ECTOPIC PREGNANCY

In a normal pregnancy, your ovary releases an egg into your fallopian tube. If the egg meets with a sperm, the fertilized egg moves into your uterus to attach to its lining and continues to grow for the next 9 months.

In some cases, the fertilized egg grows and settles in locations other than the uterus.  It may be in the fallopian tube, the ovary, cervix, or abdomen.  The danger in having an ectopic pregnancy is that it may rupture, and cause bleeding.

The fetus in an ectopic pregnancy cannot develop properly and cannot survive.  Thus, early treatment is important to save the mother and preserve the chance for future healthy pregnancies.

Several factors are associated with ectopic pregnancy:

  • Previous ectopic pregnancy
  • Inflammation or infection in the pelvic organs
  • Fertility issues especially those who has undergone in vitro fertilization
  • Damaged fallopian tube because of previous surgery
  • Use of intrauterine device (IUD)
  • Smoking

There are three classical signs for Ectopic Pregnancy, these are:

  • Abdominal pain
  • Absence of menstrual period (amenorrhea)
  • Vaginal bleeding or intermittent bleeding (spotting)

Other symptoms of an Ectopic Pregnancy:

  • Nausea and vomiting with pain
  • Sharp abdominal cramps
  • Pain on one side of your body
  • Dizziness or weakness
  • Pain in your shoulder, neck, or rectum
  • If the fallopian tube ruptures, the pain and bleeding could be severe enough to cause fainting.

Unfortunately, some women with a bleeding ectopic pregnancy do not recognize they have symptoms of ectopic pregnancy. Their diagnosis is delayed until the woman shows signs of shock (for example, low blood pressure, weak and rapid pulse, pale skin and confusion) and often is brought to an emergency department. This situation is a medical emergency.

DIAGNOSIS

Once you arrive at the hospital, a pregnancy test, a pelvic exam, and an ultrasound test may be performed to view the uterus’ condition and fallopian tubes.

Sometimes it is too soon to detect a pregnancy through ultrasound. If the diagnosis is in question, your doctor might monitor your condition with blood tests until the ectopic pregnancy can be confirmed or ruled out through ultrasound — usually by four to five weeks after conception.

In an emergency situation — if you’re bleeding heavily, for example — an ectopic pregnancy might be diagnosed and treated surgically.

 

RECOMMENDED MEDICATIONS

Medicine can only be used for early ectopic pregnancies that have not ruptured. Depending on where the ectopic growth is and what type of surgery would otherwise be used, medicine may be less likely than surgical treatment to cause fallopian tube damage.

For an ectopic pregnancy that is more developed, surgery is a safer and more dependable treatment.

Methotrexate is used to stop the growth of an early ectopic pregnancy. It can also be used after surgical ectopic treatment to ensure that all ectopic cell growth has stopped.

If your blood type is Rh-negative, Rh immunoglobulin may be used to protect any future pregnancies against Rh sensitization.

In other cases, ectopic pregnancy is usually treated with laparoscopic surgery. In this procedure, a small incision is made in the abdomen, near or in the navel. Then your doctor uses a thin tube equipped with a camera lens and light (laparoscope) to view the area.

If the ectopic pregnancy is causing heavy bleeding or the fallopian tube has ruptured, you might need emergency surgery through an abdominal incision (laparotomy). In some cases, the fallopian tube can be repaired. Typically, however, a ruptured tube must be removed.

Your doctor will monitor your HCG levels after surgery to be sure all of the ectopic tissue was removed. If HCG levels don’t come down quickly, an injection of methotrexate may be needed.

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