When the fertilized egg attaches itself outside the uterus, it is called an ectopic pregnancy. The uterus of a woman, also called the womb, is the fetus’s home before the baby is born. Pregnancy begins when the fertilized egg implants itself in the uterus. For a normal pregnancy, the fertilized egg must attach to the uterine wall.
In many instances, the fertilized egg attaches itself outside the uterine wall – in the fallopian tubes, cervix, etc. When this happens, it is called an ectopic pregnancy.
More about Ectopic Pregnancy
How common is it?
An ectopic pregnancy occurs in about 1 in every 50 pregnancies and needs immediate attention. The reason being that this type of pregnancy cannot proceed normally and can lead to excessive bleeding, which is a medical emergency.
Types of ectopic pregnancies
Based on where the fertilized egg implants itself outside the uterus, ectopic pregnancy can be of the following types:
● Tubal Pregnancy: Ectopic pregnancy that occurs within the fallopian tubes when the egg is released from the ovaries is called a tubal pregnancy. This is the most common type of ectopic pregnancy and can be further classified based on where the implantation of the fertilized egg occurs in the fallopian tube.
● Non-tubal Pregnancy: This type of pregnancies account for about 2% of all the ectopic pregnancies. The fertilized egg in these cases can attach itself to the cervix, ovary, or anywhere in the abdominal wall.
● Heterotopic Pregnancy: In very rare cases, one egg implants in the uterine wall but the other implants itself outside of the uterus.
Symptoms of an ectopic pregnancy
The early symptoms and signs of an ectopic pregnancy may be confused with the signs of a normal pregnancy. Nausea, breast tenderness, and missed periods are the early symptoms of both.
One of the first and early signs of an ectopic pregnancy is pelvic pain and vaginal bleeding. However, these coincide with the normal early symptoms of any pregnancy, and therefore, your doctor will use a step-by-step method to diagnose if your pregnancy is ectopic. The following are the early signs of ectopic pregnancy:
● Pelvic pain as well as light vaginal bleeding
● Urge to have a bowel movement
● Referred pain on the shoulder
Certain symptoms depend on where the blood collects and which nerves are irritated.
If the fertilized egg keeps growing in the fallopian tube, it can lead the tube to rupture. There is a possibility of heavy bleeding inside the abdomen. Symptoms of this life-threatening event include extreme lightheadedness, fainting as well as shock.
If you suffer from any of these symptoms, seek medical help immediately.
What Causes an Ectopic Pregnancy?
What causes an ectopic pregnancy is still unclear. However, certain causes have been linked to it:
● Hormonal derangements
● History of smoking
● Fertility treatments like IVF
● Previous history of an ectopic pregnancy
● Birth defects
● Genetic factors
● The shape of the fallopian tubes
There are a few risk factors that are linked to an ectopic pregnancy. Some of these include–
1. Maternal age is 35 years or above
2. History of endometriosis
3. History of pelvic inflammatory disease.
4. History of Sexually Transmitted Infections (STIs)
5. History of pelvic or abdominal surgery.
6. In few rare cases, conception occurs despite tubectomy or placement of an Intrauterine Device(IUD), leading to an ectopic pregnancy.
If you have one or more of these risk factors, it may be a good idea to discuss with your doctor to avoid serious complications.
How is an Ectopic Pregnancy Diagnosed?
The first thing to do if you suspect an ectopic pregnancy is to visit your obstetrician-gynecologist. Though a physical exam does not help determine an ectopic pregnancy, your doctor may still perform a physical examination.
Apart from this, your doctor will also advise you to undergo a few blood tests to determine progesterone and hCG levels. If these hormones’ levels are less or decreasing, it may indicate the absence of the amniotic sac.
Your doctor will also perform a transvaginal ultrasound by inserting a lubricated wand-like ultrasound head into your vagina to better view the amniotic sac inside the uterus.
However, in cases where the symptoms are very severe, there might not be enough time to perform all the evaluation steps. You may be taken in for an emergency procedure.
Treatment of Ectopic Pregnancy
Though still considered to be a pregnancy, ectopic pregnancies are unsafe for the mother and the fetus. The fetus in these cases rarely reaches full-term and needs to be aborted. For this reason, ectopic pregnancy requires prompt treatment. This include–
If the ectopic pregnancy is diagnosed before it becomes an emergency, your doctor may prescribe you medications to prevent the rapid division of cells within the ectopic mass. This medication will cause cramps, bleeding, and enable the ectopic tissue’s easy passage – similar to a miscarriage.
In many cases, however, surgery is preferred over medications. In this case, the ectopic mass is removed surgically laparoscopically.
After the ectopic mass has been removed, your doctor will advise you on some post-treatment instructions and signs to watch out for.
● You must not lift very heavy weights(>10 pounds).
● Keep yourself hydrated and drink lots of fluids to avoid constipation.
● Avoid having sex, using tampons, and give your pelvic region some rest.
● Complete rest one week after the surgery or miscarriage and incremental increase in activity slowly.
Preventing an Ectopic Pregnancy
Having had one ectopic pregnancy puts you at an increased risk of having a subsequent one, but that must not stop you from trying to conceive again. Once you have completely recovered from the surgery, you must visit your doctor before you try conceiving again. There is no way to completely prevent an ectopic pregnancy, but you can reduce the risk factors that can lead to it.
You must know that after an ectopic pregnancy, it is possible to have healthy, full-term pregnancies subsequently. If you have any queries, contact our team of Obstetricians and Gynaecologists.