Ectopic Pregnancy: Things to Know

Ectopic pregnancy is also known as extra uterine pregnancy occurs when the fertilized egg grows outside your uterus. In normal pregnancy the fertilized egg gets attached to the inner lining of your uterus. However, in ectopic pregnancy the fertilized egg not only attaches to outside the uterus but sometimes it also can attach to your belly, fallopian tube, lower part of cervix, which is just above your vagina or the ovaries. When a fertilized egg attaches to the fallopian tube, it is called tubal pregnancy and this happens in more than 90% of ectopic pregnancy cases.

What is Ectopic Pregnancy?

When a fertilized egg attaches itself to the outside of the womb or uterus, it is called ectopic pregnancy. In most cases of ectopic pregnancy the egg attaches to the fallopian tube. Studies suggest that 1 out of 100 pregnancies in the country is ectopic. Sometimes, the fertilized egg ruptures and causes internal and external bleeding. This may be life-threatening. This alarming sign tells you to seek emergency medical care right away. In case of ignorance, it can be deadly. According to an estimated survey, ectopic pregnancy is the one of the greatest causes of pregnancy-related deaths, especially in the first trimester. 

Let’s dive into the stream of knowledge about the symptoms, causes and treatment options of Ectopic Pregnancy!

Is Ectopic Pregnancy similar to Miscarriage?

In ectopic pregnancy the egg bursts in the first trimester and causes fatal bleeding while miscarriage can happen before the 24 weeks of pregnancy. Miscarriage is actually an abrupt loss of pregnancy. Most of the ectopic pregnancies end in miscarriage but miscarriages may happen for many other reasons, such as extra or missing chromosomes. 

Is Survival of a Baby Possible in Ectopic Pregnancy?

In ectopic pregnancy the fertilized egg goes outside of the uterus and implants itself to any outside structure. Therefore, it is not visible. That’s why the fertilized egg in ectopic pregnancy cannot survive or grow into a baby. Ectopic pregnancy always ends in pregnancy. This is because the egg implanted outside the womb cannot get the blood supply that brings oxygen and food to it.

Symptoms of Ectopic Pregnancy

In the earlier days of pregnancy there may be no signs that can help you identify the ectopic pregnancy. It shows usual symptoms similar to normal pregnancy, including missed periods, tenderness in your breasts and discomfort in your belly. Studies suggest that just 50% of women with ectopic pregnancy have prominent signs of ectopic pregnancy, including belly pain, missed period and vaginal bleeding that help them to identify their condition. 

Other signs of ectopic pregnancy include:

• Dizziness and weakness.
• Vomiting due to an upset stomach.
• Severe pain in rectum, shoulder and neck.
• Pain in one side of your body.
• Sharp cramps in the belly.

Signs of Ruptured Ectopic Pregnancy

The fallopian tube bursts due to ectopic pregnancy. No doubt it is a major sign but other symptoms that may help you identify the ectopic rupture include major abdominal pain with or without bleeding. Heavy vaginal bleeding is the major symptoms that indicate seeking emergency medical help. In most cases women with ectopic pregnancy rupture also had complained about severe shoulder pain, lightheadedness and fainting. If you experience any of these all the emergency help line.

When Do Ectopic Pregnancy Symptoms Occur?

The symptoms of ectopic pregnancy usually occur in the early days of the first trimester. It may be between the 3rd to 10th week of pregnancy. However, studies also show that the appearance of ectopic pregnancy symptoms also depend on the location of ectopic pregnancy. How? Let’s learn about it!

Location of Ectopic Pregnancy

Although 90% of ectopic pregnancies happen in the fallopian tube where the fertilized egg implants itself into the fallopian tube and is known as tubal pregnancy. But research suggests that in some cafes the fertilized egg can also implant itself outside of uterus other than fallopian tube, including:

Ovarian Ectopic Pregnancy

Ovarian ectopic pregnancy occurs when the egg attaches itself to outside of your ovary. This usually happens due to incorrect release of eggs during your menstrual cycle. The problematic release of egg happens when the fertilized egg remains in the follicle, a specific structure present in the ovary. However, sometimes ovarian ectopic pregnancy also happens when the egg moves to your ovary from the fallopian tube.

Abdominal Ectopic Pregnancy

Although it happens in rare cases, abdominal ectopic pregnancy is more dangerous than other options. As in this type of ectopic pregnancy the egg implants itself in the space between your spine (abdominal cavity) and abdominal wall. In this situation, the fluid present in the abdomen transports the egg behind the uterus where a sperm comes to fertilize it. Sometimes, the embryo itself moves to the abdominal cavity from the reproductive tract by means of lymphatic vessels. 

Cervical Ectopic Pregnancy

The implantation of a fertilized egg in the cervical canal, caused a cervical ectopic pregnancy. This usually happens due to damage to the uterine cavity (space inside your uterus).

Cesarean Scar Ectopic Pregnancy

When a fertilized egg implants itself with the scar tissue from a C-section, it is called CSEP. scar tissue is not tough and durable as the lining of your uterus. That’s why it ruptures due to the weight of the egg and causes heavy bleeding. Its common symptoms like lower abdominal pain and heavy bleeding from vagina are similar to fallopian tube ectopic  pregnancy. 

Causes of Ectopic Pregnancy

The actual causes of ectopic pregnancy are still unknown. However,medical researchers are working to find out the main cause. Meanwhile the analytical studies of the condition have revealed that the damage to your fallopian tube can be the major cause of ectopic pregnancy. This damage prevents your egg from getting into the uterus. 

