Ectopic Pregnacy Ectopic pregnancy by Justina September 17, 2024 September 17, 2024 A+A- Reset 6 Normally, a fertilized egg implants itself in the uterus, but in an ectopic pregnancy (also known as an extrauterine pregnancy), the fertilized egg grows outside the uterus. This can happen in places like the fallopian tubes, ovaries, abdomen, or the cervix (the area just above the vagina). Over 90% of these cases occur in the fallopian tubes, which is known as a tubal pregnancy. Frequency of Ectopic Pregnancies Determining how common ectopic pregnancies are can be challenging, but one study estimates that about 1 in 50 pregnancies in the U.S. are ectopic. As the fertilized egg grows, there is a risk of the fallopian tube rupturing, which can lead to dangerous internal bleeding. Immediate medical attention is crucial in these situations since untreated ectopic pregnancies can be fatal, making them the leading cause of pregnancy-related deaths during the first trimester. Can the Baby Survive? No, unfortunately, a fertilized egg in an extrauterine pregnancy cannot survive. The egg is not “viable,” meaning it cannot develop into a healthy baby. It is impossible for it to grow properly outside the uterus because it doesn’t receive the necessary blood supply and support. Ectopic Pregnancy vs. Miscarriage An ectopic pregnancy results in a pregnancy loss, but it differs from a miscarriage. While an extrauterine pregnancy occurs when the egg implants outside the uterus, a miscarriage happens when a pregnancy ends before the 20th week, often due to chromosomal issues. Signs and Symptoms of an Ectopic Pregnancy Early symptoms of extrauterine pregnancy may be similar to those of a normal pregnancy, like missed periods, breast tenderness, and mild abdominal discomfort. However, only about half of those with ectopic pregnancies will experience the main symptoms: missed periods, vaginal bleeding, and abdominal pain. Here are early signs to watch for: Nausea and vomiting Sharp cramps in the belly Pain on one side of the body Dizziness or feeling faint Pain in the shoulder, neck, or rectum Signs of a Ruptured Ectopic Pregnancy If the fallopian tube ruptures due to an extrauterine pregnancy, severe pain and bleeding can occur, which can be life-threatening. If you experience heavy vaginal bleeding, dizziness, fainting, or extreme pain in your abdomen or shoulder, seek emergency medical attention immediately. When Do Ectopic Pregnancy Symptoms Begin? Typically, symptoms appear early in the pregnancy, between the 4th and 12th weeks. Locations of Ectopic Pregnancy Although most ectopic pregnancies occur in the fallopian tubes, they can also happen in other locations outside the uterus, such as: Ovarian Ectopic Pregnancy (OEP): When the egg implants in the ovary. Abdominal Ectopic Pregnancy: When the egg implants in the abdomen. Cervical Ectopic Pregnancy: When the egg attaches inside the cervical canal. Cesarean Scar Ectopic Pregnancy (CSEP): When the egg implants on a scar from a previous C-section. Symptoms in these cases often resemble those of a tubal extrauterine pregnancy, including vaginal bleeding and lower abdominal pain. Causes Growths or Blockages: Benign growths or other obstructions in the fallopian tubes can prevent the egg from reaching the uterus. Scar Tissue, Adhesions, or Inflammation: Previous pelvic surgeries, such as for ovarian cysts or appendicitis, can leave scar tissue that blocks or slows the egg’s passage. Fallopian Tube Damage: Damage from sexually transmitted infections (STIs), like chlamydia or gonorrhea, can result in scarring or blockages in the fallopian tubes. Congenital Irregularities: Some people are born with abnormally shaped fallopian tubes, which can make it harder for the egg to travel. Risk Factors Certain factors can increase the risk of extrauterine pregnancy, including: Smoking Being over 35 years old Having a sexually transmitted infection (STI) Previous pelvic surgery History of ectopic pregnancies Having had tubal ligation or a reversal procedure Fertility treatments like IVF Becoming pregnant with an intrauterine device (IUD) in place Endometrial tissue growing outside the uterus Pelvic Inflammatory Disease (PID Notably, up to 50% of people who have an ectopic pregnancy do not have any of these risk factors. Therefore, even without known risks, it’s important to monitor any unusual symptoms during early pregnancy. Ectopic Pregnancy and Endometriosis Endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus, can cause scarring in the fallopian tubes, which may lead to an extrauterine pregnancy. Diagnosis To diagnose an ectopic pregnancy, healthcare providers use several methods, as many individuals are unaware of the condition until a prenatal visit. Here’s a breakdown of how it’s diagnosed: Pelvic Exam: The doctor will check for tenderness or unusual masses in the pelvic area, which can indicate an extrauterine pregnancy. Urine Test: A simple pregnancy test, either done by urinating on a strip or in a cup, detects the hormone human chorionic gonadotropin (HCG). This hormone is produced during pregnancy, but lower-than-expected levels may suggest an ectopic pregnancy. Blood Test: Blood tests are used to measure the levels of HCG more accurately. If the levels of this hormone don’t rise as they should during early pregnancy, it may indicate an ectopic pregnancy. Ultrasound Exam: This is a crucial tool. The provider will perform an ultrasound, either transabdominally or transvaginally, to look inside the uterus and fallopian tubes. The ultrasound helps to determine the location of the fertilized egg and confirm whether the pregnancy is ectopic. Ultrasound imaging is often used to check the uterus and fallopian tubes, looking for signs like the gestational sac and whether a fetal heartbeat is present. The ultrasound may be done either abdominally or transvaginally, and the procedure usually takes about 15-20 minutes. Culdocentesis (rarely used): In some emergency situations where a rupture is suspected, a doctor may use culdocentesis, which checks for blood in the pelvic cavity. This can help confirm internal bleeding. Once an ectopic pregnancy is diagnosed, a treatment plan is discussed since immediate medical intervention is necessary to prevent serious