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What is an ectopic pregnancy?
Ectopic pregnancy is a condition in which a fertilized ovum (egg) settles and grows in any location other than the inner lining of the uterus (womb). Most of ectopic pregnancies occur in the Fallopian tube (98%), however, they can occur in other locations, such as the ovary, cervix, and abdominal cavity. Ectopic pregnancy occurs in about one in 50 pregnancies.
What causes an ectopic pregnancy?
Ectopic pregnancies are caused by one or more of the following:- Any infections or inflammations of the fallopian tube can cause it to become partially or entirely blocked.
- Scar tissue left behind from a previous infection or an operation on the tube may also impede the ovum's movement.
- Previous surgery in the pelvic area or on the tubes can cause adhesions.
- An abnormality in the tube's shape can be caused by abnormal growths or a birth defect.
Who is at risk for having an ectopic pregnancy?
Women who are more at risk for having an ectopic pregnancy include the following:- Are 35-44 years of age
- Have had a previous ectopic pregnancy
- Have had pelvic or abdominal surgery
- Have Pelvic Inflammatory Disease (PID)
- Have had several induced abortions
- Women who get pregnant after having a tubal ligation or while an IUD is in place
What are the symptoms of an ectopic pregnancy?
Ectopic pregnancy can be difficult to diagnose because symptoms often the same as a normal early pregnancy. These can include missed periods, breast tenderness, nausea, vomiting, or frequent urination. Although you may experience typical signs and symptoms of pregnancy, the following symptoms may be used to help recognize a potential ectopic pregnancy:- Sharp or stabbing pain that may come and go and vary in intensity. The pain may be in the pelvis, stomach or even the shoulder and neck (due to blood from a ruptured ectopic pregnancy gathering up under the diaphragm).
- Vaginal bleeding, heavier or lighter than your normal period
- Gastrointestinal symptoms
- Weakness, dizziness, or fainting
- low blood pressure (also caused by blood loss)
- Low back pain
Options for Treatment
Treatment of an ectopic pregnancy varies, depending on how the health status of the woman is and the size and location of the pregnancy. An early ectopic pregnancy can sometimes be treated with an injection of methotrexate, which stops the growth of the embryo.If the pregnancy is further along, you'll likely need surgery to remove the abnormal pregnancy. In the past, this was a major operation, requiring a large incision across the pelvic area. This might still be necessary in cases of emergency or extensive internal injury.
The pregnancy may sometimes be removed using laparoscopy, a less invasive surgical procedure. The surgeon makes small incisions in the lower abdomen and then inserts a tiny video camera and instruments through these incisions. The image from the camera is shown on a screen in the operating room, allowing the surgeon to see what’s going on inside of your body without making large incisions. The ectopic pregnancy is then surgically removed and any damaged organs are repaired or removed.
Whatever your treatment, the doctor will want to see you regularly afterward to make sure your hCG levels return to zero. This may take several weeks. An elevated hCG could mean that some ectopic tissue was missed. This tissue may have to be removed using methotrexate or additional surgery.
What About Future Pregnancies?
Some women who have had ectopic pregnancies will have difficulty becoming pregnant again. This difficulty is more common in women who also had fertility problems before the ectopic pregnancy. Your prognosis depends on your fertility before the ectopic pregnancy, as well as the extent of the damage that was done.The likelihood of a repeat ectopic pregnancy increases with each subsequent ectopic pregnancy. Once you have had one ectopic pregnancy, you face an approximate 15% chance of having another.
When to Call Your Doctor
If you believe you're at risk for an ectopic pregnancy, meet with your doctor to discuss your options before you become pregnant. You can help protect yourself against a future ectopic pregnancy by not smoking and by always using condoms when you're having sex but not trying to get pregnant. Condoms can protect against sexually transmitted infections (STDs) that can cause PID.If you are pregnant and have any concerns about the pregnancy being ectopic, talk to your doctor, it's important to make sure it's detected early. You and your doctor might want to plan on checking your hormone levels or scheduling an early ultrasound to ensure that your pregnancy is developing normally.
Call your doctor immediately if you're pregnant and experiencing any pain, bleeding, or other symptoms of ectopic pregnancy. When it comes to detecting an ectopic pregnancy, the sooner it is found, the better.
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