Risk Factors relevant to Ectopic Pregnancy

The chances of getting ectopic pregnancy becomes higher if you:

• Had a previous ectopic pregnancy.
• Had fertility treatments such as in vitro fertilization (IVF).
• Smoke cigarettes or tobacco products.
• Are older than 40.
• Tried to have tubal ligation reversal or tube tied.
• Have a sexually transmitted infection.
• Have scarring from previous pelvic surgery or C-section.

Studies also suggest that becoming pregnant while having an intrauterine device (IUD) for birth control is another major cause of ectopic pregnancy.

Endometriosis and Ectopic Pregnancy

Most women experience a painful condition when the tissues found in the lining of their uterus start to grow outside of the uterus. The tissues usually start to grow in the lining of pelvis, ovaries or fallopian tube. This condition causes many scars and the scarring stops the fertilized egg from entering the uterus. This may result in ectopic pregnancy.

Complications Occurring due to Ectopic Pregnancy

Ectopic pregnancy occurs when the fertilized egg starts to grow outside your uterus for several weeks, in the form of a wrapped structure. However, the problem gets more severe when the wrapped structure ruptures between 5 to 15 weeks of pregnancy. Severe bleeding results after ruptured ectopic pregnancy. Uncontrolled bleeding causes your body to shut down. Excessive loss of blood leads to hemorrhagic shock and the chances of getting die increased to many folds. Studies also claim that treating the wrapped egg before it bursts can also cause death. 

The erupting of the egg caused damage to the fallopian tube where it was implanted itself. A surgery is recommended at that time to remove the fallopian tube. As you have two fallopian tubers, the healthy fallopian tube can still help you get pregnant in future. But in case of damage to both fallopian tubes, you would face fertility issues in future life. In this situation, you should talk to your doctor so that they may suggest other options for getting pregnant like in vitro fertilization (IVF).

Diagnosis of Ectopic Pregnancy

A detailed pelvic exam and pregnancy test are usually performed to diagnose the ectopic pregnancy. Ultrasound ,may also help to have a clear look at the condition of your fallopian tubes and uterus. In ultrasound tests the sound waves are used to create clear images of the inside of the uterus. As this is a noninvasive test, it is done transabdominally or trans-vaginally by a sonographer. If your doctor finds a gestational sac during the ultrasound, they look for the location of the gestational sac to determine whether there’s a fetal heartbeat. This test takes 20 to 3 minutes but it’s painless and creates no damage. Doctors also do an abdominal ultrasound test to check for internal bleeding or confirmed pregnancy. This test is done by moving a wand over the abdomen.

Treatment of Ectopic Pregnancy

Doctors usually prefer to take the fertilized egg out, because it can;t survive outside the uterus. Taking out eggs saves you from serious health problems. Removing eggs from the outside uterus needs medication or surgery.

Medications

Your doctor will recommend a shot of methotrexate to take out the fertilized egg from your body. But it will work only if your pregnancy isn’t far long and the fallopian tube is not ruptured. Only one dose of this injection stops the growth of the fertilized egg. Thus your body easily absorbs the egg in 5 to 8 weeks. This treatment doesn’t need the removal of any fallopian tube.

However, a few blood tests are recommended before taking methotrexate medicine or injection. The blood tests help your healthcare professionals to learn about the levels of hCG. hCG (human chronic gonadotropin) is a hormone produced by your body when it detects a pregnancy. Females with certain health issues or breastfeeding are not allowed to take methotrexate. 

After getting a shot of methotrexate, your hCG level is checked once again. No change in the level of hCG indicates that the egg is not fully diminished and you may need another dose of the same injection. The procedure continues until your blood test shows nill hCG level. 

Moreover, taking methotrexate is totally different from abortion as the abortion is the procedure of ending a normal pregnancy that has a healthy fertilized egg attached inside the uterus. But methotrexate is essential to burst the egg in ectopic pregnancy. It helps lower the risk of serious health complications and death. 

Surgery for Ectopic Pregnancy

The last option for getting rid of ectopic pregnancy is surgery. Its commonly applied surgery is laparoscopy. Very small and minute cuts are made on the lower abdominal part to insert a thin, flexible slide or tube in your belly. These tin tubes are called laparoscopes and used to remove the ectopic pregnancy. Sometimes, the fallopian tube is also damaged during laparoscopy. So it is also removed. In some cases, the fallopian tube ruptures but not removed which causes frequent life-threatening bleeding. Then the doctors decide to make a larger cut in your belly as emergency surgery. This emergency surgery is called laparotomy. 

Although surgery is the last option and is adopted when no other treatment option works but it is not only life-threatening but also associated with side effects, such as:

• Infection.
• Pain.
• Bleeding.

How to Avoid an Ectopic Pregnancy?

You can lower the risk for developing an ectopic pregnancy but it can’t be avoided completely. Certain lifestyle changes can help you, including:

• Avoid using vaginal douche. It can cause ectopic pregnancy.
• Always use condoms to lower the risk for sexually transmitted infection. This may reduce the risk of ectopic pregnancy as well.

Conclusion

Ectopic pregnancy is not the signal of end of sexual life. After ending an ectopic pregnancy, people often have many healthy pregnancies. But if you have preexisting reproductive problems, you need to seek medical help. Ectopic pregnancy is not dangerous until it causes physical damage to you. This means, interaction of fallopian tubes even after ending an ectopic pregnancy can make it easy to fertilize eggs in another try. An already disturbed reproductive system or having UTIs can cause infertility or increase the chances of ectopic pregnancy in the next attempt. 

In addition, surgery often damages fallopian tubes leading to future ectopic pregnancy. After removal of both fallopian tubes, you may need fertility treatments for future pregnancies. Taking rest and eating a nutritious diet is essential after losing an ectopic pregnancy.