Ectopic Pregnancy

ECTOPIC PREGNANCY pain

Last Updated February 21st, 2019

How Does Pregnancy Normally Occur?

In order for a woman to become pregnant, at least one of her ovaries must release a mature ovum. This ovum then remains in the fallopian tube for some time while it awaits fertilization. If it is successfully fertilized by a sperm during this time, the fertilized ovum will eventually move into the uterus and become implanted in the endometrial lining of the uterus which has become thickened with blood in anticipation of this very event. Once it has become implanted in the uterine endometrium and barring any subsequent complications, the embryo will then continue to grow until it is delivered through the birth canal. This is how a normal or uterine pregnancy takes place.

 

What Is An Ectopic Pregnancy?

ECTOPIC PREGNANCY fertilizationJust as the embryo becomes implanted within the uterine cavity, it is perfectly possible for it to become implanted in another location altogether. Such pregnancies are known as ectopic pregnancies. The most common site for implantation outside the uterus is the fallopian tube. However, it is not unheard of for the embryo to become implanted in locations such as the ovary, fimbriae, cervix and even the abdomen. Such pregnancies do not always produce symptoms but can be very painful when they do.

 

Under What Conditions Does This Happen? What Are The Risk Factors?

Any woman of childbearing age could potentially suffer an ectopic pregnancy. The underlying causes for this are not well understood. However, there are a number of well-recognized risk factors. The list below enumerates some of these risk factors:

  • The risk increases with the age of the woman.
  • Smoking.
  • Having a history of ectopic pregnancy raises the risk of suffering a repeat.
  • Any factors that hinder the movement of the ovum through the fallopian tube. This includes tubal ligation for prevention of pregnancy or even certain contraceptives that can affect the character of the fallopian tube, making it difficult for the ovum to travel into the uterus and thus, increasing the probability of implantation within the tube itself. In general, any condition like surgery or infection that gives rise to inflammation, scarring, obstruction or damage in the fallopian tube can increase the probability of developing an ectopic pregnancy.
  • Pelvic inflammatory disease (PID) is one of the most common risk factors.
  • Sexually transmitted diseases such as chlamydia.
  • Endometriosis.
  • Presence of scars from surgery in the pelvic area. Examples of such procedures include a Caesarean section for a previous pregnancy or an appendectomy.
  • Having a history of procedures such as dilation and curettage for abortion, miscarriage or other reasons.
  • Using assisted reproductive techniques or fertility drugs can increase the likelihood of developing an ectopic pregnancy. In fact, such methods increase the likelihood of developing what a ‘heterotopic’ pregnancy which is otherwise extremely rare in nature. In such instances, one embryo may implant in the uterus while the other implants elsewhere.
  • When pregnancy occurs despite using contraceptive measures such as intrauterine devices.
  • Having a medical condition or a birth defect that affects the structure or shape of organs like the fallopian tubes.
  • Some studies have found that women are more likely to suffer ectopic pregnancies in their first pregnancy as compared to subsequent ones.

 

How Can I Identify An Ectopic Pregnancy?

In most cases, women are usually not aware that they have developed ectopic pregnancies. In instances where symptoms are present, they are usually non-specific and the actual cause is only clearly identifiable after performing some tests. An ectopic pregnancy may also share some of the typical symptoms of a normal uterine pregnancy or even a miscarriage. Generally, symptoms manifest between 4 to 8 weeks following the last menstrual bleeding. Here are some of the indications to look out for:

 

What Are The Different Kinds Of Ectopic Pregnancy?

ECTOPIC PREGNANCY typesThe fertilized ovum could implant in any of a number of possible locations outside of the uterus, giving rise to a variety of possible ectopic pregnancies as the list below will briefly explain:

  • Tubal Pregnancy: This is the most common form of ectopic pregnancy, wherein the embryo becomes implanted anywhere along the length of the fallopian tube. Depending on which particular section of the fallopian tube is involved, a tubal pregnancy can be of the following types: fimbrial, ampullary, isthmic or interstitial.
  • Ovarian Pregnancy: The embryo becomes implanted in the ovary.
  • Cervical Pregnancy: The embryo becomes implanted in the cervical canal.
  • Abdominal Pregnancy: In such instances, implantation occurs within the abdominal region. For example, the embryo may attach itself to the bowels. This form of ectopic pregnancy represents a greater risk to the mother’s life than other types. However, in very rare instances, live fetuses have been successfully delivered via laparotomy or Caesarean section.
  • Caesarean Scar Pregnancy: This is extremely rare. Here, implantation takes place in the scar from prior Caesarean section procedures.

