Embarazo Ectópico Accidentado mas Shock Hipovolémico

Abstract

Ectopic pregnancy is defined as the implantation of the fertilized egg outside the uterine cavity. In Ecuador, according to data released by the INEC in 2014, ectopic pregnancy is the fourth leading cause of maternal death with a result of 6.02%. The most common location of ectopic pregnancy is in the fallopian tube. There are multiple factors related to ectopic pregnancy and the prevalence of such factors is increasing, it correlates with a history of sexually transmitted diseases, ectopic pregnancy, tubal surgery, adult women and snuff disease. It is one of the most important causes of acute abdomen in obstetrics and despite progress in diagnostic and therapeutic methods, ectopic pregnancy continues to represent worldwide problem of maternal morbidity and mortality in the first trimester of pregnancy.

This case describes a female patient of 29 years old with no medical history of importance, date of last menstruation know, go to the emergency room because of abdominal pain for about 2 hours, accompanied by tachycardia, hypotension and generalized pallor. Laboratory tests which report leukocytosis, decreased hemoglobin, hematocrit and positive BHCG are made. In addition to reporting abdominal ultrasound performed rugged ectopic pregnancy. Patient is assessed by emergency obstetric resulting test income is decided to surgical center for emergency laparotomy for ectopic pregnancy injured more hypovolemic shock finding free bleeding cavity more clots approximately 3000 milliliters, is administered crystalloid and packed red blood cells plus thereby controls the patient hemodynamically. Approximately 24 hours after the patient has difficulty breathing and chest x-ray desaturation is valued by internal medicine and cardiology who diagnostic acute pulmonary edema, treatment is established it is done. Patient course and is discharged 5 days later.

Despite scientific advances in diagnosis, prevention and treatment of this disease is still left unnoticed patients of this kind, either suspicion at the time of care, delay in referral to areas of higher resolution, or perhaps for lack diagnostic tools that enable us to reach a concrete analysis quick and timely manner, it is important to consider the relevance of the investigation of this case report that aims to create a clear and precise understanding of the diagnosis and management of ectopic pregnancy for early intervention, for the benefit of the patient.