Laparoscopic Management of Ectopic Pregnancy

By Sadhana Mishra

Ectopic pregnancy is one of the abnormal outcomes of pregnancy in 2% of pregnant woman and is defined as implantation of a fertilized egg outside the endometrial cavity. It remains a major cause of maternal morbidity and mortality when left untreated and accounts for as much as 9% of maternal death in this country. Quantitative measurements of the beta subunit of human chorionic gonadotropin (ß-hCG) and transvaginal ultrasonography have improved the accuracy of diagnosis and allow earlier detection of ectopic pregnancies.

History of the Procedure:

In modern medicine the ability to diagnose and treat ectopic pregnanciesClick Here! has significantly improved, thereby reducing the maternal risks. Recently Laparoscopy has revolutionized the way of dealing with the ectopic pregnancy says Prof. R.K. Mishra the recipient of Global Laparoscopic Trainer award of 2008 and Director of Laparoscopy Hospital, New Delhi.

Approximately 97.7% of all ectopic pregnancies occur in the fallopian tubes, and the others in the ovary, abdomen, or cervix. The ampullary pregnancy is the most common site of implantation (80%), followed by the isthmus (11%), fimbria (4%), cornua (2%), and interstitia (3%). Approximately 85% of ectopic pregnancies occur in multigravid women. In the United States, rates are nearly twice as high for women of other races compared with white women.

Aetiology:

Common risk factors for ectopic pregnancy include tubal damage, smoking, and altered motility in the fallopian tube. Bad smoking habits in the new generation women is a risk factor in about one third of ectopic pregnancies and may contribute to decreased tubal motility by damage to the ciliated cells in the fallopian tubes. Altered tubal motility can also occur as the result of oral contraceptive. Progesterone only oral contraceptive and progesterone intrauterine devices have been associated with increased risk of an ectopic pregnancy.

Clinical Symptoms:

Ectopic pregnancy can be diagnosed by typical triad which includes bleeding and abdominal pain and a positive pregnancy test result. The clinical presentation can therefore be confusing, since symptoms overlap with miscarriage. One third of women have no clinical signs and 9% have no symptoms of ectopic pregnancyClick Here!. As a result, almost half of cases are not diagnosed at the first prenatal visit by their gynecologists.

On physical examination signs include lower abdominal tenderness with or without rebound and pelvic tenderness usually much worse on the affected side. Gynaecologists can find abdominal rigidity, involuntary guarding, and severe tenderness as well as evidence of hypovolemic shock with tachycardia, should alert the clinician to a surgical emergency; this may occur in up to 20% of cases. On per vaginal examination, the uterus may be slightly enlarged and soft, and uterine or cervical motion tenderness may suggest peritoneal inflammation.

Indications for surgery in ectopic pregnancy include women with the following criteria:
o    Not suitable candidate for medical therapy
o    Failed medical therapy
o    Heterotopic pregnancy with a viable intrauterine pregnancy
o    Hemodynamically unstable and need immediate treatment

Medical therapy:

While methotrexate has remained the most effective and popular drug used in medical therapy for an ectopic pregnancy, other protocols have been used, such as potassium chloride, hyperosmolar glucose, RU 486, and prostaglandins.

Surgical therapy:

Surgical therapy may be open laparotomy or via the laparoscopyClick Here!. According to Prof. R. K. Mishra all ectopic pregnancies requiring surgery should be treated laparoscopically. Risk factors for converting laparoscopy to laparotomy should be considered and include multiple prior surgeries, pelvic adhesions, skill of the surgeon and surgical staff, availability of the equipment, and condition of the patient. If the ectopic pregnancy is at the fimbria, then fimbrial evacuation is feasible, in the absence of indications for salpingectomy. Partial salpingectomy may be indicated if the pregnancy is in the mid portion of the tube, none of the indications for salpingectomy is present, and the patient may be a candidate for later tubal reanastomosis.

Laparoscopy Technique:

Desiccate the tube between the uterus and the ectopic pregnancy using bipolar cautery and compress and desiccate the tuboovarian artery, while preserving the uteroovarian artery and ligament. Cut along the desiccated path, closer to the specimen, leaving a pedicle for hemostasis. Infiltration of the mesosalpinx with vasopressin (20 IU in 50 mL of isotonic sodium chloride solution [ie, normal saline or NS]; some authors use only 10 IU in 50 mL of NS) to get transient ischemia and to avoid bleeding. Needle electrode, is used to make a 1- to 2-cm incision on the antimesenteric side of the tube. Aquadissector, under pressure can be used to dissects and dislodges the ectopic pregnancy and clots.

