What is ectopic pregnancy puncture

When ectopic pregnancy occurs, many people are not clear about their specific conditions. This can easily lead to missing the best time for treatment, causing various complications in their bodies, which will affect their normal pregnancy in the future. In this case, ectopic pregnancy puncture is needed. This treatment method is very effective and can be used for treatment and testing, so that your body will not be too damaged.

Ectopic pregnancy puncture is actually vaginal posterior fornix puncture (culdocentesis), which can extract blood, fluid and pus accumulated in the rectouterine pouch in the abdominal cavity, and perform visual observation, laboratory testing, and pathological examination. It is also used for egg retrieval.

Indications

1. When intra-abdominal bleeding is suspected, such as ectopic pregnancy, ovarian corpus luteum rupture, etc.

2. When there is suspected fluid or pus accumulation in the pelvic cavity, a puncture and fluid extraction examination can be performed to understand the nature of the effusion. Puncture and drainage of pelvic abscesses and local injection of drugs can also be performed.

3. Egg retrieval through the posterior fornix of the vagina under the guidance of B-ultrasound is used for various assisted reproductive technologies.

Contraindications

1. Severe pelvic adhesions, the rectouterine pouch is completely occupied by a large mass and has bulged into the rectum.

2. Suspected adhesion between the intestine and the posterior wall of the uterus.

3. Clinical suspicion of malignancy.

4. When preparing for non-surgical treatment of ectopic pregnancy, puncture should be avoided to avoid infection.

Procedure

The patient empties his bladder, takes the lithotomy position, and routinely disinfects the vulva and lays a drape. The speculum is used to fully expose the cervix and posterior vaginal fornix and then disinfected. Use a cervical clamp to clamp the posterior lip of the cervix and pull it forward to fully expose the posterior fornix of the vagina, and disinfect it again.

Use the puncture needle to insert parallel to the cervical canal in the center of the posterior fornix or slightly to the affected side, slightly below the junction of the posterior vaginal wall and the posterior lip of the cervix. When the needle passes through the vaginal wall, aspirate immediately after a feeling of emptiness (the needle is inserted about 2-3 cm deep). If necessary, change the direction and depth of the puncture needle. If no liquid is extracted, withdraw the needle while aspirating.

After suction, remove the needle, take out the cervical forceps, apply pressure with a cotton ball for a while, and remove the vaginal speculum after the bleeding stops.

Nursing measures

1. During the operation, the changes in the pregnant woman's vital signs should be closely observed and the pregnant woman's chief complaint should be taken seriously.

2. During puncture, pay attention to the direction or depth of needle insertion to avoid damaging pelvic organs.

3. Pay attention to the properties and color of the extracted liquid to see if there is any agglutination. If the drawn blood is bright red and coagulates, it is intravascular blood; if it is dark red and does not coagulate, it is intra-abdominal bleeding. The drawn fluid should be sent for examination in time.

4. Pay attention to vaginal bleeding and keep the vulva clean.

If an ectopic pregnancy ruptures, it will bleed and the blood will flow into the posterior fornix peritoneal cavity. The peritoneum has the function of defibrinating the blood, so it can hinder blood coagulation. If the blood coming out of the fornix puncture is not coagulated, it can be determined that the blood drawn comes from the pelvic cavity rather than the blood vessels. Therefore, the purpose of posterior fornix puncture for patients suspected of ectopic pregnancy is to be able to clearly diagnose whether it is an ectopic pregnancy.