Everything you need to know about Ectopic pregnancy

Have you ever heard of a condition called ectopic pregnancy? This type of conception is very risky for the mother’s life and most babies are unable to live. Every woman should be aware about ectopic pregnancy and everything you need to know is here.

What is ectopic pregnancy?

An ectopic pregnancy is when the fertilized egg is implanted and grows outside the ovary. This usually starts within the first few weeks of pregnancy. However, doctors are only able to indicate ectopic pregnancy during the 8th week.

In most cases, the fertilized egg is unable to move itself into the uterus. Thus, the fertilized egg continues to develop inside the fallopian tube. This kind of ectopic pregnancy is called a tubal pregnancy.

In some cases, ectopic pregnancy brings danger to the woman’s life. This affects the baby’s life as well, where there is a big possibility that the baby will not make it out alive.

There are rare cases where the baby survives despite the abnormal pregnancy condition. But unfortunately the baby is unable to survive when the pregnancy case is tubal, cornual, and cervical.

Aside from the fallopian tube, an ectopic pregnancy can also occur in other locations such as…

Pregnancy week by week
  • Abdominal cavity
  • Cornua (horn) of the uterus
  • Cervix
  • Ovaries
  • Cesarean section scar

Ectopic_Pregnancy01

Image source : Wikipedia by Takatakatakumi shared under CC BY-SA 3.0

How does it start?

Here is how ectopic pregnancy starts.

  1. A few weeks after conception, the fertilized eggs move into one of the fallopian tubes and through the uterus.
  2. However, the tube is damaged or blocked and the egg is unable to move forward to the womb.
  3. So the egg implants itself inside the tube and continues to grow there.

Causes of ectopic pregnancy

Ectopic pregnancy is not caused by a damaged tube alone. The risks of having ectopic pregnancy become higher due to the following causes:

  • History of ectopic pregnancy. When a woman experienced one ectopic pregnancy… chances of having another one is 1 out of 10%. However, if she has had two or more ectopic cases the chances will be 1 out of 4%.
  • Birth control usage such as, intrauterine device (IUD)—a device which prevents the egg cell from implanting inside the uterus. On the contrary, previous IUD usage does not increase the risk of having ectopic pregnancy.
  • Smoking cigarettes damages the normal functioning of the female tubes.
  • Fertility drug usage
  • Intake of progestin-only hormonal contraceptives
  • Pelvic inflammatory disease (PID), an upper reproductive tract infection. This is caused by an untreated sexually transmitted disease (STD) such as Chlamydia and Gonorrhea— which are contagious. In some cases, these diseases go unnoticed so it is best to have a medical check-up to determine if infection is present or not.
  • Inherited abnormality of the fallopian tube
  • Endometriosis, a gynecological condition which affects the fallopian tubes. The scarring caused by the operation can block the fertilized egg when it tries to move out of the tube.
  • When a woman underwent an infertility treatment called vitro fertilization (IVF).
  • Fallopian tube surgery– unsuccessful operation of tubal ligation/ tubal ligation reversal also known as female sterilization. The chance of an ectopic pregnancy is about 20-50%
  • History of miscarriage (threatened abortion)

Moreover, women who are 35 years of age and older have higher risks of ectopic pregnancy as well. This is because the fallopian tube weakens as a woman ages.

Having ectopic pregnancy is very depressing on both parties, now that you know the causes. Women should take care of their body and maintain fidelity in their sex life. So that there is no need for them to take drugs and undergo treatments that will trigger the aforementioned causes.

If women are in a high-risk group for having ectopic pregnancy, immediate consultation with a healthcare provider is required.

Signs of ectopic pregnancy

Did you know that about 1 out of 50 women experience this kind of pregnancy? However, despite of the rare occurrences, this pregnancy condition is dangerous and extremely painful.

Symptoms of ectopic pregnancy

The symptoms of ectopic pregnancy usually occur during the 6th-8th week after the last menstruation. But if the fertilized egg is not implanted inside the fallopian tube, the symptoms occur late.

Below are the following symptoms to be aware of:

Normal pregnancy symptoms

It is possible to experience normal pregnancy symptoms despite of suffering from an abnormal type of pregnancy. Such symptoms include:

  • Swollen breasts
  • Over fatigue

Vaginal spotting

When experiencing ectopic pregnancy, the vaginal blood appears brownish-red like that of dried blood. Aside from that, vaginal bleeding of all kinds may also occur:

  • Sporadic
  • Continuous
  • Heavy
  • Mild

Abdominal and pelvic cramps

Mild and irregular cramps may be experienced in the beginning but may later become severe and persistent.

Cramps may also get worse during active movement and even coughing.

The cramps can be mild and severe and are usually felt on one side only but can occur anywhere in the abdominal and pelvic area.

Amenorrhea

Despite vaginal spotting, some women experience amenorrhea or the absence of menstrual periods.

Painful nausea and vomiting

Nausea and vomiting is more painful when suffering from ectopic pregnancy. This is due to the abdominal and pelvic pain.