Laparoscopic [http://www.laparoscopyhospital.com/SERV02.HTM]Treatment and [http://www.laparoscopyhospital.com/SERV01.HTM]Training

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Never Ignore Ectopic Pregnancy Symptoms - It is an Emergency

By Anupriya Jain

Ectopic pregnancy symptoms start occurring when the egg is fertilized outside the uterus and the baby starts developing outside the womb. Most commonly, ectopic pregnancyClick Here! occurs inside the fallopian tube, but in some cases, though quite rare, it occurs in the ovary or the stomach area. These are not normal kinds of pregnancies and should not be allowed to proceed further as they may cause permanent damage to the system.

The reason why an ectopic pregnancy takes place is due to a condition in which the passage of the fertilized egg through the fallopian tube is blocked or slowed down. This blockage may be physical and can occur due to some previous infections, surgery in the fallopian tube, and inflammation of the area or earlier ectopic pregnancy.

Symptoms To Watch Out For

Ectopic pregnancy symptoms are abdominal and are characterized by pelvic pain and vaginal bleeding. These are often confused with the pregnancy symptoms of miscarriage or pelvic inflammatory diseases. The best thing is to approach your doctor if you experience any of these symptoms as a delay in action might cause a ruptured ectopic pregnancy, which is a serious medical condition.

Ruptured Ectopic Pregnancy

Common early symptoms of ectopic pregnancy include lightheadedness, dizziness, passing-out, sweating, and pale complexion, extreme and unbearable pain in pelvic area and/or stomach. You must go to your doctor if you experience any of these and undergo certain examinations which the doctor will perform on you. The doctor generally goes for a pelvic exam and ultrasound to determine enlargement of the uterus and the area affected by this kind of pregnancy. Blood hormone levels are also checked to see the changes.

If you are having any ectopic pregnancy symptom,Click Here! it should be treated as an emergency as this type of pregnancy may rupture anytime and damage the fallopian tube permanently. Such pregnancies if diagnosed at early stages can be treated accordingly and the pregnancy can be terminated safely without damaging the tube. However, if it ruptures, surgery is the only option to save the patient's life.

With the advancement in medical science and technology, this kind of pregnancy can be terminated safely with a small surgery today and the woman can still hope to conceive and deliver a healthy child next time. Earlier, all of the fallopian tube used to be terminated and there was no chance for having a baby in the womb. Thanks to the medical advancements today, women who had such type of pregnancy once can dream to have a healthy pregnancy in the near future.

All women should be vigilant enough not to take signs of pregnancy lightly and start getting pre-natal care immediately. This way, she can recognize and tell her doctor about ectopic pregnancy symptoms, if any, at the earlier stages and get the condition treated properly without harming herself and her reproductive system.

Ectopic pregnancy is a very severe pregnancy complication, which could have disastrous effects. Be watchful about [http://www.pregnancy-period.com/ectopic-pregnancy-symptom.html]ectopic pregnancy symptoms, such as pelvic pain and contact your doctor immediately because a ruptured ectopic pregnancy href="http://b99b7je4-7t6sube5i6amhh9fg.hop.clickbank.net/" target="_top">Click Here! could signal an emergency. [http://www.pregnancy-period.com]Early Pregnancy Symptoms provides more information about normal [http://www.pregnancy-period.com/pregnancy_symptom.html]symptoms of pregnancy and even some early pregnancy symptoms that could indicate that you are on your way to being a mother.

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Pregnancy Spotting - What Causes Vaginal Spotting During Pregnancy?

By Asheesh Mani

Pregnancy spotting during the first trimester of pregnancy is the most normal sign of pregnancy. Though women tend to worry about the spotting found in vaginal areas, medical professionals advise them not to worry about the condition. Chances of vaginal spotting to appear vary from seven weeks of pregnancy to nine weeks. This vaginal spotting results from the implantation of the embryo in the lining of the uterus. This type of bleeding, which is also an early sign of pregnancy is termed as implantation bleeding. Mild spotting or bleeding from the vagina is not something to be worried about and you need not seek the help of doctors. However, when the bleeding seems to be heavy and accompanies cramping abdominal pain, please your doctor immediately.

