Lower quadrant abdominal pain can occur due to the fertilized egg developing within the confined space of the fallopian tube. This can be a very painful experience for the pregnant woman and can cause sharp stabbing pains when the tube stretches.
Ectopic pregnancy can cause decreased menstruation or hypomenorrhea, as a result of the formation of uterine adhesions and scar tissue and may be a sign of injury within the fallopian tubes.
One major complication of an ectopic pregnancy is miscarriage because the egg is not able to develop appropriately within the fallopian tube. Vaginal bleeding can also occur as a result of damage to the tissue that is endured during an ectopic pregnancy.
If the tubal pregnancy ruptures, the woman is at risk for hemorrhage. The woman should be monitored closely for signs of hypovolemic shock, as the woman is at risk for losing large volumes of blood. The nurse should monitor the patient’s blood pressure, heart rate, and oxygen saturations very closely.
When the fertilized egg grows too big for the fallopian tube to handle, the tube can rupture. This produces severe abdominal pain and often referred shoulder pain.
In the event of a tubal pregnancy, the pregnant woman’s umbilicus may display an ecchymotic-bluish color, this is referred to as Cullen sign and is indicative of blood within the peritoneum. When this sign is present, it means that the tubal pregnancy has ruptured.
If a tubal pregnancy is identified, the woman may be given methotrexate to dissolve the pregnancy as the tube will not be able to withstand the growth of the fetus. This medication is only recommended if the ectopic pregnancy has not ruptured yet.
Surgery to remove the ectopic pregnancy may be recommended in order to prevent rupturing of the tube. If the woman would like to maintain fertility for the future, the surgeon can make a small incision on the tube to remove the fertilized egg, this is referred to as a salpingostomy.
If the mother is identified to be Rh negative, RhoGam is administered. The woman with an ectopic pregnancy is at risk for rupture of the tube and/or miscarriage. Therefore, RhoGam is necessary to prevent sensitization to the fetal antibodies for the Rh negative mother.
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