Ectopic Pregnancy: Causes, Risk Factors, Symptoms, Diagnosis And Treatment

Ectopic Pregnancy: Causes, Risk Factors, Symptoms, Diagnosis And Treatment

What is an ectopic pregnancy?

Ectopic pregnancy is a pregnancy disorder in which a fertilized ovum implanted outside uterus where it attach to the cervix, fallopian tube or abdominal cavity.

From fertilization to delivery, pregnancy requires a number of steps in a woman’s body. One of these steps is when a fertilized egg travels to the uterus to attach itself. In the case of an ectopic pregnancy, the fertilized egg doesn’t attach to the uterus. Instead, it may attach to the fallopian tube, abdominal cavity, or cervix.

While a pregnancy test may reveal a woman is pregnant, a fertilized egg can not properly grow anywhere other than the uterus. According to the American Academy of Family Physicians (AAFP), ectopic pregnancies occur in about 1 out of every 50 pregnancies (20 out of 1,000).

An untreated ectopic pregnancy can be a medical emergency. Prompt treatment reduces your risk of complications from the ectopic pregnancy, increases your chances for future, healthy pregnancies, and reduces future health complications.

What causes an ectopic pregnancy?

The cause of an ectopic pregnancy is not always clear. In some cases, the following conditions have been linked with an ectopic pregnancy:

Genetics abnormality

Inflammation and scarring of the fallopian tubes from a previous medical condition, infection, or surgery

Birth defects

Hormonal factors

Medical conditions that affect the shape and condition of the fallopian tubes and reproductive organs

What are the risk factors of ectopic pregnancy?

Some things that make you more likely to have an ectopic pregnancy are:

I. Fertility treatments. 

Some research suggests that women who have in vitro fertilization (IVF) or similar treatments are more likely to have an ectopic pregnancy. Infertility itself may also raise your risk.

 II. Previous ectopic pregnancy. 

If you have had this type of pregnancy before, you are more likely to have another.

III. Tubal surgery. 

Surgery to correct a damaged or closed fallopian tube can increase the risk of an ectopic pregnancy.

IV. Choice of birth control. 

The chance of getting pregnant while using an intrauterine device (IUD) is rare. However, if you do get pregnant with an IUD in place, it is more likely to be ectopic.

V. Tubal ligation

A permanent method of birth control commonly known as "having your tubes tied," also raises your risk, if you become pregnant after this procedure.

VI. Smoking. 

Cigarette smoking just before you get pregnant can increase the risk of an ectopic pregnancy. The more you smoke, the greater the risk.

VII. Inflammation or infection. 

Sexually transmitted infections, such as gonorrhea or chlamydia, can cause inflammation in the tubes and other nearby organs, and increase your risk of an ectopic pregnancy.

What are the symptoms of an ectopic pregnancy?

Nausea and breast soreness are common symptoms that occurs in both ectopic and uterine pregnancies. 

The following symptoms are more common in an ectopic pregnancy and can indicate a medical emergency:

Sharp waves of pain in the abdomen, pelvis, shoulder, or neck

Severe pain that occurs on one side of the abdomen

Light to heavy vaginal spotting or bleeding

Dizziness or fainting

rectal pressure.

You should contact your doctor or seek immediate treatment if you know that you’re pregnant and have any of these symptoms.

How to diagnose an ectopic pregnancy?

If you suspect you may have an ectopic pregnancy, see your doctor immediately. Ectopic pregnancies can’t be diagnosed from a physical exam. However, your doctor may still perform one to rule out other factors.

Another step to diagnosis is a transvaginal ultrasound. This involves inserting a special wand-like instrument into your vagina so that your doctor can see if a gestational sac is in the uterus.

Your doctor may also use a blood test to determine your levels of hCG and progesterone. These are hormones that are present during pregnancy. If these hormone levels start to decrease or stay the same over the course of a few days and a gestational sac isn’t present in an ultrasound, the pregnancy is likely ectopic.