What Does Vaginal Spotting Signal In Pregnancy?

Although to an extent, pregnancy spotting is completely normal and harmless in early pregnancy. However, bleeding beyond a level it may signal certain serious problems happening inside the pregnant woman's body. In such cases, the expectant mothers should consider a few pregnancy tests to ascertain that both their and their babies' health is fine and devoid of any possible pregnancy risk. Mainly on observing heavy vaginal bleeding, pregnant women are suggested a screening of their condition through examinations. If you experience heavy bleeding, rush to an emergency clinic or hospital if you cannot contact your gynecologist.

What Causes Vaginal Spotting?

There can be diverse reasons that lead to pregnancy spotting in the early months of pregnancy. This spotting is somewhat different from how normal menstruation appears. Spotting is usually experienced as a light form of vaginal bleeding before the start and end of your menstruation cycle. The main reason why this bleeding occurs is the increase in the supply of blood to the cervix and pelvis area. Spotting differs from the color of normal menstruation. The color of pregnancy spotting can be pink, dark red to brown or resembling the color of dried blood.

So what are the causes of pregnancy spotting in the early stage of pregnancy? Medical experts answers this question taking into account the following factors -

First, is bleeding due to implantation in the uterus. As the embryo is attached to the walls of uterus at about 6 to 7 days after fertilization, bleeding is secreted from the vagina. The fertilized egg by itself is attached to the uterus wall, so slight spotting results from this process of implantation.


Ectopic pregnancy can also be a reason why some women experience pregnancy spotting. Implantation and thereafter, development of the baby outside the uterus can cause vaginal bleeding. Outside the uterus, the embryo mainly begins to develop in the fallopian tube, which is why this ectopic pregnancy is also termed as tubal pregnancy or molar pregnancy. Molar pregnancy marks a diminished chance for the fetus to survive and marks an early termination of pregnancy.

There are other causes of pregnancy spotting too, such as certain infections like vaginal or yeast infections or bacterial infections, sexually transmitted infections like gonorrhea, Chlamydia, herpes etc. Stay alert to vaginal spotting and take the right precautions when it occurs. [http://www.pregnancy-period.com/pregnancy-spotting.html]Pregnancy spotting is a generally caused by implantation bleeding and is generally termed as an [http://www.pregnancy-period.com/early-sign-of-pregnancy.html]early sign of pregnancy. However, not all forms of pregnancy spotting is harmless and its better if you contact your doctor to rule out any possibility of pregnancy risks and pregnancy complications. [http://www.pregnancy-period.com]Pregnancy-Period.Com offers information and details about all stages of pregnancy, pregnancy symptoms and almost everything that you need to know about pregnancy and related issues.

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Awareness Of Different Pregnancy Types

By Saurabh K Jain

Pregnancy types vary from woman to woman and it is important for her that she knows about each type. Not all types of pregnancy are normal, and a certain pregnancy type might spell danger and she needs to be alert to it.

Ectopic And Lupus Pregnancy

Of all the pregnancy types, lupus pregnancy and ectopic pregnancy are the most dangerous. Lupus is an immunity related disease affecting a woman. It can lead to miscarriage and still birth. If a woman suffers miscarriage for no apparent reason, she should consult her gynaecologist before conceiving again. Proper treatment can help her become a mother but she has to take extra care and make sure that the hospital she is going to deliver has an emergency neo-natal unit.

Ectopic pregnancy on the other hand has no proven medical reason. It happens when the foetus implantation occurs in any other body part instead of the uterus. It inevitably results in miscarriage and can be deadly for the mother if medical attention is delayed. Symptoms of  such a pregnancy are abdominal pain, dizziness and low blood pressure in the first few weeks after conception.

New And Second Pregnancy

New pregnancy makes a mother out of a woman. It is a new sensation that her body undergoes. She changes everyday; each new day brings new joy and challenge. In early pregnancy stages, she may feel morning sickness, nausea vomiting tendency, fatigue and lethargy. As her pregnancy progresses, she may need to go to the bathroom frequently and back aches may cause a major problem.
All these symptoms may be lower in intensity during her second pregnancy. But that does not mean that she has it easy. For now in addition to the child inside her, she has to take care of her older baby. Still second pregnancy is a bit more enjoyable than first pregnancy as the mother now understands every change her body undergoes.

