ECTOPIC PREGNANCY CAUSES The incidence of ectopic pregnancies is on rise. Of all pregnancies worldwide, 2 in 100 are found ectopic.
ECTOPIC PREGNANCY SYMPTOMS Pregnancy is meant to be a great time for expectant mothers and their families. Many little miracles turn o
ECTOPIC PREGNANCY TREATMENT It is all too easy to read a section on treatment for ectopic pregnancy but the truth is that in order to u
Ectopic pregnancies are by no means rare and can occur anytime, in anyone in the world. The problem with these conditions is that the fetus has to grow and as a result this poses serious implications for the mother, the most serious of which are rupture, hemorrhage and septic shock, which can all lead to death. When an ectopic pregnancy is expected it is important for the condition to be adequa
Ectopic pregnancy literally means pregnancy out of place.
i. An unexpected pregnancy outside the womb, but symptoms appears to be somewhat similar to the normal pregnancy. Since ectopic pregnancy is an emergency situation occurring very early in pregnancy causing great risk to the health of woman, therefore it needs to be terminated immediately. Delay in prompt care may lead to death of a woman due to internal bleeding.
ii. Commonly, the fertilized egg travels to the uterus and gets implanted in womb to grow further, but in 1% of cases, fertilized egg embeds to grow in pelvic cavity somewhere outside womb causing pain and bleeding.
iii. In very early pregnancy, unusual discomfort or pain in lower abdomen (while passing urine or having bowl movement) in varying degrees (dull to extremely severe), may or may not be associated with nausea/vomiting must be informed without delay to health care provider to rule out the doubt of ectopic pregnancy.
iv. With better diagnostic equipments, detecting ectopic pregnancy is a thing of the past where every prenatal clinic or primary health centre is equipped with ultrasound facilities whereas the situation is dim on the other side. Under developed countries, where basic facilities like ultrasound examination are not readily accessible at primary health centers, account for major portion of maternal deaths.
Possible locations and types of ectopic pregnancy
A chance in developing ectopic pregnancy is one in 40-100 women. Ectopic pregnancy can occur in one or more possible multiple locations in the pelvis of a woman and they are categorized into four groups as explained below:-
a) Tubal pregnancy - means pregnancy in one of the fallopian tubes (a paired tubular structure of 4-5 inches in length on either of womb) 98% of ectopic pregnancies develop in fallopian tube and 2/3rd of this occurs in the middle part of the fallopian tube (ampulla).
b) Non Tubal pregnancy - only 2% of ectopic pregnancies develop in one of the two ovaries, abdomen or cervix (rare).
c) Heterotropic pregnancy - (Concomitant or combined ectopic pregnancy)
Sometimes, when two eggs get fertilized, one gets set in the womb and another one outside. Since the warning signs of ectopic pregnancy erupt very early in pregnancy, an ultrasound examination may not sense another intrauterine pregnancy at this stage. When HCG level (human chorionic gonadotrophin hormone is produced in pregnancy by growing fetus) in blood keeps on rising after taking away ectopic pregnancy there is a possibility of viable pregnancy in uterus, which can be detected through ultrasound examination.
There are reports on successful tubal pregnancy, on rupture of tube it embeds its placenta on abdominal organs or outside the uterus.
d) Persistent ectopic pregnancy
Few cells from trophoblasts (first cells to originate from fertilized ovum) of ectopic pregnancy escape during the removal of ectopic pregnancy and continue to grow giving rise to clinical symptoms and bleeding. In order to avoid such circumstances to crop up, it is a must to perform a blood test for HCG post surgery to ensure HCG levels have declined, in support to that methotraxate is given at the time of surgery.
Possible reasons for ectopic pregnancy?
Complications due to ectopic pregnancy
Managing ectopic pregnancy
Half of ectopic pregnancies get solved with no treatment as the embryo escapes from the fallopian tube into the abdominal cavity causing acute abdominal/pelvic pain and large internal bleed or at times no such signs take place and conception product gets soaked up intra abdominally. Occasionally the disintegrated tissue re-embeds on abdominal cavity organs (intestinal wall, outside uterus wall, ovary etc) and grow into abdominal pregnancy causing persistent ectopic pregnancy. So HCG level monitoring and USG is carried out to counter check. Use of methotrexate in treating ectopic pregnancy has brought down surgical interference.
One is left with no choice, but laproscopy/laprotomy when the tube ruptures or is about to rupture.
Prevention of ectopic pregnancy
By dealing with certain issues one can combat the risk of building up ectopic pregnancy.
Chances to conceive after ectopic pregnancy
After ectopic pregnancy your probability to conceive will depend on issues like:-
Cases of Live births with ectopic pregnancy
Ectopic pregnancies are on a rise due to increased use of IVF (in vitro fertilization), with the improved rate of survival in uterine foetus. Few cases of live births, delivered by laprotomy (large surgical incision into abdominal wall), after many months of ectopic pregnancy are reported.
