Ectopic Pregnancy

What is an Ectopic Pregnancy?

Fertilization of the ovum by sperm takes place in the fallopian tubes. After fertilization, the fertilized egg travels through the fallopian tube to the uterus. Normally, this embryo gets attached to the wall of the uterus and develops. In an ectopic pregnancy, the fertilized egg gets attached anywhere outside the uterus.

It can get attached to the fallopian tube or the abdominal cavity or the cervix. Here, the pregnancy test will be positive, but the embryo cannot grow properly anywhere other than inside the uterus. Ectopic pregnancies are very common and occur in about 1 in every 50 pregnancies. It is a medical emergency and if left untreated, can also be fatal.

Ectopic Pregnancy Causes and Risk Factors

The development of an ectopic pregnancy cannot be predicted, but some of the factors and conditions that increase the risk of developing an ectopic pregnancy are:

• Damaged fallopian tube.

• Pelvic inflammatory disease (PID).

• Sexually transmitted diseases (STD).

• Previous ectopic pregnancy.

• Complications during tubal ligation or tubal ligation reversal surgeries.

• Taking fertility drugs.

• Infertility treatment like in vitro fertilization (IVF).

• Pregnancy with an intrauterine device (IUD).

• Smoking.

• Birth defects.

• Genetic abnormalities.

• Hormonal factors.

What are the Symptoms Seen During an Ectopic Pregnancy?

Some of the symptoms seen during an ectopic pregnancy are similar to normal pregnancies, but the symptoms that can indicate abnormal pregnancy are:

• Nausea and vomiting.

• One-sided body pain.

• Breast soreness.

• Sharp abdominal and pelvic pain.

• Pain in the shoulder or neck region.

• Vaginal spotting or bleeding.

• Dizziness.

• Fainting.

• Rectal pressure.

Ectopic Pregnancy Diagnosis

If you have symptoms that indicate an ectopic pregnancy, consult your gynecologist immediately. A physical examination cannot diagnose ectopic pregnancies, but your doctor will perform one to rule out any other cause of your symptoms. The doctor will perform a transvaginal ultrasound, where a probe is inserted into the vagina to look for a gestational sac in the uterus. Blood tests to determine the levels of hCG (human chorionic gonadotropin) are also performed.

If the transvaginal ultrasound does not show a gestational sac, and if the levels of hCG and progesterone remain the same or drop, then it is most likely an ectopic pregnancy. All these tests are done in case you do not have severe symptoms. If you are experiencing severe abdominal pain and dizziness, surgery is done as further waiting might cause the fallopian tube to rupture and result in severe internal bleeding.

Ectopic Pregnancy Treatment

Untreated ectopic pregnancy is dangerous for the mother, and the embryo will not be able to develop to term. The treatment options are as follows:

Medication:

In cases where an ectopic pregnancy is detected at an early stage, Methotrexate injection is administered. In such cases, the embryo would not have been developed much, so the chances of it rupturing the fallopian tube are less.

Methotrexate prevents growth by stopping the embryo cell from multiplying. If the medication is successful in eliminating the pregnancy, then you will experience symptoms like cramping, bleeding, and passing tissue and clots. The use of this medication prevents damage to the fallopian tube that might result from surgery. After taking Methotrexate, you will not be able to conceive for several months.

Surgery:

Laparoscopic surgery is performed to remove the embryo and to repair any internal damage. Here, the surgeon makes a small incision in your abdomen through which they insert flexible instruments to remove the embryo and also repair any damage to the fallopian tube.

If the damage is extensive and internal bleeding is too much, then the surgeon might do a laparotomy, which requires a larger incision.

If the fallopian tube is damaged, then the doctor might perform salpingostomy or salpingectomy or total salpingectomy.

Postoperative Infection:

It is normal to have light vaginal bleeding with clots up to 6 weeks after surgery. After surgery, the incision might take time to heal. The aim is to keep the incision dry and clean. Incisions might get infected, so if you see any of the following signs of infection, get medical attention immediately:

• Excessive bleeding.

• Foul-smelling discharge from the incision.

• The incision area is hot, red, tender, and swollen.

Postoperative Care:

• Avoid lifting anything that weighs more than 4 kg.

• Prevent constipation by drinking a lot of fluids.

• Refrain from sexual intercourse, using a tampon, and douching for 6 weeks.

• Take complete rest during the first week after surgery.

• After a week, go for a walk and be active as much as you can.

How Can an Ectopic Pregnancy affect Future Pregnancies?

• If the fallopian tubes are not damaged, then the chances of future pregnancy are very good.

• If one fallopian tube is present, then the chances of conceiving are only slightly reduced.

• You will not be able to conceive naturally if both your tubes are damaged.

It is difficult to deal with the loss of pregnancy, no matter how early. It is important to take care of yourself, rest, eat healthily, and exercise. And when you are ready to conceive again, you can talk to an experienced fertility specialist with the help of online healthcare platforms.

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