ECTOPIC PREGNANCY
All information on this site is given for research purposes only. This information is not given as a substitute for your personal care and
diagnosis by a licensed physician. Under any and all circumstances, if you think that you may have an ectopic pregnancy, consult your
physician immediately. Always insist that your medical professionals take your concerns seriously.
You, yourself, cannot cause an ectopic pregnancy!! Being cautious of these risk factors can reduce the possibility of an ectopic pregnancy
What is Ectopic Pregnancy?
An Ectopic Pregnancy (more commonly known as a tubal pregnancy) is pregnancy where a fertilized egg implants itself somewhere other than the womans uterus. This could be a life threatening pregnancy. Other places that an ectopic pregnancy can occur are: within the cervix, on the ovaries and abdominal cavity. Around 97% of ectopics are located in the Fallopian Tube. Around 100,000 ectopic pregnancies occur each year. Approximately 1 in 66 women will experience this type of
pregnancy. Ectopic pregnancy is a very serious condition. When the pregnancy grows in these areas, it can easily cause massive,
rapid bleeding, and can even result in death. Ectopic pregnancies are the second leading cause of pregnancy related deaths in the first trimester. Ectopic pregnancies account for 9% of all pregnancy related deaths in the USA.
What are the causes of these types of pregnancy?
*Endometriosis. This is a condition where the tissue that is usually the lining of the uterus, is found outside the uterus, and can block a fallopian tube.
*Exposure to diethylsilbestrol (DES) as a fetus. If a woman's mother took DES(synthetis verson of estrogen) during pregnancy, this could cause a woman to have abnormalities in her fallopian tubes. This can make an ectopic pregnancy more likely.
*Taking some hormones. Estrogen and progesterone are hormones taht regulate a woman's menstrual cycle. They may be prescribed by a doctor and taken for birth control or some other reasons. These hormones can affect the interior lining of the fallopian tubes and slow the movement of a fertilized egg.
*A history of PID (pelvic inflammatory disease) This is an infection of the fallopian tubes(salpingitis) that can spread to the uterus or ovaries. This is an STD (sexually transmitted disease),usually caused by Gonorrhea and Chlamydia. As many as 50% of women that have experienced ectopic pregnancies have had a history of PID.
*Use of intrauterine device(IUD). This type of contraceptive is used to prevent a fertilized egg from becoming implanted in the uterus. This has little effect on preventing ectopic pregnancies. If a woman becomes pregnant while using the IUD, the fertilized egg is more likely to implant itself somewhere other than the uterus.
*Having previous pelvic or tubal surgeries.
*Tubal ligation or reversed Tubal ligation. (Having tubes "tied" or "untied")
*Smoking (may damage the ampulla of the fallopian tube)
*History of ectopic pregnancy.
Symptoms of Ectopic Pregnancy.
Early Symptoms
Ectopic pregnancies can have the same symptoms as a normal pregnancy.
Early symptoms can include: fatigue, nausea, a missed menstral cycle, pain in the lower back, some mild cramping on one side of the pelvis, breast tenderness, abnormal vaginal bleeding and or spotting.
If you are experiencing any of these symptoms, consult your doctor.
Later Symptoms
The first sign that something is wrong can be a stabbing pain in the abdomen or pelvis. This is caused by the embryo growing to big for the small space in the fallopian tube.
If the fallopian tube has ruptured, blood can irritate the diaphragm and it can also cause shoulder pain. Some other warnings are lightheadedness and fainting.
The tube rupturing can cause serious internal bleeding and may even cause death.
How are Ectopic Pregnancies diagnosed?
First the doctor must confirm pregnancy. Then, if an ectopic pregnancy is suspected, the doctor will do a pelvic exam to determine where the pain is coming from and to detect a mass in the abdomen.
There are several laboratory tests that can be done on the patients blood. Measurements of the human chorionic gonadotropin (hCG)in the patients blood serum is what is most useful laboratory test in early stages of pregnancy.
In normal pregnancies, the level of this hormone doubles about every two days during the first ten weeks of pregnancy. In ectopic pregnancies, the rate of the increase is a lot slower.
The low hCG level for the stage of pregnancy is a very strong indication that the pregnancy is abnormal.
(It can also mean that a miscarriage is possible.) The level of hCG is usually tested several times over a period of days to determine whether or not it is increasing at a normal rate.
Progesterone levels in the blood are also measured. Lower level than expected can also indicate that the pregnancy is not normal.
An ultrasound may show information about the pregnancy being an ectopic pregnancy.
A culdocentesis may also confirm a diagnosis. This is where a needle is inserted into the space at the top of the vagina, behind the uterus, and in front of the rectum. Blood in this area may indicate bleeding from a ruptured tube.
A laparoscopy can enable the doctor to see the patient's reproductive organs and examine an ectopic pregnancy. A hallow tube with a light on one end is inserted through a small incision in the abdomen. Through this intrument the internal organs can be seen.
Treatments for Ectopic Pregnancy
One treatment for ectopic pregnancies is the use of a drug called Methotrexate. This drug works by inhibiting the growth of rapidly growing cells.
This treatment is only given in the early stage of ectopic pregnancy. The best results are received when the pregnancy is less than six weeks old and the tubal mass is no more than 1.4 in (3.5cm) in diameter.
Most side effects are mild and temporary, but the patient must be monitored. The medication is can be injected into muscle, using only a single dose. It can also
be given intravenously or injected directly into the fallopian tube to dissolve the embryonic tissue.
Methotrexate has also been used to treat ovarian, cervical, and abdominal pregnancies that are discovered in the early stages.
There is also a surgical treatment. When a doctor performs a laparoscopy to view the ectopic pregnancy, the scope can be fitted with surgical tools.
These tools are used to remove the ectopic mass immediately after it is identified.
This provedure can be done without requiring an overnight hospital stay.
When the pregnancy has ruptured, a surgical incision into the abdomen, or laparotomy is done to stop loss of blood and to remove the embryo.
This, almost always, requires general anesthesia and a hospital stay. Physican's do everything they can to try to save and repair the injured fallopian tube.
But if the tube has already ruptured, the repair is very difficult and the tube is usually removed.
Subsequent Pregnancies
There is a possibility that you may have another ectopic pregnancy. A woman that has experienced an ectopic pregnancy has about a 12% chance of having another ectopic pregnancy.
When you feel you are ready for another pregnancy, check with your doctor. There are tests that can be done to
see if your remaining tube is alright. Your next pregnancy maybe closely monitored during the first few weeks. The doctor may order
blood work and an ultrasound to be sure that the embryo is in the uterus.
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