PowerPoint English Case KET
PowerPoint English Case KET
Ectopic Pregnancy
dr. Wahyuridistia M.
Consultant :
dr. Hj. Ermawati Sp.OG (K)
CHAPTER I
INTRODUCTION
IDENTITY
• Name : Miss. M
• Age : 34 years old
• MRNo : 00 72 03
• Date : May, 3rd 2017
• Adress : Dhamasraya
CHIEF COMPLAIN
Abdoment
• Inspection : Abdomen didn’t seem enlarge, cicatrix (-)
• Palpation : Uterine fundal hard to palpate, abdominal
tenderness (+), defence muskular (-)
• Percution : Tympani
• Auscultation: Peristaltic sound was dicress
Genitalia
Inspection : V/U normal, Bleeding pervaginam (+)
Inspeculo
Vagina : Tumor (-), laceration (-), fluxus (+) blackish red
blood seemed to accumulate in the posterior fornix
Portio : Multiparous, size equal to 1st digiti of plantar
pedis, tumor(-), laceration (-), fluxus (+) There was
black redish blood oozing from cervical canal, EUO
was closed
VT bimanual
Vagina : tumour (-)
Portio : multiparous, size equal to 1st digiti of plantar
pedis, tumor(-), motion pain of the servix (+), EUO
was closed
CUT : hard to examine
AP : hard to examine
Douglas’ pouch: bulging
Laboratory Finding
No Parameter Result
12,00-14,00
1 Haemoglobin 8,3 gr/dl
37,0 % - 43,0 %
2 Haematocryte 30 %
150000-400000
4 Trombocyte 182.000/mm3
5 PT 11,4 seconds
Plan :
• Emergency laparotomy
at 11.00 am
laparatomy was performed
• After opening the peritoneum in the blood and
blood clot looked ± 700 cc. Exploration was the
source of bleeding coming from the right tubal
rupture pars ampularis. Size 6x5x4,5 cm
• Impression: right fallopian tube rupture pars
ampularis.
DEFINITIONS
• Abnormal implantation site
Risk Factor
• Infection
• Prior ectopic pregnancy
• Contraceptive Pill & IUD
• IVF
• Smoking
• Prior tubal surgery/obstruction
• Advanced maternal age
Sign and Symptoms
• USG
• Serum β-hCG level
• Laparoscopy
• Culdocentesis
Transvaginal sonography (TVS)
• Extrauterine GS
• Hemoperitoneum
• Trilaminar endometrial pattern
• Psudosac
• Heterotopic pregnancy
• Double decidual sac sign (decidua
capsularis and decidua parietalis)
Serum β-hCG level measurement
• Direct visualization
• Transition definitive operative
Treatment Options
•Uncontrolled bleeding
•Extensive damage
•Recurrent ectopic pregnancy
•Sterilization
• Unruptured ectopic linear salpingostomy
• No differences with or without suturing
preferred salpingostomy
SUMMARY