It is common for many women to fret over pregnancy complications. An ectopic pregnancy is one such serious condition.
In an ectopic pregnancy, the fertilized egg attaches to the inner lining of the uterus, unlike a healthy pregnancy. It occurs in the Fallopian tube or sometimes in the abdominal cavity or the cervical region. The condition can prove fatal if you do not get treatment on time.
Now you may be curious to know more about ectopic pregnancy causes, symptoms and its treatments. Let’s satiate your curiosity. Read on and learn all about ectopic pregnancy.
What Is An Ectopic Pregnancy?
Pregnancy begins with the fertilization process. Normally, the fertilized egg attaches itself to the lining of the uterus. Whereas in an ectopic pregnancy, the fertilized egg develops in a wrong place. It attaches itself to the outer lining of the uterus.
In some of the ectopic pregnancies, the egg attaches to the Fallopian tube. The type of pregnancy is a ‘tubal pregnancy.’ In some other rare conditions, an ectopic pregnancy can occur in other parts like ovary, the cervical region and abdominal cavity.
An ectopic pregnancy is far from normal. It is a serious condition, serious where in the egg cannot survive, and the growing tissue destroys surrounding maternal structures. It causes internal bleeding and infections. Get early treatment to save the chances for healthy pregnancies in the future.
Out of every 100 pregnancies, at least two will turn out to be ectopic. Also, the cases have gone up from the past 30 years. Experts say that ectopic pregnancies may happen due to infertility treatments or sexually transmitted infections.
Causes And Risk Factors Of An Ectopic Pregnancy
An Ectopic pregnancy may happen due to damage in your Fallopian tube, which helps the egg reach its destination. The egg will, therefore, implant either in the Fallopian tube or somewhere else.
You will be at higher risk of experiencing an ectopic pregnancy if you have had any of the following:
- History Of Ectopic Pregnancy: If you have had an ectopic pregnancy in the past, your risk increases from 1 in 90 to 1 in 10.
- Infection Or Inflammation: Infection of the Fallopian tubes, uterus or ovaries and also inflammation of the Fallopian tube (salpingitis) can improve the chances of ectopic pregnancy. Chlamydia or gonorrhea are the main causes of the infection.
- Structural Concerns: An ectopic pregnancy can occur if you have damaged Fallopian tube orb unusually shaped Fallopian tube. Also, any surgery done to the Fallopian tube can increase the risk of an ectopic pregnancy.
- Fertility Concerns: Any difficulties with fertility and also the use of fertility drugs can increase the chance of ectopic pregnancy.
- Related Surgeries: Any abdominal surgery, including appendicitis, caesarean section or sterilization reversal can also increase the risk.
- Contraceptives: Pregnancy is rare if you use contraceptives like IUD (Intra Uterine Device) or any pill. It is the same if you conceive after undergoing tubal ligation method, a permanent birth control method. Pregnancy is rare after tubal ligation, but if it happens, it turns out to be ectopic.
- Smoking: Smoking a cigar before your conception can increase the chances of ectopic pregnancy. The more you smoke, the higher the risk.
- Age: There is a chance your pregnancy will be ectopic if you are 40 and above.
- Endometriosis: Endometriosis is a gynecological condition that causes scarring in the Fallopian tubes, and affects them badly. The condition also increases the chance of ectopic pregnancy.
Symptoms Of An Ectopic Pregnancy
Symptoms develop in the early stage of pregnancy itself and vary from woman to woman. Some women will develop no symptoms until the pregnancy ruptures.
In the early pregnancy, you will begin to experience similar symptoms like that of a normal pregnancy. They may include:
- Sore breasts
- Vaginal spotting or bleeding
- Abdominal pain or tenderness
In some cases, the gynecologist will be able to detect an ectopic pregnancy in your first abdominal examination. See your health care provider immediately if you experience any of the symptoms like:
Pain Or Tenderness In The Abdominal Or Pelvic Region
A sudden, severe and persistent pain that can also be mild or intermittent can develop. You may find it difficult while you cough or move your bowels. Pain can be anywhere in the abdominal or pelvic region accompanied by vomiting and nausea.
Vaginal Bleeding And Spotting:
During the initial stage of pregnancy, there are chances you may bleed lightly. The blood may vary from red to brown, heavy to light, continuous to intermittent.
Pain in the shoulder, especially when you lie down is a warning of ruptured ectopic pregnancy. The main cause for the pain is internal bleeding that signals the nerves traveling to the shoulder area.
You will experience signs of shock, weak and racing pulse, clammy skin and dizziness.
