diagnosis for ectpic pregnancy

dear gnaecologists,how we should go for diagnosing ectopic pregnancy,as we abadly mised a cae of it recently.pt presented with abdominal pain over epigastrium and vomiting,sometime getting semiconsciousness.

Posted by: abidrana Posts: 19 :: 25-09-2002 :: | Reply to this Message

Re: diagnosis for ectpic pregnancy

This is a very frequent presentation of ectopic pregnancy. In fact, I have seen many presenting as acute gastroenteritis.Therefore with any woman of reproductive age the Adage is to exclude ecoptic pregnacy before anthing else.
The best thing to do is to perform a pregnancy test of suitable sensitivity = Beta HCG upto 25mUL/ml at least, to check if pregnant, & if positive,confirm its site by ultasonography of the pelvis. {that is if the patient is not hemodynamically compromised !]I have not yet seen ultrasound being superior to common sense.& unfortunately I have seen an abdominal ectopic >12weeks being missed by an incompetent sonographer! If in shock then getting her to the theatre & stopping the haemorrhage is a priority.

Posted by: rzaskhan Posts: 8 :: 30-12-2002 :: | Reply to this Message

Re: diagnosis for ectpic pregnancy

quote:

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abidrana wrote:
dear gnaecologists,how we should go for diagnosing ectopic pregnancy,as we abadly mised a cae of it recently.pt presented with abdominal pain over epigastrium and vomiting,sometime getting semiconsciousness.

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Looks like a case of ruptured ectopic was missed. If the resources are limited, then a general diagnosis of acute abdomen secondary to any rupture/bleeding from any organ, should be entertained and that would lead to some type of exploratory laparotomy and might save a life or two. Other fancy stuff like ultrasound/CT/MRI and serial BHCG, is usually not applicable in urgent situations like this. My guess is that this patient died. Correct?

Posted by: chameed Posts: 173 :: 02-02-2003 :: | Reply to this Message