What is Ectopic Pregnancy

What is Ectopic pregnancy

Ectopic pregnancy is when a pregnancy occurs outside of the uterus.

In normal conception, sperm passes along the vagina through a mucus barrier at the cervix, into the uterus and then along the fallopian tube. The sperm meets and penetrates the ovum as it moves down the fallopian tube towards the uterus. If the sperm successfully penetrates the ova and fertilization occurs, the zygote (fertilized ovum) must implant in the wall of the uterus.

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An ectopic pregnancy occurs when the fertilized ovum implants (attached to tissue) in the fallopian tubes (over 50% of cases), the ovary, or in the abdominal cavity, attached to ligaments, membranes or other organs. The sac containing the developing ectopic zygote can rupture or cause the fallopian tube to rupture, causing severe hemorrhage (bleeding), which may result in rapid death. Tubal rupture can occur within 6 – 8 weeks after implantation if located in the lower portion of the tube, or 12 to 16 weeks if the implantation has occurred at the top of the tube, next to the uterus.

An ectopic pregnancy occurs in approximately 1 out of 100 pregnancies. Although ectopic pregnancy may occur to any woman, women who have had a previous ectopic pregnancy or pelvic inflammatory disease (PID), abdominal or pelvic surgery, IUD, or are using the progesterone-only pill or in-vitro fertilization (IVF) are at a greater risk.

OTHER NAMES
Tubal pregnancy

SYMPTOMS of Ectopic Pregnancy

Ectopic pregnancy: normal symptoms of pregnancy (usually little or no enlargement of breasts, uterus, or lower abdomen), abnormal vaginal bleeding (spotting after first missed period), missed a period, cramping pains in one side of the pelvis or lower abdomen (lower level than the navel).

Rupture: severe pain in the pelvis, which may also be felt spreading to the anus, vagina or legs, internal hemorrhage (dizziness, fainting, coma).

DIAGNOSIS

A medical history will be taken including questions on the severity of symptoms, the timing of the last period, whether currently trying to get pregnant, what form of contraception is being used, previous pregnancies, previous pelvic inflammatory disease or vaginal infections, sexual history.

Medical tests will include a urine or blood pregnancy test, and either a vaginal ultrasound or laparoscopy (optic fiber tube inserted through the abdomen to examine the ovaries, fallopian tubes, and abdomen).

TREATMENT

In most cases a surgical operation will be done by laparoscopy, to either inject a drug into the ectopic sac to kill the fetal tissue or to remove the fetal tissue. In severe cases, especially if ruptured, the operation may require the surgical opening of the abdomen and repair to the damaged fallopian tube.

Full details of the surgical procedures can be found under ectopic pregnancy surgery.

OUTCOMES

In most cases, pregnancy can still occur after surgical treatment, unless both fallopian tubes have been removed.

If untreated ectopic pregnancy may be fatal.

IMPORTANT NOTES

Always seek medical attention if suffering from severe, cramping pains in the pelvis or lower abdomen, especially after a missed period.

There is an increased risk of an ectopic pregnancy, from 1 in 100 to 1 in 20, in women who have previously had one