Ectopic Pregnancy – What it is, Symptoms and Drug Treatments. Also, Ectopic Pregnancy occurs when a fertilized egg begs somewhere other than the main cavity of the uterus. Pregnancy starts with a fertilized egg . Normally, the fertilized egg attaches to the lining of the uterus .
An Ectopic Pregnancy usually occurs in one of the tubes that carry eggs from the ovaries to the uterus (fallopian tubes). This type of Ectopic Pregnancy is known as a tubal pregnancy. In some cases, however, an Ectopic Pregnancy occurs in the abdominal cavity, ovary, or neck of the uterus ( cervix ).
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An Ectopic Pregnancy cannot continue normally. The fertilized egg cannot survive, and the growing tissue can destroy various maternal structures. Untreated and potentially fatal blood loss is possible. Early treatment of an Ectopic Pregnancy can help preserve the chance of healthy future pregnancies.
Causes of Ectopic Pregnancy: Damage to the fallopian tubes is a common cause of Ectopic Pregnancy . A fertilized egg can become parked in a damaged area of a tube and begin to grow there. The most common causes of fallopian tube damage that can lead to an Ectopic Pregnancy include:
- Pelvic inflammatory disease, which can arise from chlamydia or gonorrhea infection
- Inflammation and scarring of the fallopian tubes from a medical condition or previous surgery
- Previous ectopic pregnancy in a fallopian tube
The causes of an Ectopic Pregnancy are not clear in all cases. However, the following conditions may be linked to an abnormal pregnancy:
- hormonal factors
- genetic abnormalities
- birth defects
- Medical conditions that affect the shape and condition of the fallopian tubes and reproductive organs.
Symptoms of Ectopic Pregnancy: At first, an Ectopic Pregnancy may not cause any signs or symptoms. In other cases, the first signs and symptoms of an Ectopic Pregnancy can be the same as any pregnancy – a missed period, breast tenderness and nausea. If you take a pregnancy test, the result will be positive. Still, an Ectopic Pregnancy cannot continue as normal.
Mild vaginal bleeding with abdominal or pelvic pain is often the first warning sign of an Ectopic Pregnancy . If blood oozes from the fallopian tube, it’s also possible to feel a pain in the shoulder or an urge to have a bowel movement – depending on where the blood pools or which nerves are irritated.
If the fallopian tube ruptures, heavy bleeding into the abdomen is likely – followed by dizziness, fainting, and shock. At first, an Ectopic Pregnancy often feels like a normal pregnancy, with symptoms such as:
- delay in menstruation
- Sensitive and swollen breasts
- Increased urination.
Early signs of an Ectopic Pregnancy can include:
- Vaginal bleeding, which may be mild
- Abdominal pain or pelvic pain, usually six to eight weeks after a missed period.
As Ectopic Pregnancy progresses, other symptoms may develop, including:
- Belly pain or pelvic pain, which may get worse with movement or exertion. It may start abruptly on one side and then spread throughout the pelvic region
- Moderate or heavy vaginal bleeding
- Pain with intercourse or during a pelvic exam
- Dizziness, lightheadedness, or fainting, caused by internal bleeding
- Signs of hypovolamic shock
- Shoulder pain caused by bleeding in the abdomen under the diaphragm. Bleeding irritates the diaphragm and is felt as pain in the shoulder.
- The symptoms of miscarriage are often similar to the early symptoms experienced during Ectopic Pregnancy . For more information, see the topic miscarriage.
When to See a Doctor: Seek emergency medical help if you notice signs or symptoms of an Ectopic Pregnancy , including:
- Severe abdominal or pelvic pain accompanied by vaginal bleeding
- Extreme irritation or fainting
- Pain in the shoulder
Ectopic Pregnancy Risk Factors: Up to about 20 out of every 1,000 pregnancies are ectopic. Several factors are associated with Ectopic Pregnancy , including:
- Previous ectopic pregnancy. If you had one Ectopic Pregnancy , you are more likely to have another.
- Inflammation or Infection. Inflammation of the fallopian tube (salpingitis) or an infection of the uterus, fallopian tubes or ovaries (pelvic inflammatory disease) increases the risk of ectopic pregnancy . Often these infections are caused by gonorrhea or chlamydia.
