

As the fetus grows the tube may rupture and its contents enter to the peritoneal cavity ,causing peritonitis and fatal(harmful/causing death) intra-peritoneal hemorrhage. 

 Causes of ectopic pregnancy

previous pelvic inflammatory diseases e.g. salpingitis ,genital TB ,previous ectopic pregnancy ,previous tubal surgery/injury ,presence of IUCDs ,prolong infertility, tubal damage due to any reason.

Clinical features 

👉-Amenorrhea OR irregular bleeding and spotting through vagina

👉-pelvic pain

👉-No intrauterine gestational sac in U/S with BHG greater than 2000mili-units/ml.  

Sonological features--

1- US shows an empty uterine cavity.

2- False gestational sac may be seen in 10-20% of ectopic pregnancies with no fetal pools.

3- Endometrium will appear thick and echogenic.

4- Simple adnexal cyst (10% may be present in ectopic pregnancy.

5- Fluid in the pouch of Douglas will seen during ectopic pregnancy.

👉Intra-peritoneal fluid will be due to ectopic pregnancy if β-HCG is positive otherwise further investigations are needed to exclude exact cause of intra-peritoneal fluid.   

(By; Dr-Abdullah Noor wazir)