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Ectopic Pregnancy

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Introduction

An Ectopic Pregnancy is a dangerous condition which affects about 1 in every 50 pregnant women. If left untreated, an ectopic pregnancy can lead to a medical emergency. Proper treatment on time can avoid severe complications and increase your chances of having a normal and healthy pregnancy in the future.

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What is Ectopic Pregnancy?

Every pregnancy requires a number of steps, from the fertilisation of the egg to delivery of the baby. Usually, the sperm fertilises the egg, and the fertilised egg, known as the zygote, implants itself in the uterine lining.

In cases where the zygote implants itself outside of the uterus, such as the fallopian tube, it is known as an ectopic pregnancy.

An ectopic pregnancy where the implantation of the zygote takes place in the fallopian tubes is known as tubal pregnancy. In rare cases, the zygote implants itself in the abdominal cavity, ovary, or the lower part of the cervix.

It is unlikely for an ectopic pregnancy to proceed normally. The zygote cannot survive outside of the uterus. It may also cause severe bleeding if not treated on time.

What are the Causes of Ectopic Pregnancy?

The exact causes of an Ectopic Pregnancy are known yet. However, doctors believe the following to be the causes:

  • ● Damaged fallopian tube
  • ● Pelvic Inflammatory Disease
  • ● Genetic abnormalities
  • ● Scarring from pelvic surgery
  • ● Hormonal imbalances
  • ● Previous ectopic surgery
  • ● Usage of fertility drugs
  • ● Undergoing fertility treatments such as In-vitro Fertilisation

What are the Symptoms of Ectopic Pregnancy?

In both uterine and ectopic pregnancies, breast soreness, and nausea are common signs and symptoms. However, in an ectopic pregnancy, you may experience a set of different symptoms, such as:

  • ● Pelvic pain
  • ● Slight vaginal bleeding
  • ● Sharp abdominal cramps
  • ● Rectal pressure
  • ● Pain in your neck or shoulder
  • ● Vomiting
  • ● Upset stomach
  • ● Pain on one side of the body

If you know you are pregnant and experience any of these symptoms, seek immediate medical assistance to avoid future complications.

How is Ectopic Pregnancy Diagnosed?

Your doctor may do a pelvic examination to identify the areas of tenderness, pain, or feel a mass in the ovaries or fallopian tube. However, it may not help the doctor diagnose an ectopic pregnancy.

For a complete diagnosis, your doctor may do the following tests:

  • Ultrasound: To see the exact location of the implantation of the zygote, a transvaginal ultrasound may be done. To do this, the doctor may insert a wand-like device into your vagina. It will create images of your fallopian tubes, ovaries, and uterus using sound waves.

To evaluate internal bleeding, an abdominal ultrasound may be done.

  • Blood test: The blood test can help determine the levels of progesterone and hCG in your blood. Normally, the levels of these hormones increase when you are pregnant. If the hormone levels are lower than normal or stay the same for a prolonged time, you are likely to have an ectopic pregnancy.

How is Ectopic Pregnancy Treated?

Normally, it is difficult for the ectopic tissue to survive outside of the uterus. The removal of the tissue is essential to prevent severe health complications.

Depending on your symptoms and how far along are you in your pregnancy, the doctor may recommend the following treatment options:

  • Medications: If your ectopic pregnancy is diagnosed in its early stages, the doctor may prescribe medications such as methotrexate for the treatment. The medication will dissolve the existing ectopic cells and prevent the growth of new cells. The doctor may give you the medication through an injection.

Once the injection is given, the doctor may order another blood test to check how the medication is working.

  • Laparoscopic surgery: Salpingectomy and salpingostomy are two of the laparoscopic surgical options that your doctor may recommend. These procedures are done using a thin tube consisting of a tiny camera. It is inserted into your abdomen through a small incision made to view the area where zygote implantation has taken place.

For salpingostomy, the ectopic pregnancy and fallopian tube both are removed. In salpingectomy, only the ectopic pregnancy is removed, and the fallopian tube is left to heal on its own.

  • Emergency surgery: If your ectopic pregnancy starts causing excessive bleeding, the doctor may perform emergency surgery. It can either be done laparoscopically or through a laparotomy (by making an incision in your abdomen). If your fallopian tube bursts, the surgeon will have to remove it.

Result

The result of the ectopic pregnancy surgery depends on whether it caused any physical damage. In most cases, women with ectopic pregnancies go on to have normal pregnancies in the future. If the fallopian tube is intact, you may have a healthy pregnancy later on.

What are the Risks Associated with Ectopic Pregnancy treatments?

In most cases, ectopic pregnancy surgery does not cause any complications. However, in some rare cases, the following issues may be experienced by the patient:

  • ● Swelling
  • ● Redness
  • ● Bleeding
  • ● Constipation
  • ● Pelvic pain

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FAQ's

Can the Baby be Saved in An Ectopic Pregnancy?

If a fertilised egg implants itself in one of the fallopian tubes, it is unlikely it will develop into a baby. If the pregnancy continues, you may be at risk of severe medical complications. It is not possible to save the pregnancy and has to be removed by medications or surgery.

How Long Does An Ectopic Pregnancy Last?

The tissues surrounding the fertilised egg cannot provide it the required blood supply and support. The structure within which the fertilised egg lives usually ruptures in about six to sixteen weeks.

Can an Ectopic Pregnancy be Detected at Five Weeks?

The best way to diagnose an Ectopic Pregnancy is through a transvaginal ultrasound. A normal pregnancy is usually detected at five to six weeks, and so is the case with an Ectopic Pregnancy. If the fetus is not found in the uterus, or the hCG levels in your blood are more than 1500 IU/l, it is likely an Ectopic Pregnancy.

How is An Ectopic Pregnancy Distinguished from An Ovarian Cyst?

The Ovarian Cyst appears with a thin, avascular wall that distinguishes it from an Ectopic Pregnancy.

Where is Ectopic Pregnancy Pain Located?

Usually, Ectopic pain appears on the lower abdomen and the pelvic region. It is often localised on one side of the body. The pain can feel crampy, dull, continuous, or scattered, and worsens with movement.

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