The word ectopic literally means ‘out if place’. Basically during an ectopic pregnancy, a completely fertilized egg is simply places itself outside the uterus for gestation. The slightly developed foetus then reconciles in the sac that is enclosed by the fallopian tube. This happens almost 95% of the times and hence due to this sole reason it is also called tubal pregnancy. The various cavities like abdomen, ovary or even the cervix cannot be as good as the uterus for the nurturing of the foetus. During an ectopic pregnancy, in the very initial stage the growing foetus tend to burst the placental bag that contains it. This ends up in excessive internal bleeding and the mother and child both are at equivalent risk. It is believed that a conventional tubal pregnancy never results in childbirth.
There are many signs of tubal pregnancies. The early signs are benign and basically symptom free. Most cases occur between 5 and 8 weeks after conception. Early signs include a strong stomach-like or cramp-like pain in the lower abdomen along with inflammation of that area. Other symptoms may include pain while urinating or having a bowel movement, mild vaginal bleeding. Later signs include pain and bleeding, both internal from the affected tube and external from falling progesterone levels. At this junction, it may be difficult to distinguish these symptoms as a normal pregnancy, a miscarriage or a tubal pregnancy. Tubal pregnancies are often misdiagnosed as pelvic inflammatory disease (PID) and can be ruled out as PID with a positive pregnancy test since it is very rare to find pregnancy and PID occurring at the same time.
If you have symptoms of bleeding and stomach pain, be sure to see your doctor immediately. They can determine if you have tubal pregnancy from a simple blood test or an ultrasound. The key is early detection. If it can be treated early on, then the risks to your health and future pregnancies are greatly reduced. By keeping yourself aware of the signs of ectopic pregnancy you can eliminate potential health risks.
An ectopic pregnancy occurs as a result of the fertilized egg’s inability to travel down the fallopian tube and into the uterus. This may be caused by an infection, such as pelvic inflammatory disease, or swelling that has formed an obstruction inside the tube.
Tubal surgery – women who have had operations on their tubes are more at risk of ectopic. This includes tubal ligatoin, reversal of sterilisation or tubal surgery for a previous ectopic.
Previous ectopic – about 10-20% of those attempting pregnancy after one ectopic will have another.
DES exposure – this is a drug that was once used during pregnancy, until it was found that female babies of women who used it were at risk of developmental abnormalities of the genital system. Their tubes are more likely to be abnormal and predisposed to ectopic pregnancy. This is a very rare problem and you would most likely already know about it.
Smoking. Women who smoke or who used to smoke have higher rates of ectopic pregnancy. The more you smoke, the higher your risk.1 Smoking is thought to damage the fallopian tubes’ ability to move the fertilized egg toward the uterus.
Diagnosis
Ectopic pregnancies are often difficult to diagnose. However, based on the symptoms, the obstetrician may prescribe any of the following tests:
- Blood test
- Vaginal examination
- Ultrasound
If the tests are still inconclusive, the obstetrician may suggest examination of the fallopian tubes using laparoscopic surgery.
Treatment
If the embryo is still small, the ectopic pregnancy may be terminated by injecting the drug methotrexate. However, in more advanced cases, or where the medication is not advisable, a surgery may be required.
