Ectopic Pregnancy is a condition where the word ectopic simply means out of place. As the name suggests in ectopic pregnancy the fertilized egg of the woman is planted at a place outside the uterus. In around 95% of cases this egg settles within the fallopian tubes. For this reason ectopic pregnancies are also called tubal pregnancies. Some other regions where the egg is seen implanted in this condition include the cervix, abdomen and the ovary. These pregnancies are therefore often called abdominal or cervical pregnancies.
This condition may result from the inability of the fertilized egg to work its way quickly down into the uterus through the fallopian tubes. This can be because of inflammation or infection of the tube. Blockages can also be caused because of any previous fallopian surgeries or changes in the shape of the tube because of abnormal growth and other birth defects.
Ectopic pregnancy cannot successfully develop into live birth for the simple reason that these areas do not have much space for the pregnancy to develop. These areas also do not have nurturing tissue and when the fetus grows it can cause the organ containing it to burst. This can in turn result in severe bleeding and can pose danger to the life of the mother.
Signs and symptoms of ectopic pregnancy
Women having ectopic pregnancy display all the classical symptoms of normal pregnancy including missed periods, nausea, frequent urination and vomiting and breast tenderness. So the diagnosis of this condition is quite difficult.
One of the most important signs of ectopic pregnancy is vaginal bleeding. The woman might feel pain in the abdomen region, pelvis and in some cases even in the neck and shoulder. This pain is often extremely sharp.
Some other symptoms of this condition include vaginal spotting, low blood pressure, dizziness and fainting and lower back pain.
Diagnosis
Once a pregnancy is diagnosed through urine pregnancy test and blood test an ultrasound examination is conducted. However an ectopic pregnancy cannot always be detected even with an ultrasound examination.
In case the woman is experiencing pain the doctor can determine the areas where the pain is located through a pelvic exam. Any pregnancy can be located properly only after the 5 week period. In case the doctor suspects ectopic pregnancy then he may direct the patient to come back every 2 to 3 days to check the hCG levels. The levels of this hormone increase with every day of pregnancy and if they don’t rise as quickly as expected then the doctor will have monitor the patient’s progress. Eventually an ultrasound is used to determine the exact location of the pregnancy.
Treatment
The treatment options for this condition depend on the medical stability of the case and the location of the pregnancy along with its size. If this condition is in its early days then it can be treated with the help of a methotrexate injection. This injection stops further embryo growth.
In case the pregnancy is advanced surgery is an option that may be needed. Incision in the pelvic area may be done in case of emergency or where a case of internal injury is observed. Nowadays laparoscopy is used to handle this condition. In this procedure the doctor makes a few small incisions through which a small camera and surgical instruments are inserted. The camera allows the doctor to see what is happening and the pregnancy can be surgically removed without making large incisions. After a condition of ectopic pregnancy is handled the patient will need to follow up with the doctor on a regular basis so as to ensure that the hCG level returns to zero. If this level is seen to remain continuously elevated then it might mean that some part of the ectopic tissue is still remaining in the area. This tissue can then be removed through a methotrexate injection or through another surgery.
Future pregnancies
Women with this condition may find it difficult to get pregnant again. This is particularly true with women who have had fertility issues before this condition. However the possibility of repeat ectopic pregnancy is higher.
