Ectopic
pregnancy, also known as tubal pregnancy, is a complication of pregnancy in
which the embryo attaches outside the uterus. Almost all ectopic pregnancies
occur in the fallopian tube.The fallopian tubes are not designed to hold a
growing embryo; thus, the fertilized egg in a tubal pregnancy cannot develop
properly and must be treated. An ectopic pregnancy happens in 1 out of 50
pregnancies.
CAUSES:
An infection
or inflammation of the fallopian tube can make it to become partially or
entirely blocked.
Previous
infection or a surgical procedure on the tube may also impede the egg’s
movement.
Previous
surgery in the pelvic area or on the tubes can cause adhesions.
Abnormal
growths or a birth defect can result in an abnormality in the tube’s shape.
CHANCES:
Maternal age
of 35-44 years
If you have
had a previous experience of ectopic pregnancy
Previous
pelvic or abdominal surgery
Pelvic
Inflammatory Disease (PID)
If you have
had several induced abortions
Conceiving
after having a tubal ligation or while an IUD is in place
Smoking
Endometriosis
One who is undergoing
fertility treatments or using fertility medications
SYMPTOMS:
Although you
may experience typical signs and symptoms of pregnancy, the following symptoms
may be used to help recognize a potential ectopic pregnancy:
Sharp pain
that may come and go and vary in intensity. (The pain may be in the pelvis,
abdomen, 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
It is
important to contact your doctor immediately if you are experiencing sharp pain
that lasts more than a few minutes or if you have bleeding.
DIAGNOSIS:
Your
physician will have to perform a pelvic examination to locate pain, tenderness,
or a mass in the abdomen. Your physician will also use an ultrasound to
determine whether the uterus contains a developing fetus. The measurement of
hCG levels is also important.
Progesterone
levels are also checked because low levels could be a sign of an ectopic
pregnancy. In addition, your physician may do a culdocentesis, which is a
procedure that involves inserting a needle into a space at the very top of the
vagina, behind the uterus and in front of the rectum. The presence of blood in
this area may indicate bleeding from a ruptured fallopian tube.
TREATMENT:
An ectopic
pregnancy may be treated in any of the following ways:
Methotrexate
may be given, which allows the body to absorb the pregnancy tissue and may save
the fallopian tube, depending on how far the pregnancy has progressed.
If the tube
has become stretched or has ruptured and started bleeding, part or all of it
may have to be removed. In this case, bleeding needs to be stopped promptly,
and emergency surgery is necessary.
Laparoscopic
surgery under general anesthesia may be performed. This procedure involves a
surgeon using a laparoscope to remove the ectopic pregnancy and repair or
remove the affected fallopian tube. If the ectopic pregnancy cannot be removed
by a laparoscopically, another surgical procedure called a laparotomy may be
done.
For future
purposes, your hCG level will need to be rechecked on a regular basis until it
reaches zero if you did not have your entire fallopian tube removed. An hCG level that remains high could indicate
that the ectopic tissue was not entirely removed, which would require surgery
or medical management with methotrexate.
The chances
of having a successful pregnancy after an ectopic pregnancy may be reduced, but
this will depend on why the pregnancy was ectopic and your medical history. If
the fallopian tubes have been left in place, you have approximately a 60%
chance of having a successful pregnancy in the future.
