Ectopic pregnancy from fertilization to delivery, pregnancy requires a number of steps in a woman’s

body. One of these steps is when a fertilized egg travels to the uterus to attach itself. In the case of an
ectopic pregnancy, the fertilized egg doesn’t attach to the uterus. Instead, it may attach to the fallopian
tube, abdominal cavity, or cervix.

Symptoms

Nausea and breast soreness are common symptoms in both ectopic and uterine pregnancies. The
following symptoms are more common in an ectopic pregnancy and can indicate a medical emergency:

 sharp waves of pain in the abdomen, pelvis, shoulder, or neck

 severe pain that occurs on one side of the abdomen
 light to heavy vaginal spotting or bleeding
 dizziness or fainting
 rectal pressure

Causes

An ectopic pregnancy is often caused by damage to the fallopian tubes. A fertilized egg may have
trouble passing through a damaged tube, causing the egg to implant and grow in the tube.

Things that make you more likely to have fallopian tube damage and an ectopic pregnancy include:

 Smoking. The more you smoke, the higher your risk of an ectopic pregnancy.
 Pelvic inflammatory disease (PID). This is often the result of an infection such as chlamydia or
gonorrhea.
 Endometriosis, which can cause scar tissue in or around the fallopian tubes.
 Being exposed to the chemical DES before you were born.

Some medical treatments can increase your risk of ectopic pregnancy. These include:

 Surgery on the fallopian tubes or in the pelvic area.

 Fertility treatments such as in vitro fertilization.

Treatment

Ectopic pregnancy treatment is medicine or surgery:

 You get shots of a medicine called methotrexate that ends the ectopic pregnancy. It stops the
fertilized egg’s cells from growing, and your body absorbs any cells that have already developed.
This shouldn’t damage the fallopian tubes at all.
 The pregnancy is removed with a surgical procedure using laparoscopy. Your doctor makes a
small cut near your belly button, and removes the pregnancy using surgical tools and a tiny
camera to see inside your body. This is the most common treatment for ectopic pregnancy.
 Sometimes, this procedure causes scarring in your fallopian tube, or a piece of fallopian tube
needs to be removed.

Complications

The most common complication is rupture with internal bleeding which may lead to hypovolemic shock.
In the first trimester, ectopic pregnancy is the most common cause of pregnancy-related deaths and
10% of maternal deaths may be due to ectopic pregnancy.

Prevention

An ectopic pregnancy is assuming greater importance because of its increasing incidence and its impact
on women’s fertility and mortality.

Lack of knowledge regarding sexual health predisposes women to sexually transmitted diseases. Health
education regarding safe sexual practices, to get quick treatment for sexually transmitted infections
(STIs), avoidance of risk behaviors such as smoking and provision of family planning services is very
much needed for the prevention of ectopic pregnancy.

Occurrence of ectopic pregnancy cannot be prevented but complications can be reduced/ prevented
with early diagnosis and treatment. Increased awareness in physicians and use of ultrasonography in
early pregnancy may lead to early diagnosis and a conservative management.

Women should seek early advice from a healthcare professional when she is pregnant. She should be
advised an ultrasound scan between 6 and 8 weeks of pregnancy to confirm that the pregnancy is
developing in the uterus.

Nursing Interventions

 Assess vital signs

 Assess for signs of dehydration; skin turgor, mucous membranes, cap refill
 Position patient for comfort and assist with movement as needed
 Assess for abdominal pain and tenderness
 Monitor blood loss and administer blood products as necessary