What is ectopic pregnancy?
From fertilization to delivery, pregnancy occurs after 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’t properly grow anywhere other than the uterus. 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.
An ectopic pregnancy can’t proceed normally. The fertilized egg can’t survive, and the growing tissue may cause life-threatening bleeding, if left untreated.
What causes an ectopic pregnancy?
The cause of an ectopic pregnancy isn’t always clear. In some cases, the following conditions have been linked with an ectopic pregnancy:
- inflammation and scarring of the fallopian tubes from a previous medical condition, infection, or surgery
- hormonal factors
- genetic abnormalities
- birth defects
- medical conditions that affect the shape and condition of the fallopian tubes and reproductive organs
Your Gynecologist may be able to give you more specific information about your condition.
Who is at risk for an ectopic pregnancy?
All sexually active women are at some risk for an ectopic pregnancy. Risk factors increase with any of the following:
- maternal age of 35 years or older
- history of pelvic surgery, abdominal surgery, or multiple abortions
- history of pelvic inflammatory diseases
- history of endometriosis
- conception occurred despite tubal ligation or intrauterine devices
- conception aided by fertility drugs or procedures
- history of ectopic pregnancy
- history of sexually transmitted diseases
- having structural abnormalities in the fallopian tubes that make it hard for the egg to travel
If you have any of the above risk factors, talk to your doctor. You can work with your Gynecologist or a fertility specialist to minimize the risks for future ectopic pregnancies.
What are the symptoms of an ectopic pregnancy?
Nausea and breast soreness are common symptoms 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 bleeding or spotting
- 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.
Diagnosing 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.
Dr. Ruchi Tandon is a specialist Gynecologist , with over 13 years of clinical experience and is practicing in leading hospitals in South Delhi, namely, Max smart superspeciality hospital, saket, Apollo cradle Royale, nehru place. She has dealt with the management of thousands of ectopic pregnancies.