Ectopic pregnancy – diagnosis and therapy
How is the diagnosis?
A pregnancy is known or the period remained, and it to develop these characters, should as soon as possible be a woman medical attention. The suspicion of a court of first instance, in accordance with the Request of the clinical history and the palpation (possibly uterine and/or abdominal pain-sensitive) is first performed an ultrasound examination and examination of blood and urine (pregnancy test by Determining Beta-HCG, to the exclusion of urinary tract infections). Especially in early pregnancy, the findings are sometimes not clear; however, a hospital admission is the slightest suspicion rates.
What kind of therapy are there?
The procedure in the hospital depends on the symptoms and ranges from a wait-and-see behavior with regular checks via a diagnostic and/or therapeutic laparoscopy to open surgery.
The risk of life-threatening complications for the Pregnant is very high – a EUG is during the first trimester of Pregnancy is the most common cause of death of Pregnant women, a total of at least fourth most common cause of death of women in connection with pregnancy and childbirth. Therefore, a diagnosed ectopic is aborted pregnancy. To v. a. surgical and medical measures are available, their Benefits and risks are weighed according to the Situation to each other:
- Operation: the possibility to remove only the fruit to get to the fallopian tubes, but (Salpingotomie) or the affected fallopian tube removed (Salpingectomy). The first approach increases the risk of recurrence of ectopic pregnancy and carries the risk of the remains in a Eizellrest (trophoblast persistence), which can later degenerate. Therefore, planning is in the case of women with completed family size, rather that 2. The method applied. In the case of ovarian pregnancy, attempt fruit as much as possible the conservation of the ovary out of the surgery, sometimes the entire ovary has to be removed. In the case of cervical pregnancy usually, the entire uterus must be removed.
- Medications: methotrexate (MTX, a cell poison, what else is used for cancer and rheumatism therapy), prostaglandins such as Dinoprostone and anti-progestins such as mifepristone as well as Hyper-osmolar glucose lead to the death and to Repel the fruit into the abdominal cavity. MTX comes v. a. then, if an ectopic pregnancy is not without complications, as well as to bring to the support of the Operation, for example, the Eizellrest to the death. Whether the treatment is working, checked with the pregnancy hormone Beta-HCG. For the other substances, the previous experience, especially as a sole therapy is still very limited. The drugs are used mainly as a blood transfusion, or Muscle injection, or more rarely as a tablet or a local application (e.g., during laparoscopy into the fallopian tube injected).
Here you will find a literature summary of “Heterotopic pregnancy”
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- Ectopic pregnancy – pregnancy outside of the uterus
- Ectopic pregnancy – causes and symptoms
- Ectopic pregnancy – diagnosis and therapy