Early Signs and Symptoms of Ectopic Pregnancy
What is Tubal Pregnancy or Ectopic Pregnancy?
What are the Symptoms of Ectopic Pregnancy?
1. Per abdominal examination:
- Abdomen intense and tender and tenderness more in the lower abdomen,
- Shifting dullness may be elicited,
- The gut may be distended.
2. Per vaginal examination:
- Usually not done due to fear of precipitating more bleeding and extreme tenderness,
- Vaginal mucosa blanched white,
- No mass usually felt through the cervix,
- Extreme tenderness on palpation of the fornix or movement of the cervix.
3. A short period of amenorrhea,
4. Severe lancinating pain in one iliac fossa or the hypogastrium immediately followed by profound collapse,
5. Slight, sanguineous, or dark-colored vaginal bleeding,
6. Feeling of nausea, vomiting, and dyspnea,
7. There may be anemia, fever (2% of cases), and signs of shock.
All the diagnosis ways of acute ruptured ectopic pregnancy have pointed out below:
- Exhibits abdominal or pelvic tenderness during palpation,
- Tenderness in patients with EP may be generalized (45%), located bilaterally in the lower quadrants (25%), or located unilaterally in a lower quadrant (30%),
- Rebound tenderness may or may not be present,
- A palpable adnexal mass or mass in the cul-de-sac is reported in approximately 40% of cases; absence of a palpable mass does not rule out EP,
- Additional signs include shoulder pain (15%) and low-grade fever (Less than 10%).
2. P/V Examination:
It should not be done due to tenderness.
3. Lab Investigation:
- TC, DC (Neutrophilic leukocytosis),
- Hb% below normal,
- ESR raised,
- Blood grouping and Rh typing- should be done for management beta-HCG.
Urine Specific Gravity (USG):
- TVS (Transvaginal sonography is the choice)- can detect an EP greater than 2cm,
- USG can show,
- Empty uterus,
- Cystic or sold adnexal masses,
- Dilated and thick-walled fallopian tubes,
- Free echogenic fluid in the pelvis; hematosalpinx,
- The extrauterine gestational sac contains a yolk sac, with or without an embryo.
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