Twin Pregnancies

Lucky is the woman who undergoes nine months of labour instead of eighteen to have two babies. Twin pregnancy is common in woman with prior family history of twins but nowadays due to fertility treatment, many more woman are having multiple pregnancies. It is also a risky affair as the woman needs special care and attention while carrying two foetuses. Most of the time twins are born prematurely with low birth weight. So this kind of pregnancy type needs regular check ups, a balanced diet and a healthy lifestyle.

Teen Pregnancy

Though a woman's body is theoretically ready for motherhood with the arrival of puberty, but biologically or emotionally, she is not ready in her teens to be a mother. Of the pregnancy types, this one should be avoided at all cost. But sadly, with puberty setting early and average age of sexually active youngsters going down, teen pregnancy is a problem in modern society. A teen mother gives birth to undernourished babies, become victims in domestic life and sometimes neglects and abandons the child. Spread of sex education and availability of contraception can reduce this pregnancy type.

So, if you are a mature woman who can provide an environment where a child can grow safely and happily, there is no greater joy than motherhood. Have knowledge of [http://www.pregnancy-period.com/pregnancy_types.html]pregnancy types, avoid the [http://www.pregnancy-period.com/pregnancy-risk.html]pregnancy risk factors and enjoy the road to [http://www.pregnancy-period.com]Pregnancy Period for a blissful motherhood.

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Get To Know About Ectopic Pregnancy

Get To Know About Ectopic PregnancyBy [http://ezinearticles.com/?expert=Apurva_Shree]Apurva Shree
Ectopic Pregnancy is commonly known as tubular pregnancy. The word 'Ectopic' stands for body part found in an unusual position. As a woman it is important for you to know about it because it is difficult to detect. Know more about it here.
What Happens In An Ectopic Pregnancy?
Normally a fertilized egg implants itself inside the womb (uterus). It attaches itself to tissues other than the lining of the womb. The most common occurrence is in the fallopian tube. It can also happen in the cervix, or in any organ in the pelvic region. In the initial stages the woman experiences only the normal early symptoms. But when the egg grows bigger you start experiencing the other various symptoms.
What Are The Symptoms?
You must know that the fetus can be nurtured only in the womb. Therefore in most cases, the body rejects this abnormal pregnancy by spontaneous miscarriage. When this does not happen, medical intervention is required. Check out for any sign of ectopic pregnancy.
Abdominal pain is one of the first symptoms. This pain can be constant and severe and its onset, sudden. This happens when the egg grows in size.Shoulder pain, which intensifies while breathing is an alternative symptom.Pain during visits to the bathroom.Vaginal bleeding different from normal periods.Diarrhea, paleness, lightheadedness, collapsing.Increasing pulse rate, falling blood pressure.
If you suspect an ectopic pregnancy, rush to your doctor for immediate help. Your doctor will confirm it through internal examination or an ultrasound.
What Are The Reasons?
As explained earlier, the fertilized egg implants itself outside the womb and starts developing there. If it occurs in the fallopian tubes, it can cause bursting or damage of the tubes. Bursting of the tube is a life-threatening situation. Risk of such pregnancy increases with following factors.
Already damaged fallopian tube(s) due infections such as pelvic inflammatory disease or by previous surgery, scar tissue.Previous ectopic pregnancies.Getting pregnant when on contraceptive-coil or certain types of contraceptive pill. Pregnancies through test tube methods. Even though fertilized egg is placed directly in the uterus it can attach itself elsewhere.
What Are The Treatments?
If you are lucky with a natural miscarriage, that is great. If you are not so, medication and or surgical intervention are the only solutions. With present day technologies, it is much easier to detect and treat this condition. However methods are not available to transplant the egg from the wrong position to the uterus. The doctor can only get rid of the wrongly positioned egg from your body.
We advise you to do your homework too. Read and understand more on all issues related, to avoid panic. It is more beneficial if you do this as you plan for pregnancy.
An abnormal pregnancy period like this followed by surgical intervention can be devastating for a mother-to-be. But the reassuring fact is that most women go on to have normal pregnancies when they attempt later. It is advisable to give a gap of few cycles before getting pregnant again. Let it not happen to you. But be prepared if you find yourself with an ectopic pregnancy. [http://www.pregnancy-period.com/ectopicpregnancy.html]Ectopic pregnancy is a big risk to your life. On getting pregnant look out for the symptoms of early [http://www.pregnancy-period.com]pregnancy. Be knowledgeable about the [http://www.pregnancy-period.com/ectopic-pregnancy-symptom.html]signs of ectopic pregnancy. If you fear that you have an ectopic pregnancy, consult a doctor at once.
Article Source: http://EzineArticles.com/?expert=Apurva_Shree http://EzineArticles.com/?Get-To-Know-About-Ectopic-Pregnancy&id=1006493

