tailieunhanh - Ectopic pregnancy

Ectopic pregnancy is defined as a pregnancy in which the implantation of the embryo occurs out- side the uterine cavity, most frequently in one of the two fallopian tubes or, more rarely, in the abdo-minal cavity or the cervix . | 12 Ectopic pregnancy Pascal R. Kolk INTRODUCTION Ectopic pregnancy is defined as a pregnancy in which the implantation of the embryo occurs outside the uterine cavity most frequently in one of the two fallopian tubes or more rarely in the abdominal cavity or the cervix1. Ectopic pregnancy is one of the frequent emergencies encountered in obstetrics and gynecology and is a common condition throughout the world. It is important to have at least a basic knowledge about this condition and to recognize its symptoms. When an ectopic pregnancy ruptures it is a medical emergency and is a life-threatening condition. One study in Lagos showed that ruptured ectopic pregnancy was responsible for almost 50 of all gynecologic emergencies2. According to the World Health Organization WHO incidence in the developing world varies between one ectopic pregnancy per 50-200 pregnancies3-4. A study conducted in Ghana showed incidence rates as high as one ectopic pregnancy in every 44 deliveries5. Ectopic pregnancy is a major cause of maternal death around the world with case fatality rates in the developing world hospitalbased figures of 1-4 4. This is 10 times higher compared with developed countries4. In some countries up to 9 of all maternal deaths are caused by ectopic pregnancies4-6-7. As is stated in William s Obstetrics The risk of death from an extrauterine pregnancy is greater than that for pregnancy that either results in a live birth or is intentionally terminated 8. An extra-uterine pregnancy is 50 times more likely to result in a maternal death than a first-trimester abortion and 10 times more likely than delivery in the third trimester9. The difficulty with all these figures is that in low-resource settings the registration of women having an ectopic pregnancy is far from complete. Most of the data mentioned in research and publications are hospital-based figures. Many women with an ectopic pregnancy will survive and thus not visit a hospital after tubal abortion blood loss

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• Ectopic pregnancy
• The cervix
• Risk factors and prevention
• Previous induced abortion
• Intrauterine device
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