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Advanced Obstetrics for Critical Care Paramedic: Ectopic Pregnancy - Essay Example

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Advanced Obstetrics for Critical Care Paramedic: Ectopic Pregnancy

An ectopic pregnancy is one of the few obstetric conditions that may end up being true surgical emergencies. As much as a high index of suspicion, an early diagnosis and management of an unruptured ectopic is important, even more crucial is the quick identification and surgery for a patient with a ruptured ectopic in shock. Failure to diagnose an ectopic pregnancy can lead to malpractice litigation as it can be potentially fatal, apart from causing significant morbidity and psychological distress to the patient (Bird, 2005; Longmore, 2010). Although, the definitive management of a ruptured ectopic is institute based and can be expectant, medical or operative; supportive management in pre-hospital scenario can mean the difference between life and death situations (Hajenius et al, 2007, Lozeau & Potter, 2005). Also, it can impact on the future fertility of the patient since newer conservative modalities with fewer complications can be used if ectopic pregnancy is diagnosed in time (Kopani, Rrugia & Manoku, 2010; Hajenius et al, 2007). ...
Incidence is higher in the age group above 35 years and most common site for implantation of an ectopic is the fallopian tube, followed by ovary and abdomen(Kopani, Rrugia & Manoku, 2010). Structural abnormalities of the fallopian tubes are the most common causes of ectopic pregnancy (Braen & Krause, 2009). Sexually transmitted infections like chlamydia and gonorrhoea cause tubal infection and scarring and lead to tubal pathology. Other factors which predispose to ectopic pregnancy are history of infertility and assisted reproductive techniques, pelvic inflammatory disease, previous dilation and curettage (D & C), tubal ligation and recanalisation, history of previous ectopic, use of intra-uterine device (IUD), smoking, pelvic surgery and genital tuberculosis (Varma & Gupta, 2009). Also, it has been found that the rate of ectopic pregnancy has decreased in women using contraception like oral contraceptives and has increased in women with reproductive failure (Varma & Gupta, 2009). There are certain implications of these risk factors, thus, health care providers should be aware of them. These risk factors can help in assessment of the likelihood of diagnosis of ectopic pregnancy. Nevertheless, it should be kept in mind that up to 42% of women with a positive diagnosis have had no risk factors (Braen & Krause, 2009; Varma & Gupta, 2009). Secondly, a history of contraceptive use or tubal ligation and sterilisation should not deter a paramedic from making a diagnosis of obstetric emergencies. In fact, a positive urine pregnancy test in the presence of an IUD in situ should alert the health care provider about the possibility of an ectopic. Symptoms of pain and discomfort in the abdomen should not be ignored as being instigated by an IUD. Neglecting ...Show more
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Summary

Implantation of a fertilized ovum in places other than the endometrial lining of the uterus results in an ectopic pregnancy.As the blastocyst grows and expands at aberrant sites, it can cause rupture of those tissues with the potential for torrential bleeding…
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