00:01
Our topic here is ectopic
pregnancy, a very common disorder.
00:05
Make sure that you’re quite
familiar with ectopic pregnancy.
00:09
Abnormal implantation
of a fertilized egg,
instead of being in the uterus.
00:15
And even with the uterus, remember,
that implantation should be taking
place in the proximal portion
of the uterus.
00:23
Keep that in mind
because you can have implantation
in other parts of the uterus
uterus in which a diagnosis
becomes complete different.
00:31
Here, however,
the implantation is not taking
place anywhere near the uterus.
00:37
We’re in the fallopian tubes --
90% of the time, it will
be in the fallopian tube.
00:42
How is that possible?
Well, I want you think about the
fallopian and its behavior.
00:48
In other words, it’s
responsible for
facilitating the journey
of the fertilized egg
from the ovary and then
towards the uterus.
00:59
But what may then happen
is if you have a female
and she unfortunately developed a
sexually transmitted infection
such as gonorrhea or chlamydia.
01:09
And at some point in time,
the organism starts causing
infection to the fallopian tube.
01:15
And so therefore, this type
of salpingitis eventually,
just like any type of
injury to any organ,
begins the process of repair.
01:23
The repair to you should
mean fibrosis, scarring.
01:29
So now you have scarring in
this fallopian tube that
is relatively delicate
and it’s responsible for
contraction and such.
01:37
So imagine now that
fertilized egg comes --
it’s moving forward to the
fallopian tube and it gets stuck
in that area that’s scarred.
01:46
This is ectopic pregnancy.
01:48
So how is your patient
going to then behave?
Well, before we begin,
anytime that you have a female
in her reproductive age
and she’s experiencing
abdominal pain,
your next step of
management always is to
do a pregnancy test.
02:04
If the beta hCG comes
back to be negative,
and then you further explore, well,
what’s going on with your patient?
Comes back to you positive,
and now, let’s talk about
this abdominal pain
that the ectopic pregnant
woman is experiencing.
02:19
Approximately six weeks after
her last menstrual period
is when she will start
having abdominal pain,
pelvic pain,
there would be
adnexal tenderness
and maybe perhaps
she’ll be spotting.
02:34
All these should indicate
that perhaps your patient might be
suffering from the ectopic pregnancy.
02:40
Comes back to be
positive for beta hCG,
you do an ultrasound
and you find, my goodness,
the egg is in the
fallopian tube.
02:50
Now, what are you worried about?
If that egg keeps getting bigger,
bigger, bigger and bigger
as it would be,
then the fallopian tube cannot handle
obviously this type of growth.
03:01
It is going to rupture, isn’t
it, the fallopian tube?
And your patient’s going to die.
03:05
And we’re talking about
spontaneous bleeding
that’s going to take place
within the peritoneum.
03:09
This is no joke,
ladies and gentlemen.
03:11
You need to make sure that
you’re quite aggressive
and you’re using proper
medical clinical acuity.
03:19
Now the reason you need to
bring this to your attention
well, I need to bring this to your
attention is because take a look,
one in one fifty,
that is really common.
03:27
Anytime that you deal
with ratio in medicine,
figure out as to whether or not
this is rare or common condition.
03:34
And if the ratio is as,
what you’re seeing here,
frequent,
then you’ll know that you
definitely need to know
everything about that
particular condition.
03:43
Once again, the pregnancy
test should be
investigated so that you
can rule out pregnancy
especially if you have a
female in reproductive age
who is experiencing
abdominal pain.
03:54
Also look for spotting,
a little bit of blood
that’s being released.
03:57
It’s painful
and there’s also adnexal
tenderness, referring to what?
Well, the fallopian tube,
if that has been affected,
there’s going to be –
well, think about where
the ovaries would be
and there’d be pain in
that region, adnexa.