If you’re having severe symptoms, such as significant pain or bleeding, there may not be enough time to complete all these steps. The fallopian tube could rupture in extreme cases, causing severe internal bleeding. Your doctor will then perform an emergency surgery to provide immediate treatment.

Complications of ectopic pregnancy

When ectopic pregnancy left untreated, it causes rupture of fallopian tube that leads to life threatening bleeding.

How ectopic pregnancy is treated?

Ectopic pregnancies are not safe for the mother. Also, the embryo would not be able to develop to term. It’s necessary to remove the embryo as soon as possible for the mother’s immediate health and long-term fertility. Treatment options vary depending on the location of the ectopic pregnancy and its development.

Medication

Your doctor may decide that immediate complications are unlikely. In this case, your doctor can prescribe several medications that could keep the ectopic mass from bursting. According to the AAFP, one common medication for this is methotrexate (Rheumatrex).

Methotrexate is a drug that stops the growth of rapidly dividing cells, such as the cells of the ectopic mass. If you take this medication, your doctor will give it to you as an injection. You should also get regular blood tests to ensure that the drug is effective. When effective, the medication will cause symptoms that are similar to that of a miscarriage.

These include:

Cramping

Bleeding

The passing of tissue.

Further surgery is rarely required after this occurs. Methotrexate does not carry the same risks of fallopian tube damage that come with surgery. You won’t be able to get pregnant for several months after taking this medication, however.

Surgery

Many surgeons suggest removing the embryo and repairing any internal damage. This procedure is called a laparotomy. Your doctor will insert a small camera through a small incision to make sure they can see their work. The surgeon then removes the embryo and repairs any damage to the fallopian tube.

If the surgery is unsuccessful, the surgeon may repeat a laparotomy, this time through a larger incision. Your doctor may also need to remove the fallopian tube during surgery if it is damaged.

Long-term outlook

The long-term outlook after an ectopic pregnancy depends on whether it caused any physical damage. Most people who have ectopic pregnancies go on to have healthy pregnancies. If both fallopian tubes are still intact, or even just one, the egg can be fertilized as normal. However, if you have a preexisting reproductive problem, that can affect your future fertility and increase your risk of future ectopic pregnancy. This is especially the case if the preexisting reproductive problem has previously led to an ectopic pregnancy.

Surgery may scar the fallopian tubes, and it can make future ectopic pregnancies more likely. If the removal of one or both fallopian tubes is necessary, speak to your doctor about possible fertility treatments. An example is in vitro fertilization that involves implanting a fertilized egg into the uterus.

Pregnancy loss, no matter how early, can be devastating. You can ask your doctor if there are available support groups in the area to provide further support after loss. Take care of yourself after this loss through rest, eating healthy foods, and exercising when possible. Give yourself time to grieve.

Remember that many women go on to have healthy pregnancies and babies. When you’re ready, talk to your doctor about ways you can ensure that your future pregnancy is a healthy one.

Home care

Your doctor will give you specific instructions regarding the care of your incisions after surgery. The chief goals are to keep your incisions clean and dry while they heal. Check them daily for infection signs, which could include:

redness

swelling

bleeding that won’t stop

excessive bleeding

foul-smelling drainage from the site

hot to the touch.

You can expect some light vaginal bleeding and small blood clots after surgery. This can occur up to six weeks after your procedure. Other self-care measures you can take include:

Drink plenty of fluids to prevent constipation

Do not lift anything heavier than 10 pounds

Pelvic rest, which means refraining from sexual intercourse, tampon use, and douching

Rest as much as possible the first week postsurgery, 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.

  Preventions of ectopic pregnancy

Ectopic pregnancy can not be prevented, but here are some ways to decrease your risk:

Limiting the number of sexual partners and using a condom during sex helps to prevent sexually transmitted infections and may reduce the risk of pelvic inflammatory disease.

Stop smoking: If you do, quit before you try to get pregnant.

Choose the right method of family planning especially those that are reversible.

Visit health facility near to you whenever you start noticing symptoms of pregnancy for early diagnosis and medical suggestion.

Sources:

www.mayoclinc.org

www.healthline.com

+2 other sources