What happens if fallopian tube ruptures

Medical management of an ectopic pregnancy is with IM methotrexate. It is an anti-folate cytotoxic agent that disrupts the folate dependent cell division of the developing fetus. The pregnancy will then gradually resolve.

The ectopic should be unruptured , and without a visible heartbeat. The patient should have access to hour gynaecology services and be informed of the symptoms of rupture. In cases of tubal ectopics most common , a laparoscopic salpingectomy is usually performed — removing the ectopic and the tube that it is implanted in.

However, if there is damage to the contralateral tube from infection, disease or surgery, a salpingotomy a cut in the fallopian tube can be performed to remove the ectopic and salvage the tube to preserve future fertility. The risk of recurrent ectopic pregnancy in the salvaged tube will be increased. All rhesus negative women who receive surgical management of an ectopic pregnancy should be offered Anti-D prophylaxis.

Fig 4 — Laparoscopic view of ectopic pregnancy within the left fallopian tube red arrows. Uterus marked by blue arrows. Conservative management involves watchful waiting of the stable patient, while allowing the ectopic to resolve naturally. This is suitable in a small number of selected patients only, and is not the first line management.

This approach needs to be discussed at senior level. The patient should have access to hour gynaecology services and informed of the symptoms of rupture. An untreated ectopic pregnancy can lead to fallopian tube rupture. The resulting blood loss can cause hypovolaemic shock, resulting in organ failure and death. Endometriosis adhesion formation Intrauterine device or intrauterine system. Tubal ligation or occlusion Pelvic surgery — especially tubal surgery reversal of sterilisation.

Assisted reproduction i. If positive, a pelvic USS should be performed - this can determine the presence or absence of an intrauterine 'normal' pregnancy. In cases of tubal ectopics most common , a laparoscopic salpingectomy is usually performed - removing the ectopic and the tube that it is implanted in. Once you've finished editing, click 'Submit for Review', and your changes will be reviewed by our team before publishing on the site.

We use cookies to improve your experience on our site and to show you relevant advertising. To find out more, read our privacy policy. Risk Factors The risk factors for an ectopic pregnancy are shown in Table 1. Past Medical History Contraception Iatrogenic Previous ectopic pregnancy Pelvic inflammatory disease due to adhesion formation Endometriosis adhesion formation Intrauterine device or intrauterine system Progesterone oral contraceptive or implant due to fallopian tube ciliary dysmotility Tubal ligation or occlusion Pelvic surgery — especially tubal surgery reversal of sterilisation Assisted reproduction i.

Clinical Features The leading symptom of ectopic pregnancy is pain. Other symptoms include: Shoulder tip pain — the irritation of the diaphragm by blood in the peritoneal cavity leads to referred shoulder tip pain. This is because the diaphragm and the supraclavicular nerves which innervate the shoulder tip share the C3-C5 dermatomes. Vaginal discharge — brown in colour, classically described as being akin to prune juice.

This is the result of the decidua breaking down. Differential Diagnosis An ectopic pregnancy should always be considered in cases of abdominal pain in a woman of reproductive age.

However, its clinical features are largely non-specific , and can be seen in other conditions: Miscarriage Ovarian cyst accident this refers to cyst haemorrhage, torsion or rupture Acute pelvic inflammatory disease Urinary tract infection Appendicitis Diverticulitis By TeachMeSeries Ltd Sometimes the fertilized egg then implants in tissues outside of the uterus, resulting in an ectopic pregnancy.

Ectopic pregnancies usually develop in one of the fallopian tubes as a tubal pregnancy but may develop in other locations. A fetus in an ectopic pregnancy sometimes survives for several weeks. However, because tissues outside the uterus cannot provide the necessary blood supply and support, ultimately the fetus does not survive. The structure containing the fetus typically ruptures after about 6 to 16 weeks, long before the fetus is able to live on its own.

When an ectopic pregnancy ruptures, bleeding may be severe and even threaten the life of the woman. The later the structure ruptures, the worse the blood loss, and the higher the risk of death.

