Ectopic Pregnancy – The Trainees Perspective
Over the past seven years of my training in Obstetrics and Gynaecology, I have worked at a number of different units, both in District General Hospitals and Tertiary Centres, across the North West Thames region. In each hospital, I have been involved in the management of ectopic pregnancy on a frequent basis. Although there tend to be minor variations in local practice, the mainstay of diagnosis and treatment of ectopic remains the same.
A trainee’s involvement can be at any stage in the process, from the initial consultation with a patient with a suspected ectopic, to confirmation of the diagnosis and subsequent management of the condition. Reaching the diagnosis may not be straightforward, and it may involve a combination of careful history taking and examination, ultrasound, blood tests and sometimes even a diagnostic laparoscopy.
Once the diagnosis of an ectopic has been reached, careful counselling is required in order to discuss the various treatment options which include conservative management, medical treatment or surgery in the form of operative laparoscopy and, occasionally, laparotomy.
The Ectopic Pregnancy Foundation provides useful help for all trainees, in the form of written information on the website and videos of laparoscopic treatment of ectopic pregnancy. The Foundation also runs a course which provides up-to-date, informative lectures on the diagnosis and treatment of ectopic pregnancy, along with plenty of opportunity for hands-on use of the laparoscopic skills stations. This provides a fantastic chance to acquire and hone laparoscopic techniques under careful guidance and supervision. The course leaves trainees in a much more confident position to deal with ectopic pregnancy, and provides a valuable aid to the surgical techniques involved in their management.
After attending the course myself, my ability to manage ectopic pregnancies improved and I felt more confident in dealing with the previously daunting prospect of operative laparoscopy as treatment.
As a trainee in Obstetrics and Gynaecology, I know that I may have to manage an ectopic pregnancy at any time of the day or night, possibly in an emergency situation, with or without direct supervision. The Foundation’s website and course have helped me to prepare for those eventualities and as such have contributed in a positive way to my training.