We all know a mother carries her baby for 9 months in her uterus before giving birth. But, have you ever heard about the baby growing outside the uterus? In normal pregnancy, the egg fertilizes and latches itself on the walls of the uterus to grow a healthy foetus.
But there are times when the fertilized egg gets stuck in the fallopian tube. This condition is known as ectopic pregnancy. At times the fertilized egg can also stick to the walls of the ovaries, cervix or abdomen. It is always best to terminate ectopic pregnancy for the safety of the mother.
A] What Are The Causes Of Ectopic Pregnancy?
1. Tubal Damage
The fallopian tube might be inflamed, scared or damaged causing the fertilized egg to get stuck to the walls of the fallopian tube rather than sticking to the uterine wall. Tubal ligation, previous tubal surgery or a history of tubal pregnancy miscarriage may also lead to ectopic pregnancy.
2. Hormonal Imbalances
A hormonal imbalance often seen during PCOS or a person on oral contraception with high progestin might have a high chance of ectopic pregnancy. Hormonal imbalance during pregnancy might lead to the attachment of the fertilized egg to the wrong wall other than the uterus.
3. Abnormal Development of the Fertilized Egg
The genetic defect might cause abnormal development of the fertilized egg. History of endometriosis where the lining similar to the uterus lining is formed outside the uterus leading to attachment of the fertilized egg on the outer wall of the uterus. IVF has a high risk of ectopic pregnancy as the fertilization of the egg happens outside the body and then it is inserted in the uterus. Nobody knows where the fertilized egg will go and attach increasing the chances of ectopic pregnancy.
B] What Are The Symptoms And Risk Factors?
It is difficult to detect tubal pregnancy by only following the symptoms because those are very similar to normal pregnancy. The female might have symptoms of breast tenderness, nausea, vomiting, vaginal bleeding, lower back pain, pain in the abdomen, dizziness or weakness. But if the fallopian tube ruptures before detection it might lead to severe pain and bleeding along with fainting, low blood pressure, shoulder pain or improper bowel movement.
High-risk pregnancy Conditions like previous history of ectopic pregnancy or pelvic infections increase the risk of ectopic pregnancy. Previous ectopic pregnancy may damage the fallopian tube and cause scarring blocking the path for the fertilized egg to travel to the uterine wall for attachment. Pelvic infections are mostly caused by sexually transmitted diseases, leading to inflammation and damage to the fallopian tube. This increases the chances of the fertilized egg attaching to the tube walls instead of the uterine wall.
C] What Methods Are Used To Detect An Ectopic Pregnancy?
The doctors might perform a physical test and check the areas of pain and tenderness and decide if there are chances of ectopic pregnancy. But to confirm the doubt the doctors also perform certain other tests like urine tests, ultrasound and blood tests. A urine test is generally done to confirm the pregnancy by detecting the Hcg hormone. The HCG hormones dramatically increase in the blood once the fertilised egg attaches to the uterus. Low HCG levels indicate an ectopic pregnancy. The abdominal ultrasound shows the exact position of the foetus and evaluates the loss of blood. Whereas, transvaginal ultrasound helps to know the exact location of the fertilized egg. A blood test is done to check anaemia or other signs that indicate severe blood loss.
A fertilized egg not growing in the uterus might lead to severe consequences. A foetus growing in a fallopian tube might put high pressure on the tube leading to its rupture and bleeding the mother to death. Ectopic pregnancy can be detected easily during the initial weeks of pregnancy and some reports say it can cause early ectopic miscarriage at 6 weeks. This helps to prevent severe blood loss and related complications in the mother.
D] What Are The Treatment Options?
1. Laparoscopic Surgery
Laparoscopic surgery is done under the influence of anaesthesia, by making an incision in the abdominal area near or on the naval. A thin tube is then inserted through the incision which is attached to light and camera to know the exact location of the ectopic pregnancy. There are two types of laparoscopic surgery. Salpingostomy is where only the fertilized cell is removed if the mother is experiencing less bleeding and tube is not damaged and the tube is left to heal on its own. The other method is salpingectomy where the fertilized cell along with the tube is removed because of the rupture of the tube causing damage.
2. Medical Treatment With Methotrexate
Early detection of a foetus growing in the tube has the option of medically treating the pregnancy using methotrexate. The medication is injected once the ectopic pregnancy is confirmed, which inhibits cell growth and dissolves the fertilized egg. The doctor again performs an HCG test to confirm the termination of the pregnancy. If need be the doctor can reinject the medication to dissolve the cells. This option is used only if there is an ectopic pregnancy without unstable bleeding.
3. Expectant Management
This is conservative management of the ectopic pregnancy where the team of doctors closely observes the progress of the pregnancy. Most of the time if the assessment of the pregnancy is accurate and the HCG hormone level is gradually dropping then the body will naturally remove the ectopic pregnancy via miscarriage. The initial approach of the doctor might be to use minimally invasive techniques to get rid of ectopic pregnancy. If this doesn’t work out then the medical treatment or surgery is opted.
Ectopic pregnancy is a life-threatening condition where the baby growing in the fallopian tube may bleed the mother to death. Early detection is the key to successful treatment without any problems. It is necessary to go for a thorough examination once you confirm the pregnancy to avoid any complications related to ectopic pregnancy. Do not skip your doctor’s appointments and miss out on the chance of early detection. Our private gynaecologist in London gives the best guidance and complete information regarding ectopic pregnancy and provides appropriate treatment.