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Ime ime

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Intra-abdominal fetus being delivered.

Ime ime bụ nsogbu nke ime ime ime nke nwa e bu n'afọ na-ejikọta n'èzí akpa nwa.[1] Ihe ịrịba ama na mgbaàmà na-agụnye Ihe mgbu afọ na ọbara ọgbụgba n'ahụ nwanyị, mana ihe na-erughị pasent 50 nke ụmụ nwanyị nwere nsogbu nwere mgbaàmà abụọ a.[2] Enwere ike ịkọwa ihe mgbu ahụ dị ka ihe dị nkọ, nke na-adịghị mma, ma ọ bụ nke na-esi ísì ụtọ.[2] Ihe mgbu nwekwara ike ịgbasa n'ubu ma ọ bụrụ na ọbara ọgbụgba aghara n'ime afọ emeela.[2] Ọbara ọgbụgba siri ike nwere ike ịkpata obi ịkụsi ike, ịda mbà, ma ọ bụ nkụda mmụọ.[1][2] Ewezuga ihe ndị a na-adịghị ahụkebe, nwa e bu n'afọ enweghị ike ịdị ndụ.[3]

N'ozuzu, ime ime ectopic kwa afọ na-emetụta ihe na-erughị 2% nke ime ime n'ụwa niile.[1]Ihe ize ndụ maka ime ime ime ectopic gụnyere Ọrịa ọzịza pelvic, mgbe mgbe n'ihi Ọrịa chlamydia; ịṅụ sịga; endometriosis; ịwa ahụ tubular tupu; akụkọ ihe mere eme nke enweghị ike ịmụ nwa; na iji teknụzụ inye aka.[4] Ndị nwere afọ ime ectopic n'oge gara aga nọ n'ihe ize ndụ dị elu nke inwe ọzọ.[2] Ọtụtụ afọ ime ectopic (90%) na-ewere ọnọdụ na tube fallopian, nke a maara dị ka afọ ime tubal, mana itinye ya nwekwara ike ime na cervix, ovaries, caesarean scar, ma ọ bụ n'ime afọ.[2][2] Nchọpụta nke ime ime ime ectopic na-abụkarị site na nyocha ọbara maka gonadotropin chorionic mmadụ (hCG) na ultrasound.[3] Nke a nwere ike ịchọ nnwale n'ihe karịrị otu oge.[3] Ihe ndị ọzọ na-akpata mgbaàmà ndị yiri ya gụnyere: ime ọpụpụ, ovarian torsion, na appendicitis siri ike.[3][2]

Prevention is by decreasing risk factors such as chlamydia infections through screening and treatment.[5] While some ectopic pregnancies will miscarry without treatment,[4] the standard treatment for ectopic pregnancy is a procedure to either remove the embryo from the fallopian tube or to remove the fallopian tube all together. The use of the medication methotrexate works as w

ell as surgery in some cases.[4] Specifically it works well when the beta-HCG is low and the size of the ectopic is small.[4] Surgery such as a salpingectomy is still typically recommended if the tube has ruptured, there is a fetal heartbeat, or the woman's vital signs are unstable.[4] The surgery may be laparoscopic or through a larger incision, known as a laparotomy.[1] Maternal morbidity and mortality are reduced with treatment.[4]

Ọnụ ọgụgụ nke ime ime ime bụ ihe dị ka 11 ruo 20 n'ime 1,000 ọmụmụ dị ndụ na mba ndị mepere emepe, ọ bụ ezie na ọ nwere ike ịdị elu dị ka 4% n'etiti ndị na-eji teknụzụ enyemaka.[1] Ọ bụ ihe a na-ahụkarị na-akpata ọnwụ n'etiti ụmụ nwanyị n'oge atọ mbụ na ihe dịka 6-13% nke ngụkọta.[4] N'ime mba ndị mepere emepe, nsonaazụ emepe emeela ka ọ dị mma ebe ha nọ na mba ndị na-emepe emepe na-anọkarị ogbenye.[5] Ihe ize ndụ nke ọnwụ n'etiti ndị nọ n'ụwa mepere emepe dị n'etiti 0.1 na 0.3 percent ebe na mba ndị na-emepe emepe ọ dị n'agbata otu na pasent atọ.[6] Nkọwa mbụ a maara banyere ime ime ime bụ nke Al-Zahrawi na narị afọ nke iri na otu.[3] Okwu ahụ bụ "ectopic" pụtara "n'ebe na-adịghị". [7]

