Managing Any Problems

Problems Reported as Complications

Problems affect women’s satisfaction with female sterilization. They deserve the provider’s attention. If the client reports complications of female sterilization, listen to her concerns and, if appropriate, treat.

• Clean the infected area with soap and water or antiseptic.
• Give oral antibiotics for 7 to 10 days.
• Ask the client to return after taking all antibiotics if the infection has not cleared.

• Clean the area with antiseptic.
• Cut open (incise) and drain the abscess.
• Treat the wound.
• Give oral antibiotics for 7 to 10 days.
• Ask the client to return after taking all antibiotics if she has heat, redness, pain, or drainage of the wound.

See Managing Ectopic Pregnancy, below.

Suspected pregnancy

Assess for pregnancy, including ectopic pregnancy.

Managing Ectopic Pregnancy

Ectopic pregnancy is any pregnancy that occurs outside the uterine cavity. Early diagnosis is important. Ectopic pregnancy is rare but could be life-threatening (see Question 11).

In the early stages of ectopic pregnancy, symptoms may be absent or mild, but eventually they will become severe. A combination of these signs or symptoms should increase suspicion of ectopic pregnancy:

– Unusual abdominal pain or tenderness

– Abnormal vaginal bleeding or no monthly bleeding—especially if this is a change from her usual bleeding pattern

– Light-headedness or dizziness

– Fainting

Ruptured ectopic pregnancy - sudden sharp or stabbing lower abdominal pain, sometimes on one side and sometimes throughout the body, suggests a ruptured ectopic pregnancy (when the fallopian tube breaks due to the pregnancy). Right shoulder pain may develop due to blood from a ruptured ectopic pregnancy pressing on the diaphragm. Usually, within a few hours the abdomen becomes rigid and the woman goes into shock.

Care

Ectopic pregnancy is a life-threatening, emergency condition requiring immediate surgery. If ectopic pregnancy is suspected, perform a pelvic examination only if facilities for immediate surgery are available. Otherwise, immediately refer and/or transport the woman to a facility where definitive diagnosis and surgical care can be provided.