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Ectopic Pregnancy

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Ectopic Pregnancy

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In an ectopic pregnancy, the fertilized egg gets attached anywhere outside 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.

Medically reviewed by

Dr. Vidya Muralidhar

Published At March 7, 2019
Reviewed AtDecember 22, 2023

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.

What Are the Causes and Risk Factors of Ectopic Pregnancy?

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.
  • Sexually transmitted diseases (STD).
  • Complications during tubal ligation or tubal ligation reversal surgeries.
  • Taking fertility drugs.
  • 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.
  • Pain in the shoulder or neck region.
  • Vaginal spotting or bleeding.
  • Dizziness.
  • Fainting.
  • Rectal pressure.

How to Diagnose Ectopic Pregnancy?

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.

How to Treat Ectopic Pregnancy?

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.
  • 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.

Conclusion:

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.

Frequently Asked Questions

1.

How Long Can an Ectopic Pregnancy Survive?

A growing fetus requires abundant and adequate blood supply that can be achieved while conception happens in-utero. Any pregnancy that is the outside uterus is liable to death by itself due to inadequate blood supply, and if not diagnosed early, the fallopian tube might rupture 6 to 16 weeks.

2.

What Are the Chances of Getting Pregnant After an Ectopic Pregnancy?

The success rate of getting pregnancy of an ectopic pregnancy is pretty high, around 85% after two years. You should consult your doctor regarding this.

3.

How Painful Is a Ruptured Ectopic Pregnancy?

The pain of an ectopic pregnancy starts to be mild, and on ruptured, it is said to be excruciatingly sharp and painful. The pain spreads from the pelvis to the abdomen.

4.

How Can an Ultrasound Detect an Ectopic Pregnancy?

The type of ultrasound used to detect an ectopic pregnancy is a transvaginal ultrasound. Ectopic pregnancy is screened using ultrasound when the hCG levels peak above 1500, and the findings would be the absence of a gestational sac in the uterus.

5.

How Long You Are in Hospital After an Ectopic Pregnancy?

Complete recovery of a ruptured ectopic pregnancy would demand 4 to 6 weeks. But the woman can leave the hospital in a week. You should consult with your doctor before discharge.

6.

Can a Baby Survive Ectopic Pregnancy?

No, without an adequate environment for the uterus, any baby cannot survive an ectopic pregnancy, and it might only be life-threatening to the mother. If you are suspected of having an ectopic pregnancy, you should get proper guidance from the doctor for an ideal treatment plan.

7.

Which Shoulder Hurts During an Ectopic Pregnancy?

The shoulder tip pain during pregnancy is typical of internal bleeding due to ectopic pregnancy. If you are experiencing pain, you should consult with your doctor. It would be best if you got expert advice as the pain becomes unpredictable.

8.

What Is the First Sign of an Ectopic Pregnancy?

The early signs of ectopic pregnancy are bleeding and pain. If there is leakage of blood from the fallopian tube, then there are chances you may feel shoulder pain or an urge to have a bowel movement.

9.

How Soon Would You Know If You Have an Ectopic Pregnancy?

After six weeks to eight weeks after the missed period, you might experience vaginal bleeding if you have an ectopic pregnancy. However, you should consult with your doctor before confirming the diagnosis.

10.

How Long Can You Go With an Ectopic Pregnancy?

You can go with an ectopic pregnancy for a time period of 10-15 weeks. After this time, the fetus that is formed begins to rupture. When it is beginning to rupture, then there might be heavy bleeding.

11.

How to Prevent Ectopic Pregnancy?

There are no proper ways to prevent ectopic pregnancy. But, you can rectify the causes of ectopic pregnancy. Try to keep your hormones in balance. If you have any abnormalities relating to ectopic pregnancy, check with your doctor immediately.
Dr. Vidya Muralidhar
Dr. Vidya Muralidhar

Obstetrics and Gynecology

Tags:

methotrexatepelvic inflammatory diseaseectopic pregnancylaparoscopy
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