Ectopic Pregnancy – Synptoms, Diagnosis & Treatment

An ectopic pregnancy (also called a tubal pregnancy) happens when the fertilized egg starts growing in the fallopian tube, instead of traveling down and implanting in the uterus. As the fallopian tubes are not designed to hold a growing embryo, the fertilized egg in an ectopic pregnancy cannot grow normally and must be treated. An ectopic pregnancy usually happens in about 1 out of 60 pregnancies.

Symptoms Of An Ectopic Pregnancy

An ectopic pregnancy is usually accompanied by

  • Sharp or sudden pain that comes and goes with varying intensity. The pain could 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, heavy or lighter than your normal period. It could become heavier if the tube ruptures
  • Nausea and vomiting – that could be difficult to distinguish from morning sickness
  • Weakness, dizziness or fainting
  • Gastrointestinal symptoms

If you are experiencing sharp pain or bleeding, it is important that you seek help immediately.

Diagnosis Of An Ectopic Pregnancy

Your doctor might perform a pelvic examination first to locate the pain, tenderness or a mass in the abdomen. Measuring of hCG levels is also important as a lower than normal level of hCG is one of the reasons to suspect an ectopic pregnancy. Low levels of progesterone also indicate an abnormal pregnancy.

An ultrasound may reveal the absence of a gestational sac in the uterus or the development of a pregnancy in the fallopian tube. A laparascopy will then enable the doctor to view the tubes directly and confirm the diagnosis.

An ectopic pregnancy should be diagnosed and treated at the earliest. If it remains undetected, the pregnancy will continue to grow in the tube, leading to rupture of the tube itself – thereby endangering the mother’s life.

Treating An Ectopic Pregnancy

Based on the diagnosis, an ectopic pregnancy is usually treated by:

  • Administering a drug called Methotrexate, which allows the body to absorb the pregnancy tissue. This may help save the fallopian tube, depending on how far the pregnancy has developed
  • If the tube has become stretched or it has ruptured and started bleeding, all or part of the fallopian tube may have to be removed. Bleeding needs to be stopped promptly, and emergency surgery is needed
  • 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 had occurred in the part of the tube contained within the wall of the uterus (interstitial pregnancy), your doctor may have no choice but to perform a hysterectomy, where the uterus is removed along with the tubes and products of conception

Ectopic Pregnancy: Am I At Risk?

Many factors are known to increase the risk of having an ectopic pregnancy. The fallopian tubes aren’t like a hollow pipe with the egg rolling down. They have little hairs on the inside (cilia) which move with a wave-like motion to encourage the egg towards the womb. If the tube becomes blocked or the cilia is damaged, then an ectopic is more likely.

Sometimes, an Ectopic Pregnancy Could be Caused By:

  • An infection or inflammation of the fallopian tube, that caused a partial or complete block
  • Scar tissue from a previous infection or operation – that hinders the egg’s movement
  • A contraceptive Intra Uterine Device (IUD)
  • Previous surgery in the pelvic area or on the tubes
  • Abnormality in the tube’s shape, caused by abnormal growth or a birth defect

Women who have had two or more induced abortions, a previous ectopic pregnancy or Pelvic Inflammatory Disease (PID) are also at risk. But sometimes, an ectopic pregnancy could happen for no obvious reason.

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