Interventions for tubal ectopic pregnancy
RHL practical aspects by Mignini L
FIRST CONTACT (PRIMARY CARE) LEVEL
Ectopic pregnancy should always be considered in the differential diagnosis of women of reproductive age presenting with lower abdominal pain, and abnormal vaginal bleeding with or without a missed period. Ideally, primary health care clinics, outpatient, and emergency clinics should have access to sensitive urine hCG tests in order to initiate the diagnostic algorithm to be applied in any suspicious case of early ectopic pregnancy. Patients with results supporting the possible existence of an early ectopic pregnancy should be referred.
REFERRAL HOSPITAL (SECONDARY CARE) LEVEL
Diagnostic ultrasound facilities should be available to confirm the diagnosis of ectopic pregnancy. Facilities should be fully equipped with an operative laparoscope, a blood bank, and a 24-hour operating theatre as well as gynecologists who are well trained to confirm the diagnosis of early ectopic pregnancy and treat this entity medically as well as laparoscopically (laparotomically in the absence of equipment or skilled surgeons).
AT HOME OR IN THE COMMUNITY
Sources of support: Centro Rosarino de Estudios Perinatales, Rosario, Argentina.
This document should be cited as: Mignini L. Interventions for tubal ectopic pregnancy: RHL practical aspects (last revised: 26 September 2007 The WHO Reproductive Health Library; Geneva: World Health Organization.