 

What Are The Complications Of Ectopic Pregnancy?

Ectopic pregnancies may terminate spontaneously. If they do not, they can endanger the life of the mother and even lead to death. This is so because, apart from the uterus, no other site is conducive or properly equipped for the demands of pregnancy, barring exceptional circumstances. An ectopic pregnancy can also negatively impact the mother’s fertility in the future.

If an ectopic pregnancy does progress (which is more likely than spontaneous termination) it could potentially lead to a rupture of the fallopian tube or uterus (as in the case of a Caesarean scar pregnancy). These are medical emergencies and will require immediate hospitalization and surgical intervention.

 

What Does Diagnosis Involve?

  • Medical history, specifically with regard to previous pregnancies, abortions, miscarriages, surgeries or fertility treatments.
  • Physical examination.
  • Tests for sexually transmitted infections.
  • Pregnancy test which usually involves a blood test to look for the presence of the human chorionic gonadotropin and to assess the level of progesterone.
  • Transvaginal ultrasonography.
  • Laparoscopy.

 

The Diagnosis Was Positive. What Should I Do?

ECTOPIC PREGNANCY painIf an ectopic pregnancy is not detected timely, it can be life-threatening. Once it has been diagnosed, the ectopic tissues need to be removed immediately. This can be done by one of the following methods:

  • Medication: If the bleeding is not too severe, drugs such as methotrexate can be prescribed to dissolve the ectopic tissue.
  • Laparoscopy: This is used to view the ectopic tissues and the surrounding tubal areas. After this, the ectopic tissues are removed or repaired depending upon the severity of the condition.
  • Salpingectomy: If the bleeding is too severe and sudden, emergency surgery is the only sure shot way to avoid further complications. If the fallopian tube has been ruptured extensively, it is removed by a procedure called salpingectomy.

While there are no sure shot ways to gain 100% from ectopic pregnancies, the following methods can help mitigate the risk of developing one:

  • Maintain good reproductive health.
  • Practice safe sex. Limit the number of sexual partners.
  • Always use a condom.
  • Go for regular gynecological check-ups to ensure that you are STD-free.
  • Refrain from any form of tobacco consumption.

 

Facts

  • Only half of the women diagnosed with ectopic pregnancy show all the three classic symptoms of the condition namely abdominal pain, an absence of menses, and abnormal vaginal bleeding.

Facts

  • The prevalence of this is condition is around 1-2% of all pregnancies.
  • Before the advent of surgical intervention for ectopic pregnancies, the mortality rate due to this condition was as high as 50%.

Facts

  • Early detection of ectopic pregnancies can decrease the fatality rate to as low as 5 deaths per 100,000 reported cases.
  • The recent rise in IVF pregnancies is linked to the surge in heterotopic pregnancies; where there is a simultaneous intrauterine and ectopic pregnancy.

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Dos and Don'ts

Dos
  • Protect yourself from STDs by practicing safe sex.
  • Be extra careful of the symptoms of ectopic pregnancy of you have already experienced one in the past and/or are undergoing IVF.
Don'ts
  • Ignore the symptoms of any sexually transmitted infection such as abnormal vaginal discharge/bleeding.
  • Indulge in smoking or any form of tobacco consumption.

 

 

 

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Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
immunoglobulin M
Immunoglobulin M Test Immunoglobulin M is the largest and the first produced antibody which helps in the prevention or fighting of…
carrageenan seaweed
Carrageenan: How a simple seaweed extract could better your gut health & immunity Eat more ice cream to prevent cold and flu? –With carrageenan you get one simple seaweed extract that…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
The complete “what to eat” guide for gluten intolerance Does eating breads and pastas often makes you nauseous? Gluten intolerance is a common reason why you might…
The right way to prepare Alfalfa sprouts at home Alfalfa or lusan ghas is not just a nutritious animal fodder. This flavonoid-rich herb has some amazing health…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
Appendix pain: Recent findings on this not-so vestigial organ The exact function of the appendix is still not clear. Some consider it as an organ that once…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
bananas exercise
10 health reasons why you should go “bananas” over bananas! Bananas:The world's most popular fruit comes with a host of unbelievable health benefits. Find out how you can…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
Inversion Therapy: The anti-gravity way of healing chronic back pain Inversion therapy involves suspending a person upside dow using different types of equipment. This works by taking the…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
shoudler exercises
Keep your shoulders pain-free with these shoulder exercises Shoulder exercises are important in order to prevent chronic back and neck pain. Learn more about how you…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…