Ihe ịrịba ama na mgbaàmà

[dezie | dezie ebe o si]

Ihe ruru 10% nke ndị nwere ime ime ime na-enweghị mgbaàmà, otu ụzọ n'ụzọ atọ enweghị mgbaàmà ahụike.[1] N'ọtụtụ ọnọdụ, mgbaàmà ndị ahụ nwere obere nkọwa, ma nwee ike ịdị ka nke nsogbu ndị ọzọ na-emetụta akụkụ ahụ nwanyị na eriri afọ, dị ka appendicitis, salpingitis, rupture of a corpus luteum cyst, miscarriage, ovarian torsion ma ọ bụ ọrịa urinary tract.[1] Ngosipụta ahụike nke ime ime ime ectopic na-ewere ọnọdụ na nkezi nke izu 7.2 mgbe oge nsọ ikpeazụ gasịrị, na-agbata izu anọ na asatọ. Ihe ngosi ndị ọzọ na-adịkarị n'obodo ndị na-enweghị ikike nchọpụta nke oge a.

Ihe ịrịba ama na mgbaàmà nke ime ime ime ectopic gụnyere mmụba nke hCG, ọbara ọgbụgba n'ahụ nwanyị (n'ọ̀tụ̀tụ̀ dịgasị iche iche), ihe mgbu dị ala n'afọ, [1] ihe mgbu pelvic, ihe mgbu cervix, adnexal mass, ma ọ bụ ihe mgbu adnexal. [2] Na enweghị nyocha ultrasound ma ọ bụ hCG, ọbara ọgbụgba siri ike n'ahụ nwanyị nwere ike iduga na nchọpụta na-ezighi ezi nke ime ọpụpụ.[1] Ọrịa agbọ onunu, ịgbọ agbọ na afọ ọsịsa bụ ihe mgbaàmà ndị a na-adịghị ahụkebe nke ime ime ime.[1][1]

Nkwụsị nke ime ime ime ectopic nwere ike iduga na mgbaàmà ndị dị ka afọ mgbu, ịdị nro, peritonism na hypovolemic shock.[1] Onye nwere ime ime ime ectopic gbawara agbawa nwere ike inwe ihe mgbu mgbe ọ na-edina ala ma nwee ike ịhọrọ ịnọgide na-eguzo ọtọ dịka ọbara intrapelvic nwere ike ibute ọzịza nke oghere afọ ma kpatara ihe mgbu ọzọ.[8]

Nsogbu

[dezie | dezie ebe o si]
Ọbara dị n'Akpa Morrison n'etiti imeju na akụrụ n'ihi ime ime ectopic gbawara

Nsogbu kacha SI nu nu rupture nke obara na agba n'ime ahu nke nwere Ike ebute hypovolemic shock. Emebe fallopian tube nwere Ike ebute atughi ime n'odi n'ihu. Fallopian tube umunwaanyi ndi ozi ga na aro ofuma n'ibu afo ime. Oburu na nwaanyi wepu fallopian tube ya meberi emebe oga di one nodi n'ihu. Oburu ma ewepu ha abuo in-vitro fertilization nani ka nwanyi ga esi were di ime. [9] [10][11]

Ihe Ndị Na-akpata ya

[dezie | dezie ebe o si]

E nwere ọtụtụ ihe ize ndụ maka ime ime ime. Otú ọ dị, n'ime ihe ruru otu ụzọ n'ụzọ atọ [12] ruo ọkara [13] ọ dịghị ihe ize ndụ a ga-achọpụta. Ihe ndị dị ize ndụ gụnyere: Ọrịa ọzịza pelvic, enweghị ike ịmụ nwa, iji Ngwaọrụ intrauterine (IUD), ikpughe diethylstilbestrol (DES), ịwa ahụ tubal, ịwa ahụ intrauterine, ịwapụta intrauterine: dịka D&C), ịṅụ sịga, ime ime ectopic gara aga, endometriosis, na Njikọ tubal.[14][15] Isikwopụ afọ ime a na-akpata n'oge gara aga apụtaghị na ọ na-eme ka ite ime ndụ ahụ dịkwuo elu.[16] IUD anaghị eme ka ihe ize ndụ nke ime ime ime dịkwuo elu, mana na IUD ma ọ bụrụ na ime ime emee, o yikarịrị ka ọ ga-abụ ime dịkọrọ ala karịa intrauterine.[17] Ihe ize ndụ nke ime ime ime ectopic mgbe ọrịa chlamydia gasịrị dị ala.[18] Ezigbo usoro nke chlamydia na-eme ka ihe ize ndụ nke ime ime ime dị elu ejighị n'aka, ọ bụ ezie na ụfọdụ nnyocha na-atụ aro na ọrịa ahụ nwere ike imetụta ọdịdị nke tubes fallopian.[19]

