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Recommended: Case study on ectopic pregnancy

LIST B PERSPECTIVE : Impact on individual patient or community
Ectopic pregnancy occurs when a fertilized egg implant at any site other than the normal uterine location. This is common in 1% of pregnancies. (kumar) Late diagnosis and treatment my lead to the death of the fetus.(1) The most common site for ectopic pregnancy is fallopian tube ( approximately 97.7%), with 80% usually occurring in the ampulla followed by isthmus (12%),fimbrae (5%), cornua (2%) and interstitia (2-3%).
Sites and frequencies of ectopic pregnancy. By Donna M. Peretin, RN. (A) Ampullary, 80%; (B) Isthmic, 12%; (C) Fimbrial, 5%; (D) Cornual/Interstitial, 2%; (E) Abdominal, 1.4%; (F) Ovarian, 0.2%; and (G) Cervical, 0.2%.
There are many risk factors that can lead to ectopic pregnancy, such as previous history of ectopic pregnancy, tubal damage, previous genital infections, multiple sexual partners and the usage of intrauterine device (IUD). Classic triad of ectopic pregnancy includes vaginal bleeding, amenorrhea and abdominal pain. If patient complains of any of this symptom during pregnancy, immediate investigations should be done. There are varieties of test that can be used to detect ectopic pregnancy. These include serum progesterone level,beta human chrionic gonadotrophin level ( beta- HCG) and transvaginal ultrasound. Trasvaginal ultrasound is the preferred test, as study have shown it to have a sensitivity and specificity of 90% and 99.8% respectively, with positive predictive value of 93% and negative value of 99.8%. (4)

Emotional Impact

Ectopic pregnancy diagnosis usually comes in as a surprise for the patient. It is emotionally traumatic as the patient often receives the news a few weeks after their pregnancy confirmed. This may lead to...

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...e is pregnant. However, she would be in dilemma thinking what would happen next? Will she be able to get pregnant this time? Or she might get an ectopic pregnancy again due to her previous history? This is because the risk of ectopic pregnancy increases if the patient had previous ectopic pregnancy. And in the case of Ms B, she had previous history of ectopic pregnancy in 2008 as well as 2010. Salpingectomy, removal of a fallopian tube, also increases the recurrence of ectopic pregnancy in the future. Therefore, this is one of the biggest worried for Ms B when she got pregnant recently. She was hoping that everything would be fine this time, but the results turned her down again. Morever, several studies have shown that the risk of ectopic pregnancy increases with maternal age. Ms B is 39 this year and her chances of getting pregnant are getting lower year by year.

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