However, if an ectopic pregnancy is treated before it ruptures, the woman rarely dies. Risk factors conditions that increase the risk of a disorder for an ectopic pregnancy include. Previous pelvic inflammatory disease Pelvic Inflammatory Disease PID Pelvic inflammatory disease is an infection of the upper female reproductive organs the cervix, uterus, fallopian tubes, and ovaries.

Pelvic inflammatory disease is usually transmitted during A previous surgical procedure such as an abortion Abortion Induced abortion is the intentional ending of a pregnancy by surgery or drugs. A pregnancy may be ended by surgically removing the contents of the uterus or by taking certain drugs. Disrupting the tubes that carry sperm or the egg ends the ability to reproduce.

This form of contraception should An IUD is left in place for 3, 5, or 10 years, depending on the type, or until the Infertility Overview of Infertility Infertility is usually defined as the inability of a couple to achieve a pregnancy after repeated intercourse without contraception for 1 year.

Frequent intercourse without birth control usually Pregnancy is less likely to occur when an IUD is in place fewer than 1. However, if the tube is narrowed or blocked, the egg may move slowly or become stuck. The fertilized egg may never reach the uterus, resulting in an ectopic pregnancy. An ectopic pregnancy may be located in many different places, including a fallopian tube, an ovary, the cervix, and the abdomen.

Symptoms of ectopic pregnancy vary and may not occur until the structure containing the ectopic pregnancy ruptures. Most women have vaginal bleeding or spotting, cramping or pain in the lower abdomen, or both.

Menstrual periods may or may not be late or missed. Some women do not suspect that they are pregnant. The pregnancy then is absorbed by the body over 4—6 weeks. This does not require the removal of the fallopian tube. Methotrexate may be used if the pregnancy has not ruptured a fallopian tube.

Several factors go into the decision to use methotrexate. One of the most important factors is your ability to follow up with blood tests that check your blood levels of hCG. You will not be able to use methotrexate if you are breastfeeding or have certain health problems.

Methotrexate often is given by injection in one dose. Before you take methotrexate, blood tests will be done to measure the level of hCG and the functions of certain organs. If hCG levels have not decreased enough after the first dose, another dose of methotrexate may be recommended. You will have careful follow-up over time until hCG is no longer found in your blood. Taking methotrexate can have some side effects. Most women have some abdominal pain.

Vaginal bleeding or spotting also may occur. Other side effects may include:. It is important to follow up with your ob-gyn or other health care professional until your treatment with methotrexate is complete. The risk of a fallopian tube rupture does not go away until your treatment is over. Seek care right away if you have symptoms of a rupture, including sudden abdominal pain, shoulder pain, or weakness. Vitamins and foods that contain folic acid, including fortified cereal, enriched bread and pasta, peanuts, dark green leafy vegetables, orange juice, and beans.

These medications can affect the way methotrexate works in the body. Foods that produce gas, which can cause discomfort and mask the pain of a possible rupture of a fallopian tube. If the ectopic pregnancy has ruptured a tube, emergency surgery is needed. Sometimes surgery is needed even if the fallopian tube has not ruptured. In these cases, the ectopic pregnancy can be removed from the tube, or the entire tube with the pregnancy can be removed. Surgery typically is done with laparoscopy.

This procedure uses a slender, lighted camera that is inserted through small cuts in the abdomen. It is done in a hospital with general anesthesia. Your ob-gyn or other health care professional will talk with you about the possible side effects and risks of surgery for ectopic pregnancy. These may include pain, fatigue, bleeding, and infection. Whether you were treated with methotrexate or surgery, you may feel tired for several weeks while you recover. You may feel abdominal discomfort or pain.

If you have pain that does not respond to over-the-counter medication, talk with your ob-gyn or other health care professional. It can take time for the level of hCG in your body to drop after treatment for an ectopic pregnancy. You may continue to feel pregnant for a while. It may take a few cycles for your periods to return to normal.