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 (2014) "Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location". Human Reproduction Update 20 (2): 250–61. DOI:10.1093/humupd/dmt047. PMID 24101604.  Kpọpụta njehie: Invalid <ref> tag; name "kirk2013" defined multiple times with different content
  2. ↑ 2.0 2.1 2.2 2.3 (April 2013) "Does this woman have an ectopic pregnancy?: the rational clinical examination systematic review". JAMA 309 (16): 1722–9. DOI:10.1001/jama.2013.3914. PMID 23613077.  Kpọpụta njehie: Invalid <ref> tag; name "Crochet2013" defined multiple times with different content
  3. ↑ (2008) "Full-term abdominal pregnancy: a case report and review of the literature". Gynecologic and Obstetric Investigation 65 (2): 139–41. DOI:10.1159/000110015. PMID 17957101. 
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 (September 2014) "Methotrexate for ectopic pregnancy: when and how". Archives of Gynecology and Obstetrics 290 (3): 417–23. DOI:10.1007/s00404-014-3266-9. PMID 24791968.  Kpọpụta njehie: Invalid <ref> tag; name "Cec2014" defined multiple times with different content
  5. ↑ 5.0 5.1 (April 2009) "Tubal ectopic pregnancy: diagnosis and management". Archives of Gynecology and Obstetrics 279 (4): 443–53. DOI:10.1007/s00404-008-0731-3. PMID 18665380. 
  6. ↑ Mignini L (26 September 2007). Interventions for tubal ectopic pregnancy. who.int. The WHO Reproductive Health Library. Archived from the original on 2 April 2015. Retrieved on 12 March 2015.
  7. ↑ Cornog (1998). Merriam-Webster's vocabulary uilder. Springfield, Mass.: Merriam-Webster. ISBN 9780877799108. 
  8. ↑ (December 2011) "A new clinical sign in ruptured ectopic pregnancy". Lancet 378 (9809): e27. DOI:10.1016/s0140-6736(11)61901-6. PMID 22177516. 
  9. ↑ Ectopic pregnancy. Archived from the original on 28 August 2021. Retrieved on 4 December 2018.
  10. ↑ (2007) Pediatric clinical advisor : instant diagnosis and treatment, 2, Mosby Elsevier, 180–181. ISBN 978-0-323-03506-4. 
  11. ↑ (February 2000) "Ectopic pregnancy". American Family Physician 61 (4): 1080–8. PMID 10706160. 
  12. ↑ (2005) "Ectopic pregnancy". Lancet 366 (9485): 583–91. DOI:10.1016/S0140-6736(05)67103-6. PMID 16099295. 
  13. ↑ (June 2007) "Ectopic pregnancy--an analysis of 180 cases". Journal of the Indian Medical Association 105 (6): 308, 310, 312 passim. PMID 18232175. 
  14. ↑ BestBets: Risk Factors for Ectopic Pregnancy. Archived from the original on 2008-12-19.
  15. ↑ (October 2013) "Ectopic pregnancy: a review". Archives of Gynecology and Obstetrics 288 (4): 747–57. DOI:10.1007/s00404-013-2929-2. PMID 23793551. 
  16. ↑ (2011) "16 Answering questions about long term outcomes", Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care. John Wiley & Sons. ISBN 9781444358476. 
  17. ↑ (November 2015) "Tubal ectopic pregnancy". BMJ Clinical Evidence 2015. PMID 26571203. 
  18. ↑ (February 2008) "Chlamydia trachomatis and ectopic pregnancy: recent epidemiological findings". Current Opinion in Infectious Diseases 21 (1): 77–82. DOI:10.1097/QCO.0b013e3282f3d972. PMID 18192790. 
  19. ↑ (October 2011) "Diagnosis and management of ectopic pregnancy". The Journal of Family Planning and Reproductive Health Care 37 (4): 231–40. DOI:10.1136/jfprhc-2011-0073. PMID 21727242. 
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