Also known as tubal pregnancy, an ectopic pregnancy happens when the fertilized egg does not attach itself to the womb which should be the case. According to statistics, it happens in one out of every 50 women who conceive in the globe and noticeable in the first few weeks of pregnancy.
It is a matter of life and death when you realize, and it becomes crucial that you seek emergency medical treatment before it gets worse. The information below will explain in detail:
- What is an ectopic pregnancy?
- What causes an ectopic pregnancy?
- Ectopic pregnancy risk factors
- Ectopic pregnancy treatment
- Prevention measures
- Your future after an ectopic pregnancy
Table of Contents
What Is An Ectopic Pregnancy?
For a healthy pregnancy to occur, an egg is released by the ovary into the fallopian tube for fertilization. After this, it stays there for the next 3-4 days before heading to the uterus for implantation. An attachment to the uterus renders healthy growth of the fetus until the delivery day.
However, when the egg implants in the fallopian tube or the cervix among other parts, the resulting condition is an ectopic pregnancy. Since the pregnancy is not healthy, the next thing is to seek medical attention to rectify the situation.
What Causes An Ectopic Pregnancy?
Some of the issues that cause implantation in the fallopian tubes where an ectopic pregnancy mostly happens include a damaged or blocked tube or failure to direct the egg to the womb. This forces the egg to implant there and progresses with development. That is why it is also referred to as a tubal pregnancy.
The less often complications include implanting somewhere else such the ovary, abdomen, cervix or a previous C-section scar. Another possible occurrence though rare happens when one of the embryos is present in the uterus while another one implants in the tubes. Such a pregnancy is called heterotopic pregnancy, and it happens in one out of 4000-10,000 pregnancies globally according to reports.
If not treated early, the fallopian tube can rupture causing abnormal bleeding and harrowing abdominal pain. It can result in damaging the tube and even death if the heavy bleeding is not treated in advance.
Ectopic Pregnancy Risk Factors
It can occur in any woman’s womb, but some risk factors can lead to having the fatal pregnancy. Common risk factors include:
- Surgery:Sterilizing with tubal ligation, reversal of tubal ligation or prior surgical procedure to treat your fallopian tubes can increase the chances of acquiring an ectopic pregnancy. Though less often, if you underwent an abdominal or pelvic surgery, it also raises the effect.
- PID:A Pelvic Inflammatory Disease implies your uterus is having a bacterial infection, which could also affect the fallopian tubes and ovary. It often comes from STIs such as chlamydia and gonorrhea. A PID does not always bring symptoms so having either of the named STIs means risking an ectopic pregnancy.
- Previous ectopic pregnancy:Researchers have found out that if a woman experiences the first tubal pregnancy, there are 5-25% chances of contracting another one depending on how the doctor treated the first occurrence.
- Endometriosis:It comes into effect when the tissue aligning the uterus extends to your abdomens such as covering the intestines, ovaries, or the tubes. When it reaches the fallopian tubes, it can generate an inflammation which increases the chances of a tubal pregnancy.
- Fertility problems:An infertile woman is likely to have damaged tubes. If your pregnancy resulted from an IVF or fertility drugs, the chances of your pregnancy becoming ectopic are slightly above average.
- 35 years and older:At such an age or past, risk factors may have accumulated over time to such as previous pelvic infections or a change in how capable your fallopian tubes are.
- Smoking:Theory holds that cigarettes can impair your tubes to function abnormally.
- Your mother took DES drug when pregnant:It was used back in the day to prevent miscarriage among other complications related to pregnancy. If your mom used it while pregnant with you, the health problems were probably passed to you, and they will include affecting the tubes and uterus hence the risk of an ectopic pregnancy. In the US, the drug was removed from the market but was later available in other countries. Check with your mother on consuming the DES drug.
- Pregnancy with an IUD:It is a rare chance but having an intrauterine device raises the risks to above average in case an ectopic pregnancy happens. The IUD prevents implantation in the uterus but it is less likely to implant in other parts. Statistics show that chances of having an ectopic pregnancy are minimal when compared with the general population. Also, using an IUD in the past will not cause an ectopic in the future.
- Consuming hormonal contraceptives that are progestin-only:Some researchers have suggested it as a factor that can increase the chances of implantation occurring in other places other than the uterus.
Ectopic Pregnancies Symptoms
At first, there are no side effects encountered which means you will barely notice it during early stages. A later medical examination can confirm the danger before the fallopian tube cracks which will cause bleeding.
Symptoms start to show between the 5th -14th week of the pregnancy. They include:
- Frequent and severe pain on one side of your abdomen
- Blood shedding which is either bright or dull red from your vagina. It starts then stops, and you can confuse with a regular menstrual period.
