LIST B PERSPECTIVE : Impact on individual patient or community
Ectopic pregnancy occurs when a fertilized egg implant at any site other than the normal uterine location. This is common in 1% of pregnancies. (kumar) Late diagnosis and treatment my lead to the death of the fetus.(1) The most common site for ectopic pregnancy is fallopian tube ( approximately 97.7%), with 80% usually occurring in the ampulla followed by isthmus (12%),fimbrae (5%), cornua (2%) and interstitia (2-3%).
Sites and frequencies of ectopic pregnancy. By Donna M. Peretin, RN. (A) Ampullary, 80%; (B) Isthmic, 12%; (C) Fimbrial, 5%; (D) Cornual/Interstitial, 2%; (E) Abdominal, 1.4%; (F) Ovarian, 0.2%; and (G) Cervical, ...view middle of the document...
Grieving process such as anger, guilt, sadness and self blame should always be expressed and acknowleged. As we can see, Mrs B is still not pregnant although she has been trying for several years. She did five cycles of IVF, but the results were negative. She had a history of two ectopic pregnancies in previous years and this was considered her third. Her right fallopian tube was removed due to her previous ectopic pregnancy. Therefore, her chances to get pregnant is reduced. According to her, it is really depressing to hear the news that she has to remove the conception as it will be harmful to her. Sometimes, she wished she could do something about it.
• A study done shows that 8% to 14% women involved had a history of previous ectopic pregnancy. Several case studies have demonstrated an elevated risk among women with a history of prior ectopic pregnancies, with a seven-to nicefold adjusted ratio. (arrange) . Women who have had two or more ectopic pregnancies in the past are over 70 times more likely to develop an ectopic pregnancy in the future. ( myvmc). Not only that, a study shows that the risk of ectopic pregnancy increases three times more in women who had experienced more than three miscarriages before compared to those who have never experienced it before. (myvmc) Therefore, according to Mrs B case, the outbreak she went through after knowing that she had ectopic pregnancy was less this time compared to the past because she knew she was a high risk patient after having two previous ectopic pregnancies and a right salpingectomy in 2010. She even had three miscarriages before and this includes her in the group of high risk patients. The doctor has informed her before about her increase risk and she still agrees to go on with this pregnancy hoping a miracle might happen.
It was devastating when she came to realise she had vaginal bleeding and knew that something was wrong with her pregnancy again. However, she was keeping her finger crossed and hoping that it will not be an ectopic pregnancy this time, although she knew that was the most likely diagnosis due to her previous experience.