Ectopic Pregnancy
Ectopic pregnancy, also called extrauterine pregnancy, occurs when a fertilized egg grows outside a woman’s uterus.
In a tubal or normal pregnancy, fertilization occurs in the fallopian tubes, where an egg, or ovum, meets a sperm cell. The fertilized egg then travels into the uterus and becomes implanted in the womb lining. The embryo develops into a fetus and remains in the uterus until birth.
In an ectopic pregnancy, the symptoms start showing after 4 to 10 weeks to indicate an abnormal pregnancy. A fertilized egg cannot survive outside the womb, therefore it will not survive an ectopic pregnancy. Most often, the pregnancy cannot be saved. Rupture of the fallopian tube can occur after between 6 and 16 weeks of pregnancy. A ruptured fallopian tube can, however, be treated successfully.
Causes
- Infections – inflammations and infections of the fallopian tube, uterus, or ovaries can increase the risk of subsequent ectopic pregnancies. Ectopic pregnancy is also linked to pelvic inflammatory disease (PID).
- Sexually Transmitted Infections – Some sexually transmitted infections (STIs) increase the risk of PID, such as gonorrhea or chlamydia. PID can lead to ectopic pregnancy.
- Age: The older a woman is when she becomes pregnant, the higher the risk of an ectopic pregnancy.
- Smoking: Smoking increases the risk of ectopic pregnancy.
Symptoms
- Severe pain on one side of the abdomen
- Vaginal bleeding: The blood is often lighter or darker than during menstrual bleeding, and usually less viscous. If a woman does not know that she is pregnant, she may confuse vaginal bleeding for menstrual blood.
- Shoulder tip pain: This is a sign of internal bleeding. The bleeding may irritate the phrenic nerve which leads to pain in the shoulder.
- Pain when passing urine or faeces
- Fainting or collapse: The rupture of the fallopian tubes may cause a woman to faint or collapse leading to a medical emergency.
Treatments
Ectopic pregnancies aren’t safe for both the mother and embryo. It’s crucial to remove the embryo fast to save the mother’s life and ensure long-term fertility. Treatment options vary depending on the location of the ectopic pregnancy and its development. The most common medication is Methotrexate (Rheumatrex).
Methotrexate is a drug that stops the growth of rapidly dividing cells, such as the cells of the ectopic mass. The doctor will give you this medication as an injection. When effective, the medication will cause symptoms that are similar to a miscarriage which includes cramping, bleeding and passing of the tissue. Compared to surgery, Methotrexate does not bear the risk of fallopian tube damage. However, you won’t be able to get pregnant for several months after taking this medication.
Other forms of treatments include:
- Surgery – The surgical procedure of removing the embryo and repairing any internal damage is known as laparotomy. The doctor inserts a small camera through a small incision to make sure they can see their work. Then the embryo is removed and any damage to the fallopian tube is repaired. If the surgery is unsuccessful, laparotomy procedure may be repeated but through a larger incision. Your doctor may also need to remove the fallopian tube during surgery if it’s damaged.
- Home care – This involves specific instructions regarding the care of your incisions after surgery. The main goals are to ensure your incisions clean and dry while they heal. Also, check them daily for infection signs, which could include excessive bleeding, foul-smelling drainage from the site, redness and swelling. Expect some light vaginal bleeding and small blood clots after surgery. This can occur up to six weeks after the procedure.
- Other self-care measures – don’t lift anything heavier than 10 pounds and drink plenty of fluids to prevent constipation.
- Pelvic rest, which means refraining from sexual intercourse, tampon use, and douching. Rest as much as possible especially the first week of post-surgery, and then increase activity in the next weeks as tolerated. Always notify your doctor if your pain increases or you feel something is out of the ordinary.
