Ectopic Pregnancy

An ectopic pregnancy is a severe pregnancy-related condition. It happens when a fertilised egg grows outside the uterus. Sometimes, it may become a medical emergency that can cause severe pain and internal bleeding, requiring prompt surgical intervention. This blog will help you understand ectopic pregnancies, including why they happen, how to spot them, and what doctors can do to treat them.

What's an Ectopic Pregnancy?

An ectopic pregnancy develops when a fertilised egg gets planted and starts growing somewhere it shouldn't - usually in a fallopian tube. It's a medical emergency because as the embryo grows in size, it can put pressure on the fallopian tube, causing it to burst, eventually leading to dangerous internal bleeding.

During a normal pregnancy, the fertilised egg moves down from the fallopian tube and gets settled in the uterus lining. But in an ectopic pregnancy, the egg gets trapped along the way. While it most often happens in a fallopian tube, it can also occur in the cervix, ovary, or abdominal cavity.

Signs and Symptoms of an Ectopic Pregnancy

Ectopic pregnancies don't always show clear signs early on. Here are some common symptoms to watch for:

• Belly or Pelvic Pain: You might feel a sharp, stabbing, or dull pain in your abdomen or pelvis. It often starts on one side and gets worse over time.
• Vaginal Bleeding: You might notice light or heavy bleeding, often with a brown or dark discharge.
• Shoulder Pain: If a fallopian tube ruptures and bleeds, you might feel pain in your shoulder.
• Feeling Dizzy or Faint: Severe internal bleeding can make you feel dizzy, lightheaded, or even pass out.
• Nausea and Throwing Up: Like in a normal pregnancy, you might feel nausea or throw up.

Ectopic Pregnancy Causes

Several factors can increase your possibility of an ectopic pregnancy:

• Previous Ectopic Pregnancy: If you've had one before, you're more likely to have another.
• Pelvic Inflammatory Disease (PID): Infections that inflame your fallopian tubes can raise your risk.
• Fertility Treatments: Some treatments, like IVF, slightly increase the chance of an ectopic pregnancy.
• Tube Problems: If your fallopian tubes have scars or blockages, the egg cannot reach the uterus as easily. 
• Smoking: One of the reasons for ectopic pregnancy is smoking. Smoking makes ectopic pregnancies more likely.
• IUDs: While they're good at preventing pregnancy, IUDs don't stop ectopic pregnancies and might even increase the risk a bit.
• Tubal Ligation: If you've had your tubes tied, you have a higher (but still low) risk of an ectopic pregnancy.

Risk Factors

Several things can raise your chances of an ectopic pregnancy:

• Having had one before
• Pelvic inflammatory disease (PID)
• Fertility treatments like IVF
• Problems with your fallopian tubes
• Smoking
• Using Birth control measures, such as an IUD or tube ligation

Diagnosis of Ectopic Pregnancies

It can be tricky to spot an ectopic pregnancy because early signs can look like a normal pregnancy or miscarriage. Doctors usually use the following methods to diagnose the condition:

• Medical History Review and Physical Examination: Your gynaecologist will take the medical history and look for the signs of an ectopic pregnancy. Doctors may also perform pelvic examinations to identify tenderness, masses, or signs of internal bleeding.
• Blood Tests: These can show if you're pregnant and track hormone levels that might point to an ectopic pregnancy.
• Ectopic Pregnancy Ultrasound: The transvaginal ultrasound can help visualise the uterus and fallopian tubes, checking for the location of the pregnancy.
• Laparoscopy: Sometimes, doctors may perform this minimally invasive surgical procedure to confirm and check the ectopic pregnancy.

Treating an Ectopic Pregnancy

The ectopic pregnancy treatment modalities depend on your specific situation- where the pregnancy is, the size of the embryo, your overall health, and if there are any complications. Here are the main ways doctors treat ectopic pregnancies:

• Medicine: Sometimes, doctors give a drug called methotrexate. It stops the ectopic pregnancy from growing and lets your body absorb the embryo.
• Surgery: If the ectopic pregnancy is big, has burst, or doesn't respond to medicine, you might need surgery. The most common type of ectopic pregnancy surgery is a salpingectomy, where doctors remove the affected fallopian tube.
• Watchful Waiting: In cases where the ectopic pregnancy is suspected but not confirmed, doctors might suggest a "wait and see" approach. They'll keep a close eye on you to make sure the pregnancy goes away on its own.

Complications

If left untreated, ectopic pregnancies can cause serious problems:

• Burst Fallopian Tube: As the pregnancy grows, it can make your tube burst, causing severe internal bleeding that can be life-threatening.
• Trouble Getting Pregnant: Depending on the damage to your tube, an ectopic pregnancy might make it harder to get pregnant in the future.
• Heavy Bleeding: A burst tube can cause severe internal bleeding, which can be dangerous if not treated quickly.
• Shock: Losing a lot of blood from a burst tube can lead to shock, which can be life-threatening.

When to Call a Doctor

If you have any of these symptoms, call your doctor right away:

• Severe pain in your belly or pelvis
• Bleeding from your vagina
• Pain in your shoulder
• Feeling dizzy or fainting

Prevention

While you can't completely prevent ectopic pregnancies, you can lower your risk:

• Treat Pelvic Inflammatory Disease Quickly: Getting prompt treatment for PID can help prevent scarring in your tubes that can lead to ectopic pregnancies.
• Use Birth Control Correctly: Using condoms or birth control pills properly can help prevent unwanted pregnancies and lower your risk of ectopic pregnancies.
• Stop Smoking: Smoking increases your risk of ectopic pregnancy, so quitting can help lower it.
• Get Early Prenatal Care: Regular check-ups during pregnancy can help doctors catch and manage any issues that might raise your risk of an ectopic pregnancy.

Conclusion

Ectopic pregnancy is a life-threatening medical condition that warrants prompt diagnosis and early treatment to prevent serious complications. While it can have significant physical and emotional impacts, early medical intervention and supportive care can ensure recovery and preserve future fertility.

FAQs

1. How common are ectopic pregnancies?

Ectopic pregnancies are relatively uncommon, occurring in approximately 1 to 2 per cent of all pregnancies. However, they are the leading cause of pregnancy-related deaths in the first trimester.

2. When Do Ectopic Pregnancy Symptoms Start?

Symptoms of an ectopic pregnancy can start four to six weeks after the last menstrual period, but they may not always be immediately apparent. It's essential to seek medical guidance if you experience any symptoms that may be related to an ectopic pregnancy.

3. Can I get pregnant again if I have a history of ectopic pregnancy?

Yes, it is possible. However, the risk of having another ectopic pregnancy increased, so it's important to discuss family planning options with your doctor.

4. How long does ectopic pregnancy last?

The duration of an ectopic pregnancy can vary, but it is generally shorter than a normal pregnancy. If left unattended, an ectopic pregnancy can rupture (ruptured ectopic pregnancy) and become a medical emergency within a few weeks.

5. Is ectopic pregnancy a miscarriage?

No, an ectopic pregnancy is not the same as a miscarriage. In a miscarriage, the fertilised egg implants and grows in the uterus, but the pregnancy is lost. In an ectopic pregnancy, the fertilised egg implants and grows outside the uterus, which can be life-threatening.

6. Can a woman still have a child with an ectopic pregnancy?

No, a woman cannot have a viable baby with an ectopic pregnancy. The fertilised egg cannot develop appropriately outside the uterus, and the pregnancy must be terminated to prevent serious complications.

CARE Medical Team