Ectopic pregnancy- Signs, Symptoms, Causes, Risk, Diagnosis & Treatment

What is an ectopic pregnancy?

It is a rare pregnancy in which a fertilized egg is attached at a place other than its defined spot in the uterus. The ovum is required to travel to the uterus to get implanted in the endometrium or the uterine lining. But, probably the egg which is fertilized in the fallopian tube gets attached to the lining in the fallopian tube itself. Thus, an ectopic pregnancy is also called a tubal pregnancy. 

It’s known that when the egg is released inside the fallopian tube and comes in direct contact with the mating sperm, it forms an ovum. This ovum takes 3 to 4 days to reach the position in the uterus where it will attach to the thick inner lining of the uterus called endometrium near corpus leutum. Here the baby will take the final shape. Corpus leutem is a cyst which secretes progesterone and estrone. 

The fallopian tubes are thin and not the right organ to hold the mature baby. When the ovum gets implanted in these tubes there is a risk involved. The embryo needs proper space to grow so, this pregnancy will not develop properly. There is a treatment for such a condition. So, emergency treatment is recommended in such a situation.

Symptoms of Ectopic pregnancy

This pregnancy is found in 1 out of 50 pregnant women. An ectopic pregnancy happens in the early weeks of embryo formation so, this is not easily detected. Even the pregnant mother is not aware of the pregnancy and symptoms of this rare disease before the second month. There are hardly any signs of this problem in the first month of pregnancy.

But, this medical condition can be detected using some potential signs. Some symptoms of ectopic pregnancy are:

1.    Vaginal bleeding can be felt during pregnancy which may be heavier or lighter than the usual periods. Bleeding due to the rupturing of the fallopian tube is a very critical condition that may cause an internal flow of blood or massive blood flow from the vagina.

2.    Nausea and vomiting are common pregnancy symptoms as well as this condition also.

3.    Severe pain in the pelvic or abdominal cavity. This pain has a high intensity which frequently comes and goes. It may be due to the blood flow from the ruptured fallopian tube which carries the embryo.

4.    Gastrointestinal symptoms like indigestion.

5.    Shoulder or neck pain can also be felt.  Even there is a pain in the rectum.

6.    Weakness in the body and signs of dizziness. In extreme cases, the patient faints also.

7.    Major pain in the abdomen which causes fainting of the patient needs quick and immediate medical attention.

Causes of Ectopic pregnancy

There are no particular causes of ectopic pregnancy for any pregnant woman. These causes can be estimations only as this condition can be caused by many ways such as:

1.    Damaged fallopian tube

If there is an infection or damage in the fallopian tube, this partially blocks the fertilized egg to travel to the uterus. This way the egg is implanted in the fallopian tube by chance.

2.    PID ( pelvic inflammatory disease)

This is an inflammatory disease in the female reproductive organs which causes complications like fibrous bands in the fallopian tubes. If untreated this infection can spread to other parts of the female reproductive organ.

3.    A scar may be present on the fallopian tube which may be the result of any surgical procedure. This scar may be responsible for the tube to get blocked and the egg adheres itself in the fallopian tube.

4.    STD’s (Sexually-transmitted diseases)

Sexually transmitted diseases like gonorrhea, genital herpes, or trichomoniasis may be responsible for aggravating the tubal pregnancy. The patients with the history of STD’s are more likely to have the risk of ectopic pregnancy than others.

5.    Sometimes abnormal growth of the fetus or any birth defect in the previous pregnancies is a cause of abnormality in the tube’s shape. It causes ectopic pregnancy in the second child.

6.      Infertility treatments or usage of Fertility drugs

When the women who are unable to conceive and go for fertility drugs, they may get pregnant easily but sometimes these drugs interfere in the pregnancy. The women have a slightly higher risk of getting ectopic pregnancy than normal ones.