Near-syncope

It is the feeling of passing out upon standing, whether prolonged standing or not. Near-syncope is usually accompanied by severe internal hemorrhage. This causes low blood pressure due to the ruptured ectopic pregnancy.

Shoulder ache

Shoulder ache is considered as the red flag for a ruptured ectopic pregnancy. Aching shoulders is usually accompanied with neck aches, and is mostly felt when lying down.

Severe internal bleeding is the main cause of shoulder ache. It irritates the nerves on the shoulders. Emergency surgery is necessary to stop the hemorrhage.

Pain in the rectum

During bowel movement, extreme pain from the rectum may be experienced. This is also accompanied by abdominal and pelvic pain.

Internal hemorrhage

When the fallopian tube ruptures, extreme pain and internal hemorrhage (severe bleeding) occurs that will lead to fainting. This requires a visit to the emergency room.

Infertility

The possibility of being infertile is high for women who have damaged or blocked fallopian tubes. Situations get worst when the ectopic pregnancy becomes ruptured.

Despite the extreme abnormality of ectopic pregnancy… some women do not feel any signs and symptoms until the case has ruptured.

Signs of ruptured ectopic pregnancy

Most women are not aware about the real causes of having this type of dangerous pregnancy. As a result, they do not undergo medical check-ups.

When the diagnosis is delayed, an ectopic pregnant woman will feel the following signs:

  • Shock
  • Irregular pulse rate
  • Weakness
  • Sweatiness
  • Pale skin
  • Light-headedness
  • Confusion

This severe stage causes the spouse and/or the family members to be in shock as well. These alarming signs require an immediate trip to the hospital.

How to cure ectopic pregnancy

Despite of its complicated condition, ectopic pregnancy can be cured. The cure for ectopic pregnancy depends on how clear the results are during the diagnosis, the embryo’s size, and the available techniques.

Treatments for ectopic pregnancy

Treatments are available even though ectopic pregnancy seems impossible to cure. However, most of which require surgery as it is the only way to end ectopic pregnancy.

Methotrexate

Methotrexate is injected into the muscle then it reaches the embryo through the bloodstream. This treatment is given to end pregnancy while the embryo is still small. It prevents the cells of the placenta from developing. Over time, the small embryo is reabsorbed into the body.

Side effects:

  • Abdominal cramps
  • Nausea and vomiting
  • Diarrhea

Surgery

Surgery is required for severe pain and hemorrhage; if breastfeeding; and if methotrexate did not work.

Blood transfusion

If the internal hemorrhage is heavy, blood transfusion is necessary.

Laparoscopic surgery

If the embryo is still small and the patient is in a stable condition, consult an obstetrician-gynecologist.

A general anesthesia will be given where the obstetrician-gynecologist will examine the fallopian tubes by incising the abdomen using a laprascope—a thin and flexible instrument. Then viewing instruments are inserted to visualize the abdomen and the pelvis’s structure.

Laprascopic surgery removes the embryo while preserving the tubes. However, if they are extremely damaged or there is heavily bleeding, the tube may be removed.

Abdominal surgery

Abdominal surgery is required for the following: if thick scar tissues are present in the abdomen; if there is severe bleeding; and if the embryo is already large.

The obstetrician-gynecologist will use general anesthesia and incise the abdomen to remove the embryo.

Healing time requires six weeks and during the process, abdominal pain and bloating may be experienced.

Rh immune globulin

This treatment is needed if the blood is Rh-negative (except the baby’s father is also Rh-negative.) A shot of Rh immune globulin will be given after a treatment for ectopic pregnancy.

In addition, after the treatment blood tests are still required to check if the full tubal pregnancy was successfully removed. The blood test detects the levels of human chorionic gonadotrophin (hCG) hormones.

Diagnosis for ectopic pregnancy

Before jumping into treatment, below are the step-by-step procedures about the ectopic pregnancy diagnosis.

The primary step for ectopic pregnancy diagnosis involves an interview and examination with the doctor.

Pregnancy test

Pregnancy test is used to detect a positive or negative pregnancy and the hormone levels.

Pelvic exam

The pelvic exam is performed to diagnose whether a woman is having an ectopic pregnancy.

Transvaginal ultrasound test

Transvaginal ultrasound is performed using an ultrasound probe which is inserted into the vagina. It is the most useful diagnostic test where it reveals the following:

  • Visualizes whether a pregnancy is ectopic
  • Reveals whether the gestational sac (intrauterine) is normal
  • Reveals a mass inside the fallopian tubes
  • Absence and/or presence of pregnancy inside the uterus

Life after ectopic pregnancy

When women has had experienced ectopic pregnancy before and it has been given immediate treatment, chances are, they will have normal pregnancies and births afterwards. Even though one fallopian tube has been removed, as long as a woman has one fallopian tube that is functioning—she can be pregnant.

However, if having ectopic pregnancy is the cause of a damaged tube… there are higher risks that the other remaining tube is damaged as well.

Despite the cost you are going to spend, ectopic pregnancy needs immediate care and treatment to cease the complications.