Arrival of a baby is the most awaited moment in every couple's life. Every woman is eagerly waiting for this 'good news'. A missed menstrual period indicates a possibility of being pregnant. In normal cases, the fertilized egg settles and grows in the uterine lining. However, in case of ectopic pregnancy, the embryo is implanted outside the uterus, mostly within the fallopian tubes. Sometimes, the embryo develops in the ovary, cervix, or abdomen. Ectopic pregnancy is also referred to as tubal pregnancy, abdominal pregnancy, or cervical pregnancy. This type of pregnancy occurs in about 20 in 1,000 cases.
Ectopic pregnancy results from implantation of the fertilized egg within the fallopian tube instead of the uterus. Some of the risk factors are fallopian tube surgery, previous history of tubal pregnancy, use of fertility medications, infections of fallopian tubes like gonorrhea, chlamydia, and pelvic inflammatory disease (PID), and the use of intrauterine devices (IUD). Sometimes, this pregnancy may result from the congenital anatomical abnormalities in the fallopian tubes, cysts in the tubes, endometritis, uterine fibroids, complications of a ruptured appendix, and scarring due to previous pelvic surgery.
Early Signs and Symptoms
Tubal pregnancy is detected in the first 5-10 weeks after conception. In the early stage, it resembles a normal pregnancy. The early signs and symptoms are also similar to normal pregnancy, such as a missed period and breast tenderness. However, within a few days, a woman experiences the early symptoms like lower-back pain, lower-abdominal pain, abnormal-vaginal bleeding, cramping on one side of the pelvis, nausea, vomiting, low-blood pressure due to severe bleeding, and rapid heartbeats.
Vaginal bleeding is mainly associated with the changes in the hormonal levels. Irregular or late menstrual period is also one of the symptoms of tubal pregnancy. If the fallopian tube ruptures in this case, then it causes intense pain in the pelvis or abdomen, shoulder pain, fatigue, dizziness, fainting, lightheadedness, sweating, and rapid heartbeats. Vigorous bleeding can lead to shock. You should take this condition as a medical emergency and immediately seek medical help.
Diagnosis and Treatment
If you experience severe pain in the lower abdomen or heavy-vaginal bleeding, you should immediately consult a doctor. Ectopic pregnancy is detected on the basis of pelvic examination, ultrasound scan reports, culdocentesis, urine-pregnancy test, and blood tests like determination of changes in the pregnancy hormones (human chorionic gonadotropin/hCG), hematocrit, and white-blood cell count. The tests like D and C, laparotomy, and laparoscopy are done for the confirmation of tubal pregnancy.
In this pregnancy, the fetus cannot develop normally. On the other hand, growth of the embryo outside the womb can cause severe damage to the reproductive organs of the woman. Hence, it becomes essential to remove the developing fetus from the fallopian tube in order to save the mother's life. If this pregnancy is detected before rupturing of the tube, then a drug called methotrexate is administered, which destroys the developing fetal cells.
If the mass is more than 3.5 cm in size, the tube is ruptured and the woman experiences heavy bleeding. In this case, surgical treatment is essential, which includes salpingostomy (removal of the part of fallopian tube containing the conceptus) and salpingectomy (removal of the entire fallopian tube). The treatment is aimed at preventing the complications of tubal pregnancy and preserving the woman's subsequent fertility.
Ectopic pregnancy can be prevented by avoiding the conditions that can cause scarring of the fallopian tubes. You also need to avoid the risk factors for pelvic inflammatory diseases such as multiple-sex partners or unsafe sex without a condom. Early diagnosis and treatment of sexually transmitted diseases (STDs) is also very important.
Disclaimer: This HerHaleness article is for informative purposes only, and should not be used as a replacement for expert medical advice.