Title Ektopična trudnoća i uloga primalje u dijagnostici i liječenju Title (english) Ectopic pregnancy and the role of a midwife in diagnosis and treatment Author Katarina Mamić Mentor Nađa Aračić (mentor)Committee member Mario Marendić (predsjednik povjerenstva)Committee member Matea Dolić (član povjerenstva)Committee member Nađa Aračić (član povjerenstva)Granter University of Split Defense date and country 2021-07-16, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Ektopična trudnoća je stanje u kojem se trudnoća implantira izvan šupljine maternice. Najčešća pojavnost je u jajovodu. Ostale lokacije na kojima se može pronaći su na jajniku, u rodnici, peritoneumu abdominalne šupljine ili rudimentarnom rogu maternice. Ektopična trudnoća ima specifične znakove i simptome ovisno pojavljuje li se u akutnom ili subakutnom obliku. U akutnom obliku dolazi do izrazite boli u napetom trbuhu, znakova hemoragičnog šoka i boli u ramenima radi nakupljanja krvi ispod ošita. Kod subakutnog oblika prisutno je točkasto krvarenje i amenoreja. Asimptomatski ili ‘’tihi’’ oblik ektopične trudnoće je specifičan jer se takva trudnoća vodi kao uredna, s jedinim simptomom amenoreje. Trijasom simptoma ektopične trudnoće se smatra amenoreja, bol i vaginalno krvarenje. Rana dijagnostika je važna za pravilno liječenje takvih trudnoća. Dijagnoza ektopične trudnoće postavlja se na temelju kliničkog, anamnestičkog, ultrazvučnog i biokemijskog nalaza. U nejasnim situacijama kiretaža i kuldocenteza dolaze u obzir. Punkcije Douglasovog prostora se danas u potpunosti zamijenila s laparoskopijom. Liječenje se provodi ekspektativnim, medikamentoznim i kirurškim putem. Ekspektativnim načinom liječenja nadzire se vitalno stanje pacijentice i uočavaju se promjene. U medikamentoznom načinu liječenja u najvećem broju slučajeva koristi se metotreksat. Najbolji izbor kod kirurškog liječenja ektopične trudnoće je laparoskopija. Izvantubarne ektopične trudnoće su iznimno rijetke i čine samo 5% svih ektopičnih trudnoća. I na samome kraju, da bi se dijagnoza ektopične trudnoće uspješno provela bitna je suradnja primalje i liječnika. Iako primalja samostalno ne može odlučivati o postupcima koji će se vršiti kod pacijentice ona upućuje liječnika na to. U daljnjem dogovoru s liječnikom zajednički dolaze do zaključka što bi bilo najbolje za pacijenticu da bi osigurali najbolji mogući ishod.
Abstract (english) Condition in which a pregnancy is implanted outside the uterine cavity is called ectopic pregnancy. The most common occurrence is in the Fallopian tube. Other locations where it can be found are on the ovary, in the vagina, the peritoneum of the abdominal cavity or the rudimentary horn of the uterus. Ectopic pregnancy has specific signs and symptoms depending on whether it occurs in acute or subacute form. In the acute form, there is marked pain in the tense abdomen, signs of hemorrhagic shock and pain in the shoulders due to the accumulation of blood under the shield. In the subacute form, spotting and amenorrhoea are present. The asymptomatic or \"silent\" type of ectopic pregnancy is explicit on the grounds that such a pregnancy is treated as should be expected, with the solitary side effect of amenorrhoea. The ternion of manifestations of ectopic pregnancy is viewed as amenorrhoea, torment and vaginal dying. Early conclusion is significant for the appropriate treatment of such pregnancies. The conclusion of ectopic pregnancy is made based on clinical, anamnestic, ultrasound and biochemical discoveries. In unclear situations, curettage and culdocentesis are considered. Douglas space punctures have today been completely replaced by laparoscopy. Treatment is carried out by expectoration, medication and surgery. The patient's vital condition is monitored by an exhaustive method of treatment and changes are noticed. In most cases, methotrexate is used in medical treatment. The best choice in the surgical treatment of an ectopic pregnancy is laparoscopy. Extrauterine ectopic pregnancies are very uncommon and record for just 5% of every ectopic pregnancy. And finally, in order to successfully diagnose an ectopic pregnancy, the cooperation of a midwife and a doctor is essential. Although the midwife cannot independently decide on the procedures to be performed on the patient, she refers the doctor to do so. In further agreement with the doctor, they come to a joint conclusion on what would be best for the patient to ensure the best possible outcome.
Keywords
ektopična trudnoća
dijagnostika
liječenje
primalja
Keywords (english)
ectopic pregnancy
diagnosis
treatment
midwife
Language croatian URN:NBN urn:nbn:hr:176:989693 Study programme Title: Midwifery (university/undergraduate) Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2021-07-16 07:36:06