- Fertility Problems. Some research suggests an association between difficulties with fertility — as well as fertility drug use — and Ectopic Pregnancy .
- Structural Concerns. An Ectopic Pregnancy is more likely if you have an unusually shaped fallopian tube or the fallopian tube was damaged, possibly during surgery. Even surgery to reconstruct the fallopian tube can increase the risk of Ectopic Pregnancy .
- contraceptive. Pregnancy while using an intrauterine device (IUD) is rare. If pregnancy does occur, however, it is more likely to be ectopic. The same goes for pregnancy after tubal ligation – a permanent method of birth control commonly known as “having your tubes tied”. Although pregnancy after tubal ligation is rare, if it does occur it is more likely to be ectopic.
- Smoke. Cigarette smoking before becoming pregnant can increase the risk of an Ectopic Pregnancy . And the more you smoke, the greater the risk.
Ectopic Pregnancy Complications: When you have an Ectopic Pregnancy , the stakes are high. Without treatment, a fallopian tube rupture can lead to life-threatening bleeding.
Ectopic Pregnancy Tests and Diagnosis: If your doctor suspects an Ectopic Pregnancy , he or she may do a pelvic exam to check for pain, tenderness, or a mass in the fallopian tube or ovary. A physical exam alone is usually not enough to diagnose an Ectopic Pregnancy , however. The diagnosis is usually confirmed with blood tests and imaging studies, such as an ultrasound.
With a standard ultrasound, high-frequency sound waves are directed at tissues in the abdominal area. In early pregnancy, however, the uterus and fallopian tubes are closer to the vagina than to the abdominal surface. The ultrasound will likely be done using a wand device in your vagina (transvaginal ultrasound).
Sometimes it’s too early to detect a pregnancy through ultrasound. If the diagnosis is in question, your doctor may monitor your condition with blood tests until Ectopic Pregnancy can be confirmed or ruled out via ultrasound — usually four to five weeks after conception. In an emergency situation – if you are bleeding heavily, for example – an Ectopic Pregnancy can be diagnosed and treated surgically.
Ectopic Pregnancy Treatments: In most cases, an Ectopic Pregnancy is treated immediately to prevent tissue disruption and bleeding. The decision on which treatment to take depends on how early the pregnancy is detected and its general condition. For an early-detected Ectopic Pregnancy that is not causing bleeding, you may have a choice between using medication or surgery to terminate the pregnancy.
Medications: Using methotrexate to treat an Ectopic Pregnancy can spare you an incision and general anesthesia. But it can cause side effects and require a series of blood tests to check hormone levels to make sure the treatment is working. Methotrexate will likely be used:
- When hCG levels are low (less than 5,000)
- When the embryo has no cardiac activity
- If hCG levels don’t fall or bleeding doesn’t stop after taking methotrexate, the next step may be surgery.
Surgery: If you have an Ectopic Pregnancy that is causing severe symptoms, bleeding, or high hCG levels, surgery is usually required. This is because medications usually don’t work in these cases and a rupture becomes more likely as time goes on. When possible, laparoscopic surgery is done. For an Ectopic Pregnancy , emergency surgery is required.
Expectant Management: For an Ectopic Pregnancy that appears to be miscarrying on its own, you may not need treatment. The doctor will regularly test your blood to make sure your pregnancy hormone (hCG) levels are dropping. This is called expectant conduct. If you have the surgery, you may need to take methotrexate afterwards.
Tests After Treating Ectopic Pregnancy: During the week following treatment for an Ectopic Pregnancy , blood hCG levels are tested several times. The doctor will look for a drop in hCG levels, which is a sign that the pregnancy is ending (hCG levels sometimes rise during the first few days of treatment, then fall).
In some cases, the hCG test remains positive for weeks, until the hCG levels completely drop. Your doctor will monitor your HCG levels after surgery to make sure all ectopic tissue has been removed. If HCG levels do not drop quickly, a methotrexate injection may be necessary.
Prevention of Ectopic Pregnancy: You cannot prevent an Ectopic Pregnancy , but you can decrease certain risk factors. For example, limit your number of sexual partners and use a condom when you have sex to help prevent sexually transmitted infections and reduce your risk of pelvic inflammatory disease. Quitting smoking before trying to conceive can also reduce your risk.