Extrauterin graviditet, ektopisk graviditet
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Birgitta Segebladh
Definition:
Implantation av befruktat ägg utanför uterus. Ägget kan vara beläget i äggledare, äggstockar, cervix eller bukhåla.
Förekomst:
Uppskattad prevalens är 1–2 % av alla graviditeter.
Symtom:
Den typiska symtomtriaden är utebliven menstruation, smärta och sparsam vaginalblödning i 6–8:e graviditetsveckan.
Kliniska fynd:
Vanligen blödning, ömhet och lokal svullnad. Intraabdominal blödning kan ibland leda till blödningschock.
Diagnostik:
hCG är vanligtvis förhöjt och transvaginalt ultraljud bekräftar oftast diagnosen.
Behandling:
Behandlingsval beror på klinik, lokalisering, grad av tubaskada och anatomiska förhållanden i bäckenet. Ofta behövs laparoskopisk kirurgi, men i vissa fall räcker läkemedelsbehandling.
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- Nuvarande Birgitta Segebladh, med dr och mödrahälsovårdsöverläkare i Uppsala län
- Tidigare Kjell Åsmund Salvesen, överläkare Kvinneklinikken St. Olavs Hospital. Professor i obstetrik och gynekologi, NTNU Ingard Løge, specialist inom allmänmedicin, redaktör NEL Per Bergsjø, professor emeritus, dr. med., Universitetet i Bergen. Specialist i kvinnosjukdomar och förlossningshjälp, forskare vid Nasjonalt folkehelseinstitutt, Oslo Åsa Rytter Evensen, dr. med., specialist i allmänmedicin, Røa Helsesenter, Oslo kommune Inger Marie Steinsholt, specialist i allmänmedicin, A/S Legekontoret, Kongsberg