What are complications of ruptured ectopic pregnancy, except?

Appeared in: NIMHANS Nursing Officer - 2021

Explanation

A ruptured ectopic pregnancy causes massive internal hemorrhage, leading to a significant loss of circulating blood volume.
This blood loss results in hypovolemic shock, a primary sign of which is a severe drop in blood pressure, known as hypotension.
Hypertension, or high blood pressure, is the opposite of the expected hemodynamic response and is therefore not a complication of a ruptured ectopic pregnancy.

Option A: Hypotension (low blood pressure) is a hallmark sign of a ruptured ectopic pregnancy. It is caused by severe internal bleeding leading to hypovolemic shock.
Option B: Bleeding, specifically life-threatening intra-abdominal hemorrhage, is the primary and most dangerous complication of a ruptured ectopic pregnancy.
Option C: Severe, sharp, unilateral lower abdominal pain is characteristic of the rupture itself. Referred shoulder pain (Kehr's sign) occurs when the internal bleeding irritates the diaphragm.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestations and complications of ruptured ectopic pregnancy as background academic context rather than a clinical decision trigger.
A ruptured ectopic pregnancy is a surgical emergency. Nurses must recognize the signs of hypovolemic shock (hypotension, tachycardia, pallor, dizziness) and act quickly.
Immediate nursing interventions include establishing two large-bore IV lines for rapid fluid and blood product resuscitation, administering oxygen, and continuously monitoring vital signs while preparing the patient for emergency surgery.
Patient safety is paramount. A gentle abdominal and pelvic examination is crucial, as vigorous palpation could worsen the rupture or cause a contained rupture to bleed more heavily.

How to Approach the Question

First, identify that the question uses the word "except." This means you are looking for the option that is NOT a true complication.
Recall the pathophysiology of a ruptured ectopic pregnancy: a tear in the fallopian tube leads to massive internal bleeding.
Think through the consequences of massive internal bleeding: What happens to blood pressure? (It drops - hypotension). What is the primary event? (Bleeding). What symptoms does internal blood cause? (Abdominal pain and referred shoulder pain).
Evaluate each option against this understanding.
Option A (Hypotension): True, due to blood loss.
Option B (Bleeding): True, this is the main problem.

Concept Tested & Keywords

Concept Tested: Clinical manifestations and complications of ruptured ectopic pregnancy.
Stem keywords: ruptured ectopic pregnancy, complications
Lead-in keywords: except
Negative lead-in flag: Question asks for the exception

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E6 Obstetrics Williams pp. 19-34, 18-33

E6 Medicine Harrison 22e Part 2 p. 1040-1042

Practise the full NIMHANS Nursing Officer - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.