Ectopic Pregnancy

Ectopic Pregnancy: Causes, Symptoms, and Treatments

Ectopic pregnancies occur in 1 out of every 100 pregnancies. Though relatively infrequent, they pose a risk to the pregnant individual and can bring about emotional distress for expectant families. Let’s delve into the details of ectopic pregnancies, including insights into recognizing potential signs and symptoms.

What Exactly Is an Ectopic Pregnancy?

In a typical pregnancy, the fertilized egg attaches and grows within the uterus. However, in the case of an ectopic pregnancy, the egg attaches itself in a location other than the uterus, most commonly within the fallopian tubes. This is why these pregnancies are often referred to as “tubal pregnancies.” The egg can also attach to the ovary, abdomen, or cervix.

None of these areas provides the suitable space or nourishing tissue required for a pregnancy to progress normally. As the developing fetus grows, it can eventually rupture the organ it has implanted in. This situation leads to significant bleeding and poses a threat to the mother’s life. Importantly, a classic ectopic pregnancy does not advance to a successful live birth.

Signs & Symptoms of an Ectopic Pregnancy

Diagnosing an ectopic pregnancy can be challenging as the symptoms often resemble those of a typical early pregnancy. These indicators might encompass absent menstrual periods, breast tenderness, feelings of nausea, vomiting, fatigue, or frequent urination.

Typically, the initial signals of an ectopic pregnancy emerge as discomfort or vaginal bleeding. Pain might be experienced in the pelvic region, and abdomen, or even extend to the shoulder or neck if blood from a ruptured ectopic pregnancy accumulates and irritates specific nerves. The pain’s intensity can vary, ranging from mild and dull to intense and acute. It may be concentrated on one side of the pelvis or radiate across the entire region.

The following manifestations might also coincide with an ectopic pregnancy:

  • Light vaginal spotting
  • Dizziness or fainting due to blood loss
  • Reduced blood pressure resulting from blood loss
  • Lower back pain

What Causes an Ectopic Pregnancy?

An ectopic pregnancy typically arises when a fertilized egg encounters difficulty in promptly navigating down the fallopian tube to reach the uterus. The tube’s passage can become blocked due to factors like infection or inflammation. The blockage might result from conditions such as:

  • Pelvic inflammatory disease (PID)
  • Endometriosis is a condition where cells from the uterine lining grow in other areas of the body
  • Scar tissue resulting from prior abdominal or fallopian surgeries
  • In rare cases, birth defects that alter the shape of the fallopian tube

What Are the Risk Factors for an Ectopic Pregnancy?

Around half of women who experience an ectopic pregnancy have no identifiable risk factors. However, certain groups are more prone to ectopic pregnancies, including women who:

  • Have a history of a previous ectopic pregnancy
  • Have undergone fallopian tube, pelvic, or abdominal surgery
  • Have contracted specific sexually transmitted infections (STIs)
  • Suffer from endometriosis
  • Smoke cigarettes
  • Are above the age of 35
  • Have a track record of infertility
  • Have utilized assisted reproductive techniques like in vitro fertilization (IVF) or intrauterine insemination (IUI)

How is an ectopic pregnancy diagnosed?

Diagnosing ectopic pregnancies can be challenging due to their initial symptoms closely resembling those of a regular pregnancy. If your medical practitioner suspects an ectopic pregnancy, they might undertake the following steps:

  • Conduct a pelvic examination to assess the size and shape of your uterus.
  • Request a urine test and a blood test to measure your human chorionic gonadotropin (hCG) levels. This hormone is produced by the placenta. In the case of an ectopic pregnancy, hCG levels might be lower than expected.
  • Perform a transvaginal ultrasound, a procedure involving the insertion of a wand-like device into your vagina. Sound waves emitted from the wand create images of internal organs, enabling your doctor to visualize the site of pregnancy growth.

What Are the Treatment Options for Ectopic Pregnancies?

Ectopic pregnancies cannot be relocated to the uterus. This implies that allowing the pregnancy to progress would jeopardize your own health and well-being. To address an ectopic pregnancy, the recommended course of action, be it medication or surgery, will depend on your individual health and medical circumstances.

Medication as a Treatment for Ectopic Pregnancy 

Medication, often methotrexate, is commonly used in cases where an ectopic pregnancy has not resulted in a rupture of the fallopian tube. This medication hinders cellular growth, ultimately ending the pregnancy. Subsequent to the medication’s administration, the body progressively absorbs the pregnancy over a span of four to six weeks, typically leaving the fallopian tube undamaged.

Methotrexate is typically administered through injections and can bring about symptoms such as abdominal pain, nausea, vomiting, diarrhea, or dizziness. There might also be instances of bleeding or spotting.

During the course of ectopic pregnancy treatment with medication, it is essential to undergo regular blood tests to verify that your human chorionic gonadotropin (hCG) levels consistently decrease until reaching zero. If your hCG levels do not decrease sufficiently after the initial dose, additional doses might be recommended. The risk of fallopian tube rupture persists until the completion of the treatment process.

Surgical Approach for Ectopic Pregnancy Treatment

In specific situations, such as when a fallopian tube has ruptured, surgical intervention becomes necessary to address an ectopic pregnancy. In cases of fallopian tube rupture, the affected tube containing the pregnancy is typically removed entirely. However, if rupture hasn’t occurred, it might be feasible to surgically extract the ectopic pregnancy without causing harm to the fallopian tube.

This surgical procedure commonly involves the use of a slender illuminated camera inserted through small abdominal incisions, a technique known as laparoscopy. The surgery is performed within a hospital setting under general anesthesia. Following the treatment, you can anticipate experiencing some discomfort, fatigue, and potential bleeding.

What Can I Expect After an Ectopic Pregnancy?

Following an ectopic pregnancy, you might encounter an array of physical symptoms and navigate through challenging emotions. Fatigue is common for several weeks as your body recuperates from treatment, and you might experience abdominal discomfort or pain. Since it takes time for your human chorionic gonadotropin (hCG) levels to decrease to zero, you could also persistently encounter some pregnancy-related symptoms.

On an emotional level, ectopic pregnancies can be emotionally distressing—similar to the aftermath of a miscarriage. Feelings of loss, devastation, and even guilt may arise. However, it’s important to recognize that no pregnancy loss or complication can be attributed to any woman’s actions.

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