Which of the following treatment is not done in ectopic pregnancy :
Correct Answer: Salpingo-oophorectomy
Description: Ans. is b i.e. Salpingo Oophorectomy Surgiclt management of Ectopic pregnancy (laparoscopv nr lannrotomy) Conservative surgery Radical surgery Salpingostomy : It is the procedure of choice when the patient is hemodynamcially stable and wishes to retain her future feility Done to remove a small pregnancy less than 2 cm in length and located in the distal third of the fallopian tube- (William 22/e, p 261, 23/e, p 246) The recommended surgical procedure for ampullary ectopic pregnancy. Salpingotomy : Seldom done now-a-days Segmental resection and anastomosis : It is done in case of isthmic pregnancy. Fimbrial expression of the ectopic pregnancy : Risk of recurrence of ectopic pregnancy are high therefore not commonly performed. Salpingectomy Indications The patient has completed her family, The tubes are grossly damaged Ectopic pregnancy has recurred in a tube already treated conservatively. Uncontrolled bleeding Salpingo-oophorectomy i.e. removal of tubes along with the ovaries is not recommended in young patients "Presently salpingo-oophorectomy is never recommended unless the ovary itself is grossly diseased or damaged". "The ipsilateral ovary and its vascular supply is preserved. Oophorectomy is done only if the ovary is damaged beyond salvage or is pathological". Extra Edge : Following surgical I medical management : Estimation of J3HCG should be done weekly till the values become less than 5mlU/ml. Additional monitoring by TVS is preferred. This is done to rule out persistent ectopic pregnancy due to incomplete removal of trophoblast (in such a case single dose methotrexate 1 mg/kg should be given).
Category:
Gynaecology & Obstetrics
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