1. Ectopic pregnancy and the possibility to carry a child for the full period of pregnancy Nikola Skálová, 3.B Brno 2014

2. Content General introduction Statistical data Casuistry Graviditas extrauterina -the most frequent sudden abdominal incident -occurrence in ratio 1:80 -1% lethality

3. Kinds of ectopic pregnancy  tubarian pregnancy (graviditas extrauterina tubaria) - formation in the oviduct  ovarian pregnancy (graviditas extrauterina ovarialis) – formation on the ovary

4.  Abdominal pregnancy (graviditas extrauterina abdominalis) Formation: -implantation directly to the abdominal organs, mummification, stone fetus -the subsequent relocating from the oviduct into the abdominal cavity Rare species: - in the uterine throat - in the scar after the surgery cut on the uterus - multiple ectopic pregnancy

5. Causes of occurrence and development - infection -contraceptive intrauterine device - tubal adhesions and defects - methods of assisted reproduction - age According to the implantation place and vitality of trophoblast 3 development possibilities: - embryo dies → is absorbed -embryo grows → ruptured oviduct -embryo relocation into the abdominal cavity

6. Symptoms and diagnostic methods - pains, unconsciousness and pain in the shoulders -advanced state: severe pains, bleeding into the abdominal cavity, hemorrhagic shock Diagnostic methods : - case history -examinations: - gynaecological - laboratory - HCG (human chorionic gonadotropin) - control its levels - doubling of the HCG - ultrasound

7. Treatment and consequences -conservative -surgical - salpingectomy = surgical removal of oviduct -according to the clinical condition of the patient and the location of the fetus

8. Ectopic pregnancy in statistics - University Hospital Brno, the Obilní trh Obstetrics Clinic, for the period of the years 2011 and 2012 - the list of operations – „Operating book“ -for the period of the years 2011 and 2012: tubal ectopic pregnancy only -surgical solution: in the year 2011: 42 cases in the year 2012: 63 cases

9. Full-term baby from abdominal pregnancy -ectopic gravidity wasn´t found -live baby : 2600 g and 48 cm -baby seated freely in the abdomen just in the amniotic sac -newborn baby: no abnormalities, Apgar score 10 Casuistry

10. Interview with one of the gynaecologists participating in the birth -ectopic pregnancy wasn´t found even through all the examinations -full-term ectopic pregnancy is more frequent in developing countries (missing diagnostics) -during the birth, by the caesarean section, was found a fetus in abdominal cavity - only in amniotic sac -many risks -> ectopic pregnancy is always terminated -full-term babies: frequently deformations

11. Authentic medical documents and daily press Daily press Mladá fronta Daily press Rovnost ultrasound images : 16.week of pregnancy 5.Month of pregnancy

12. Daily press Super

13. Thank You for Your attention!