Concept about Tubal Pregnancy – This course is designed to understand the care of pregnant women and newborn: antenatal, intra-natal and postnatal; breast feeding, family planning, newborn care and ethical issues, The aim of the course is to acquire knowledge and develop competencies regarding midwifery, complicated labour and newborn care including family planning.
Concept about Tubal Pregnancy
A pregnancy that is not in the usual place within the uterus but is located in the Fallopian tube. Tubal pregnancies are due to the inability of the fertilized egg to make its way through the Fallopian tube into the uterus.
or
Figure: Tubal pregnancy
Aetiology of tubal pregnancy:
1. Abnormalities of the tube delaying or preventing the progress of fertilized ovum –
➤ Developmental errors; Hypoplasia, undue tortuosity diverticula and accessory lumina
➤ Distortion of the tube by large tumour or endometriosis.
➤ Previous inflammatory disease (salpingitis). Narrowing of the tubal lumen, intratubal adhesions, peritubal adhesions.
1. Surgical-
➤ After partial salpingectomy.
➤ After tubal ligationor hysterectomy (If operation is performed within 48 hrs of coitus) Tubal plastic surgery- (microsurgery and reversal sterilization).
➤ Inefficient tubal contractions or a poor cilial current: Developmental anomalies, results of previous infection.
➤ IUCD.
2. Overdevelopment of the ovum- external migration: An ovum discharged from one ovary can be fertilized in the peritoneal cavity and cross the pelvis by a process of external migration to enter the opposite tube. Meanwhile the fertilized ovum biggers in size and may be too big to pass isthmic portion of the tube.
3. Endometriosis of the fallopian tube.
Outcome or termination of tubal pregnancy:
A tubal pregnancy may terminate in one of the following ways and usually before it is 6 weeks old.
Tubal abortion (intratubal rupture- discharge of ovum into the lumen of the tube. One of four things may happen –
- Complete absorption.
- Complete abortion.
- Incomplete abortion.
- Missed abortion- tubal mole.
- Tubal rupture.
- Intra-peritoneal rupture.
- Extra-peritoneal rupture.
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