Risk factors involved in Ectopic pregnancy

Ectopic pregnancy

•    Women who are at the maternal age of more than 35 years are more prone to conceive tubal pregnancy. This pregnancy is risky as the fallopian tube may rupture and the fetus is at risk.

•     If the first pregnancy is ectopic one, the other is most likely to be so. So, keep a check on the second pregnancy if you have faced a similar situation in the first case.

•    If an abdominal or pelvic surgery is performed on the patient in the past, she is likely to have this type of pregnancy. The risk involved in the pregnancy outside the womb is double for the mother. She may suffer from internal bleeding which is life-threatening.

•    The baby born due to ectopic pregnancy can be deformed. It’s not that the baby can survive its complete growth cycle in the fallopian tube. The fetus has to be removed if there is an ectopic pregnancy for avoiding any life risk for the mother.

How is Ectopic pregnancy diagnosed?

 A doctor can examine a patient and tell if she has Ectopic pregnancy only by performing certain confirmatory tests. There are blood tests and some ultrasonographs which are a sure test to tell this medical state.

Consecutive pain in the abdomen and a mass in the fallopian tube are some symptoms that may alarm you or your doctor. A blood test called Human Chorionic Gonadotropin (hCG) blood test is done to confirm the pregnancy. This test gives out the levels of hCG which help to diagnose this pregnancy. If the levels of hCG are lower, it means that ectopic pregnancy may be there.

Even the progesterone levels are tested, and if they are also low it means that ectopic pregnancy exists. Some other blood tests like the ones which tell the total blood count are also helpful as they indicate the anemic or healthy mother. In cases of acute anemia, some internal blood loss may be doubted. This may indicate an ectopic pregnancy. So, a blood test for anemia is done to test for this pregnancy.

Transvaginal ultrasound is done by your doctor to know the exact location of the fetus. In this ultrasonography, a pencil-like a device is inserted inside the vagina and the images of the uterus,  fallopian tubes, and the ovaries appear on the computer monitor screen.

Along with that, the doctor can also do a culdocentesis. It is a procedure in which a needle is inserted very carefully into the space between the uterus and the fallopian tube. if there are traces of blood, an ectopic pregnancy exists. This process is a little uneasy process which is performed under the supervision of your own obstetrician.

Treatment of ectopic pregnancy

It is true that the normal growth of the embryo is not possible outside the uterus. If the fertilized egg starts growing outside the womb, it will be full of complications and uncertainty. Doctors always recommend the removal of ectopic pregnancy. This abortion can be performed using medicines, abdominal surgery or laparoscopic surgery.

Medicines like methotrexate are prescribed by the doctor that stops cell growth. It even dissolves the existing cells. The contents in the medicine allow the body to absorb the tissues of the embryo. It is an injection that is given to the patient after the confirmation about the pregnancy.

Abdominal surgery is done if the Fallopian tube has stretched or ruptured. It is an emergency situation when bleeding has started. In this case, bleeding is stopped with great effort to save the life of the patient. Hence it is an emergency surgery. This surgery requires a deep incision and the operation is performed under medical supervision.

laparoscopic surgery is also a procedure where a thin and short incision is made on the abdomen. Then a thin tube that has a camera lens and a laparoscope is inserted to view the fallopian tubes. The pregnancy is removed by removing the embryo tissue with the help of a laparoscope. Sometimes the tubes are removed completely. This procedure takes place under local anesthesia.

Conclusion

After knowing about the symptoms and other conditions of this type of pregnancy, it is advisable to take immediate action. A regular visit to the clinic and calling for an immediate appointment to the doctor is necessary.  Any abnormal symptom should not be ignored and all the tests are needed to get a healthy baby.

You should not hesitate from asking questions from your doctor regarding any difficult medical condition. It is a matter of life and death for you and the little bundle of joy. In case of emergency, there must be all the information and phone numbers of the medical practitioners handy. This is sure to avoid any difficult situation in the case of ectopic pregnancy.

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