It is important to take immediate care if you become a pregnant despite having a tubal ligation, or having an IUD or a previous history of ectopic pregnancy.
If you are already receiving fertility treatments and get pregnant, your doctor will monitor your pregnancy.
Diagnosing An Ectopic Pregnancy
It is tricky to diagnose an ectopic pregnancy. If the symptoms suggest that you are experiencing an ectopic pregnancy, your doctor will start an examination by performing an ultrasound and a blood test. The combination of both blood hormone pregnancy test and pelvic ultrasound test helps to establish a better diagnosis.
A blood test checks the levels of the human chorionic gonadotropin (hCG) hormone. If the levels are too high, but not as much as they need to be, then it can be an ectopic pregnancy. If you do not experience any pain, but still doubt the result, the test can be repeated.
Transvaginal ultrasounds help detect an ectopic pregnancy. Here, an ultrasound probe is slipped into the vagina and images are checked on a monitor. The sonographer carefully notices the uterus and tubes. If he sees an embryo in the Fallopian tube, it is an ectopic pregnancy. In most cases, the embryo will die since it cannot survive in an ectopic pregnancy. Here, he can notice a swollen tube along with some blood clots and tissue.
Then, the sonographer will examine the uterus. If the pregnancy test is positive, but he could not find the embryo, it can be a sign of ectopic pregnancy. There are also chances that you may be in the initial stages of pregnancy, or you may have miscarried. Your doctor will continue to examine you through repetitive blood tests and ultrasound exams until he establishes a proper diagnosis.
Other Diagnostic Tests:
If the above tests aren’t conclusive, your doctor may recommend a Dilation and Curettage (D&C) surgery to detect and remove the unwanted tissue from the uterus.
In rare cases, you may have to go for laparoscopy. It is a procedure where a small camera is inserted into the abdominal region to view the internal structures, to detect an ectopic pregnancy.
Treating An Ectopic Pregnancy
Treatment depends on the basis of diagnosis, like the pregnancy stage, hormonal levels and your symptoms.
If your ectopic pregnancy is detected too early within the first six weeks and you notice no symptoms, then there is an option for expectant management. The option is not to undergo any treatment, just a “wait and see” option.
Nearly 50% of ectopic pregnancies end up in miscarriage. If the blood hormone pregnancy test and the ultrasound show nil results, then expectant management is advisable. But, in rare cases, some women who opt for the method may still require medical or surgical treatment later.
If your health care provider diagnoses low pregnancy hormonal levels, no visible heartbeat and minute symptoms in early pregnancy stages, medical treatment is suggestible. It involves injecting an anti-cancer drug, methotrexate (Trexall, Rheumatrex) into the thigh. This drug, inhibits pregnancy. Some women may not respond to medical treatment, while some may require surgical treatment.
Methotrexate treatment has a high success rate and side effects are quite rare. Factors like the embryo size and hCG hormone concentrations help the doctor to choose the medical treatment. Also, the medical treatment is 90% effective in preventing the ectopic pregnancy.
If the ectopic pregnancy is detected during Laparoscopy, the surgeon will directly remove the tissue during diagnosis. If not during diagnosis, there is another surgical method called Salpingectomy that your surgeon may prefer. It involves removal of Fallopian tube and pregnancy through two small incisions.
It is also possible to preserve the Fallopian tube and remove the embryo without damaging or rupturing the tube. This method is called Salpingotomy. It is suggestible if you possess only one Fallopian tube, or the other tube seems to be unhealthy.
Your doctor will explain the benefits and risks of each treatment before proceeding to any. He will ensure to offer you the required support all through the treatment.
Can You Get Pregnant After You Had An Ectopic Pregnancy?
Most women who experience an ectopic pregnancy will have normal pregnancies in the future. It does not matter if one of the Fallopian tubes is removed since one healthy working tube is enough to help the fertilization. The earlier you prevent an ectopic pregnancy, the lesser the damage to the tube and the greater are the chances of becoming pregnant again.
If an infection or sexually transmitted disease were the causes for your ectopic pregnancy, then getting them treated improves the chances of conception. But, if the ectopic pregnancy occurs due to tubal ligation or exposure to diethylstilboestrol (DES), there are lesser chances of a normal pregnancy.
Check with your doctor before you plan for a next pregnancy. You should leave a quality time to heal your body and mind. Check with your doctor about counseling groups and consider getting some counseling for yourself and your partner.
We hope our guide helped you know about ectopic pregnancy better. Feel free to share your experiences, post your queries if any.
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