complications. Treatment Since a fertilized egg cannot survive outside the uterus, medical intervention is necessary to prevent serious health risks. Ectopic pregnancies are treated with either medication or surgery, depending on the circumstances. Here’s a breakdown of the treatment options: 1. Methotrexate for Ectopic Pregnancy How it works: Methotrexate is a medication that stops the fertilized egg from growing and dissolves existing cells. It is given as an injection. When it’s used: This option is typically recommended if the ectopic pregnancy has been caught early, before the fallopian tube has ruptured. It’s less invasive than surgery and helps preserve the fallopian tube. Follow-up: You’ll need regular follow-up appointments to monitor HCG levels (the hormone produced during pregnancy) to ensure the medication is working. In some cases, if HCG levels do not drop sufficiently, a second injection may be necessary. Risks/Side Effects: Methotrexate can have side effects, and it’s important to discuss these with your provider. The medication may cause nausea, fatigue, and mild pain as the pregnancy tissue is absorbed. 2. Surgery for Ectopic Pregnancy When surgery is required: Surgery is needed if the ectopic pregnancy has caused a rupture or if there is a risk of rupture. This is considered an emergency procedure. Laparoscopic surgery: The most common surgical method is laparoscopy, which involves making small incisions in the abdomen to remove the ectopic pregnancy. During this surgery, the surgeon may either: Remove the entire fallopian tube along with the pregnancy (salpingectomy), or Remove the pregnancy and preserve the fallopian tube if it’s not severely damaged (salpingostomy). Recovery: This procedure is done under general anesthesia, and recovery time varies. Most patients recover within a few weeks. Both treatment options aim to prevent complications such as internal bleeding and preserve as much of the reproductive system as possible. Your healthcare provider will determine the best course of action based on the stage of the ectopic pregnancy and your overall health. Life After an Ectopic Pregnancy After treatment, it may take time for the body to recover, and some women may experience difficulty getting pregnant in the future. Those who lose a fallopian tube may want to consult a fertility specialist. Additionally, waiting at least three months before trying to conceive again is often recommended. It’s important to note that having one ectopic pregnancy increases the risk of having another. Keeping an eye on early pregnancy symptoms and consulting a doctor immediately can help manage this risk. Complications of Ectopic Pregnancy A fertilized egg in an ectopic pregnancy can grow for several weeks, but if it ruptures, it can lead to heavy bleeding. If left untreated, this can result in hemorrhagic shock and potentially be fatal. In some cases, the damaged fallopian tube may need to be removed, but if the other tube is healthy, future pregnancies are still possible. Preventing Ectopic Pregnancy While it’s not possible to completely prevent ectopic pregnancy, there are ways to reduce the risk: Use condoms to prevent sexually transmitted infections. Avoid using vaginal douches, as they have been linked to an increased risk of ectopic pregnancies. Maintain a healthy weight Avoid smoking FAQS Can I get pregnant again after an ectopic pregnancy? Yes, most women who have had an ectopic pregnancies will go on to have normal subsequent pregnancies. However, the risk of having another ectopic pregnancy is slightly higher. You will need to discuss with your health care provider the possible cause of your ectopic pregnancy and any risk factors that may further increase the possibility of it occurring again. How soon after an ectopic pregnancy can I become pregnant again? In most instances, it is recommended that you should try after three months. This allows the fallopian tube and your body to recover from the surgery and reduces the chances of your getting another ectopic pregnancy. However, this is best discussed with your healthcare provider because, in certain situations, it may be different. Can I still have a baby if my fallopian tube was removed? Yes, you can still have a baby if one of your fallopian tubes is removed. You usually have two fallopian tubes, and you only need one to become pregnant naturally. Also, assisted reproductive technologies such as in vitro fertilization allow for pregnancy without using the fallopian tubes. Talk to your provider about options for getting pregnant again and ways to decrease risks in future pregnancies. Can my pregnancy continue after an ectopic pregnancy? No, an ectopic pregnancy cannot continue. The fertilized egg cannot be relocated into the uterus and, if not treated, an ectopic pregnancy can result in life-threatening complications such as serious internal bleeding. You need to seek medical attention immediately so that you can be healthy and safe. How will I address the emotional issues surrounding an ectopic pregnancy? An ectopic pregnancy can be very emotional; feelings of grief and loss or anxiety about not becoming pregnant may arise. This can be a challenging time, even if the pregnancy was unplanned, and it is normal to feel mixed emotions. It is also a good time to speak with your partner, your health care provider, or a mental health professional regarding how you are doing-your emotional well-being is important, too, as you heal physically and emotionally. If you are planning a pregnancy later, enable the provider of healthcare to follow the management of risk factors and establish a plan of care that would assure an optimum outcome. Sources WebMD American College of Obstetricians and Gynecologists KidsHealth/Nemours The March of Dimes American Society of Reproductive Medicine Mayo Clinic Journal of Obstetric, Gynecologic & Neonatal Nursing: “Vaginal Douching.” J Emerg Trauma Shock: “Primary hepatic pregnancy.” Ectopic Pregnancy Foundation National Health Service (U.K.) ISUOG UT Southwestern Medical System University of Texas Southwestern Medical Center Annals of Emergency Medicine Cleveland Clinic Merck Manual 0 FacebookTwitterPinterestLinkedinEmail Justina previous post Ear Infection next post Health benefits of cloves
