Ectopic Pregnancy
Introduction
Pregnancy begins with a fertilized egg. This egg is called a zygote. Normally, the zygote attaches itself to the lining of the uterus. With an ectopic pregnancy, the zygote implants somewhere else.
More than 95 percent of ectopic pregnancies occur in a fallopian tube — the tubes that carry the egg from the ovaries to the uterus. These are known as tubal pregnancies. Ectopic pregnancies are possible in the abdomen, ovary or neck of the uterus (cervix) as well.
An ectopic pregnancy can't proceed normally. The developing embryo can't survive, and the growing placental tissue may destroy important maternal structures. Without treatment, life-threatening blood loss is possible.
About one in every 40 to 100 pregnancies is ectopic. Thanks to earlier diagnosis and treatment, the chance for future healthy pregnancies is better than ever before.
Signs and Symptoms
At first, an ectopic pregnancy may seem like a normal pregnancy. Early signs and symptoms are the same as those of any pregnancy — a missed period, breast tenderness, fatigue and nausea.
Abdominal or pelvic pain is usually the first sign of an ectopic pregnancy. You may have lower abdominal or pelvic pain or mild cramping on one side of the pelvis. Abnormal vaginal bleeding is common, too. If the fallopian tube ruptures, you may feel sharp, stabbing pain in your pelvis, abdomen or even your shoulder and neck. You may become dizzy or faint.
If you experience any of these signs or symptoms, seek emergency care.
Causes
An ectopic pregnancy is caused by a disruption in a woman's reproductive anatomy or the timing of specific reproductive events. When the fallopian tube is damaged, scarred or misshapen, ectopic pregnancy may be related to delayed passage through the tube or to some factor that gives the tube an affinity for implantation.
Many times, what causes an ectopic pregnancy remains a mystery.
Treatment
A fertilized egg can't develop normally outside the uterus. To prevent life-threatening complications, the ectopic tissue must be removed.
If the ectopic pregnancy is detected early — when the zygote is small and hasn't caused bleeding or rupture — an injection of methotrexate may be used to stop cell growth and dissolve existing cells. If the pregnancy continues after treatment with methotrexate, more medication or surgery may be needed.
If the pregnancy is farther along, you'll probably need surgery. Laparoscopy is a common choice. In this procedure, the doctor makes a small incision in the lower abdomen, near or in the navel. Then he or she uses a thin tube equipped with a camera lens and light (a laparoscope) to view the area. Other instruments can be inserted into the tube or through other small incisions to remove the ectopic tissue and repair the fallopian tube. If the fallopian tube is significantly damaged, it may need to be removed.
If the fallopian tube has ruptured, you may need emergency surgery through a laparotomy (an abdominal incision). In some cases, the fallopian tube can be repaired. Typically, however, the ruptured tube must be removed.
After treatment, your health care provider will monitor your blood for the pregnancy hormone human chorionic gonadotropin (HCG). If the level remains high, it could indicate that the ectopic tissue wasn't entirely removed. In that case, you may need additional surgery or treatment with methotrexate.
Prevention
You can't prevent an ectopic pregnancy— but you can decrease certain risk factors. For example, limiting your number of sexual partners and using a condom when you have sex can help prevent sexually transmitted diseases and reduce the risk of pelvic inflammatory disease.
If you've had an ectopic pregnancy, talk to your health care provider before conceiving again. When you become pregnant, he or she will carefully monitor your condition to make sure your pregnancy is progressing normally.
Informations obtained from National Institute of Health.