- Pain in the shoulder, felt when lying down. It could be a sign that the pregnancy has already ruptured and a reason to seek immediate medical attention. Medical practitioners relate the pain to internal bleeding which agitates the nerves all the way to your shoulder.
- Pain in the anus when passing stool.
- Diarrhea and the urge to retch (vomit)
- Feeling dizzy which signifies a collapse. There is uneasiness when the fallopian tube ruptures and heavy bleeding starts. The side effects of the breakdown usually make the patient feel sick with an accelerated heartbeat.
- Light vaginal bleeding which should be checked immediately after noticing to rule out other complications such as hemorrhaging. It is also a good idea if you want to check overall health status and maintain your fertility.
Ectopic Pregnancies Diagnosis
It can be quite a task to detect. Your sonographer might suspect the presence of an ectopic pregnancy if you have experienced abdominal pain during your first prenatal. The specialist can also identify an unusual mass.
If all the sign leads to this type of pregnancy, your health care provider will identify how it has been there in case you did not know. He will then conduct an ultrasound and blood test to confirm everything.
During the ultrasound session, possibilities of a miscarriage or a uterine pregnancy that is still in very early stages will first be checked to exclude them out of the list. There will be a review of your tubes if the blood test confirmed a positive pregnancy, but there is no presence of an embryo in the uterus. At this point, the likelihood of having an ectopic pregnancy is high.
If there is an embryo in the tubes, then there you have it. In most cases, however, the fetus might not survive after the implanting hence so small for visibility. What the sonographer may notice is a swollen part of the tube, some blood clots and the resultant tissue after the embryo is gone.
If there is no pain yet, but the diagnosis is still questionable, the specialist will recommend another ultrasound after two days. If the hCG levels in the blood test do not increase as per the expectation, this could indicate a uterus pregnancy that is not yet visible, a miscarriage or an ectopic pregnancy.
Before anything gets further to worse, the health care provider concerned will continue a close monitor until a confirmation comes.
If it is still unclear what is happening to you, the next suggestion would be the dilation and curettage (D&C) surgical procedure to get rid of any tissue in the uterus. Another surgery would be a laparoscopic one for tubes examination. Here, the practitioner will insert a thin tube with a fitted tin camera into your abdomen.
Ectopic Pregnancy Treatment
Since it is never safe for the mother, the embryo’s removal is vital as it will not be able to grow at the attached location. Treatment will depend on where the ectopic pregnancy developed.
After your doctor determines that the complications are unusual, he or she can decide on prescribing some medications. They will help in reducing the likelihood of bursting. One known medicine for such a situation is the methotrexate.
It is a drug that prohibits rapid division of cells like what is happening with the ectopic mass. The doctor introduces it to your body through injection. Some blood tests will follow to check on the effectiveness of the drug. If practical, you are bound to experience symptoms seen in those having a miscarriage which includes bleeding, cramping, and passage of tissue.
Though not necessary and often rare, a surgery might follow. Methotrexate is not known to damage your fallopian tubes, but it will be impossible to get pregnant for the next few months after treatment.
Most of the surgeons will suggest removal of the embryo and repair any damage that comes with it. They will conduct a laparotomy where a tiny camera is inserted using a small incision to ensure that they can see what is going on. The surgeon operating will then remove the embryo and repair any damage done to the fallopian tubes.
If unsuccessful, another laparotomy might be necessary using a larger incision. If your tubes are damaged, their removal will be required.
There will be precise home instructions from your surgeon after the surgery. The main aim here is to keep the incision dry and clean during the healing period. Specific signs that you need to check on a daily basis include:
What to expect is some bleeding through your vagina or some blood clotting after the procedure. This can be there for the next six weeks after the surgeon’s visit. Some personal care measures include:
- Not lifting anything past 10 pound
- Staying hydrated
- Refraining from sex, douching and tampon use
- Take your rest during the first week after the surgery than increase slowly in activity engagement depending on how tolerable it is.
Any increase in pain or any other weird feeling may prompt you to notify the physician.
Prevention for Ectopic Pregnancy
An ectopic pregnancy is not always preventable. What you can do is try to maintain a healthy reproductive system. Let your partner wear condoms every time you are having sex, and limit the number of sexual partners.
It will reduce the chances of contracting an STD which results to a PID which brings inflammation in your fallopian tubes.
Keep visiting the doctor and have STD screenings and gynecological exams. Watch your personal health such as quitting smoking.
Your Future after An Ectopic Pregnancy
There is constant rechecking of your hCG levels to see if they will fall to zero. If not, then a tissue may have been left behind during the removal process which would lead to another medical analysis and removal procedures.
Chances of getting pregnant again depend on how the procedure was conducted and what happened. It may however be reduced if your medical history is not promising. If the fallopian tubes were left intact, you have a 60% chance of getting pregnant again in the future.