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ECTOPIC PREGNANCY

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ECTOPIC PREGNANCY

Ectopic pregnancy is a complication of pregnancy in which a fertilized egg settles and grows outside the inner lining of the uterus.

  • Normally, a fertilized egg travels to the uterus to attach itself but in an ectopic pregnancy, the fertilized egg doesn’t attach itself to the uterus rather it may attach itself to several other locations outside the cavity of the uterus.
  • Ectopic pregnancies mostly occur in the fallopian tube and are so-called tubal pregnancies. However, they can also occur in other places including the cervix, ovary, or abdominal cavity.
  • An ectopic pregnancy cannot proceed normally and may eventually lead to the death of the embryo.
  • An ectopic pregnancy is a medical emergency as it can cause life-threatening bleeding.
  • If left untreated, the fallopian tube may rupture and may lead to internal bleeding, shock, and even death

CAUSES

The following conditions have been associated with an ectopic pregnancy:

  • Inflammation or scarring of the fallopian tube
  • Hormonal imbalance
  • Genetic abnormalities
  • Medical conditions that cause the fallopian to be misshapen

Some factors that predispose a woman to have an ectopic pregnancy may include:

  • Previous ectopic pregnancy
  • Sexually transmitted diseases such as gonorrhea
  • Previous tubal surgery, abdominal surgery, pelvic surgery or multiple abortions
  • Smoking
  • Maternal age of 35 or older
  • Pelvic inflammatory disease
  • Use of assisted reproductive technology
  • History of infertility

SYMPTOMS

  • Breast discomfort
  • Vaginal bleeding in varying amount
  • Sudden lower abdominal pain
  • Pelvic pain or discomfort
  • Dizziness or fatigue
  • In some cases, there are no symptoms

DIAGNOSIS AND TREATMENT

DIAGNOSIS

Occasionally, the doctor can carry out a pelvic exam, this may help the doctor in identifying areas of pain, tenderness or mass in the fallopian tube or ovaries

The doctor may carry out a pregnancy test to ascertain that you are pregnant. This test is done via a blood test to check the level of human chorionic gonadotropin (hCG) hormone which usually increases during pregnancy.

An abnormal pattern in the rise of this hormone can be indicative of ectopic pregnancy

A transvaginal ultrasound is carried out. This allows the doctor to see the exact location of the pregnancy

Occasionally, the doctor can carry out a pelvic exam, this may help the doctor in identifying areas of pain, tenderness or mass in the fallopian tube or ovaries

In rare cases, laparoscopy may be needed to confirm diagnosis

TREATMENT

Treatment option depends on your symptoms and when the ectopic pregnancy is discovered

Medication – Methotrexate medication is often used to treat an early ectopic pregnancy. This medication stops the growing cell of the placenta and dissolves existing cells. This may cause abortion or the developing embryo may pass with a menstrual period. It is very important that ectopic pregnancy is confirmed before this treatment is given.  However, conception may be delayed for several months after taking this medication.

Surgical intervention may be required if bleeding has already occurred. Laparoscopy or laparotomy surgery is used to gain access to the pelvis.  The ectopic pregnancy is either only removed (salpingostomy) or the affected fallopian tube is removed along with the pregnancy (salpingectomy)