Get To Know About Ectopic Pregnancy

Get To Know About Ectopic PregnancyBy [http://ezinearticles.com/?expert=Apurva_Shree]Apurva Shree
Ectopic Pregnancy is commonly known as tubular pregnancy. The word 'Ectopic' stands for body part found in an unusual position. As a woman it is important for you to know about it because it is difficult to detect. Know more about it here.
What Happens In An Ectopic Pregnancy?
Normally a fertilized egg implants itself inside the womb (uterus). It attaches itself to tissues other than the lining of the womb. The most common occurrence is in the fallopian tube. It can also happen in the cervix, or in any organ in the pelvic region. In the initial stages the woman experiences only the normal early symptoms. But when the egg grows bigger you start experiencing the other various symptoms.
What Are The Symptoms?
You must know that the fetus can be nurtured only in the womb. Therefore in most cases, the body rejects this abnormal pregnancy by spontaneous miscarriage. When this does not happen, medical intervention is required. Check out for any sign of ectopic pregnancy.
Abdominal pain is one of the first symptoms. This pain can be constant and severe and its onset, sudden. This happens when the egg grows in size.Shoulder pain, which intensifies while breathing is an alternative symptom.Pain during visits to the bathroom.Vaginal bleeding different from normal periods.Diarrhea, paleness, lightheadedness, collapsing.Increasing pulse rate, falling blood pressure.
If you suspect an ectopic pregnancy, rush to your doctor for immediate help. Your doctor will confirm it through internal examination or an ultrasound.
What Are The Reasons?
As explained earlier, the fertilized egg implants itself outside the womb and starts developing there. If it occurs in the fallopian tubes, it can cause bursting or damage of the tubes. Bursting of the tube is a life-threatening situation. Risk of such pregnancy increases with following factors.
Already damaged fallopian tube(s) due infections such as pelvic inflammatory disease or by previous surgery, scar tissue.Previous ectopic pregnancies.Getting pregnant when on contraceptive-coil or certain types of contraceptive pill. Pregnancies through test tube methods. Even though fertilized egg is placed directly in the uterus it can attach itself elsewhere.
What Are The Treatments?
If you are lucky with a natural miscarriage, that is great. If you are not so, medication and or surgical intervention are the only solutions. With present day technologies, it is much easier to detect and treat this condition. However methods are not available to transplant the egg from the wrong position to the uterus. The doctor can only get rid of the wrongly positioned egg from your body.
We advise you to do your homework too. Read and understand more on all issues related, to avoid panic. It is more beneficial if you do this as you plan for pregnancy.
An abnormal pregnancy period like this followed by surgical intervention can be devastating for a mother-to-be. But the reassuring fact is that most women go on to have normal pregnancies when they attempt later. It is advisable to give a gap of few cycles before getting pregnant again. Let it not happen to you. But be prepared if you find yourself with an ectopic pregnancy. [http://www.pregnancy-period.com/ectopicpregnancy.html]Ectopic pregnancy is a big risk to your life. On getting pregnant look out for the symptoms of early [http://www.pregnancy-period.com]pregnancy. Be knowledgeable about the [http://www.pregnancy-period.com/ectopic-pregnancy-symptom.html]signs of ectopic pregnancy. If you fear that you have an ectopic pregnancy, consult a doctor at once.
Article Source: http://EzineArticles.com/?expert=Apurva_Shree http://EzineArticles.com/?Get-To-Know-About-Ectopic-Pregnancy&id=1006493