Ectopic pregnancy

What is an Ectopic Pregnancy?

During a normal pregnancy, a fertilized egg travels through the fallopian tube and securely implants into the endometrial lining of the uterus, providing an appropriate environment for development.

But in an ectopic pregnancy, the fertilized egg implants and begins to grow outside of the uterus. More than 90% of the time, such an event happens in one of the fallopian tubes (which is why it is often called a "tubal pregnancy"). Less commonly, it can occur in the ovary, the abdominal cavity, or the cervix.

Because these areas do not have the right tissue or space to support a growing embryo, an ectopic pregnancy cannot develop into a baby. It is a medical condition that requires prompt care to protect your health and preserve your future fertility.

Early Warning Signs and Symptoms

At first, an ectopic pregnancy might feel exactly like a normal pregnancy. You might miss your period, feel fatigued, or experience breast tenderness. However, as the fertilized egg grows, warning signs usually begin to appear, often between the 4th and 12th weeks of pregnancy.

Keep an eye out for these common symptoms:

• Abdominal or Pelvic Pain: This is often sharp, sudden, and localized to one side of your lower stomach.
• Vaginal Bleeding: This can range from light spotting to heavy bleeding. It might be darker or lighter than your normal period.
• Gastrointestinal Upset: Feeling pain when having a bowel movement or urinating.

When to Seek Emergency Care

If a fallopian tube stretches too much, it can rupture, causing dangerous internal bleeding. Go to an emergency room immediately if you experience:

• Sudden, severe, and unbearable abdominal pain.
• Pain at the tip of your shoulder (this is referred pain caused by internal bleeding irritating a nerve).
• Extreme dizziness, lightheadedness, or fainting.

Why Does It Happen? (Risk Factors)

Often, the exact cause of an ectopic pregnancy isn't clear. It is generally related to a damaged or misshapen fallopian tube that prevents the egg from moving down into the uterus.

While it can happen to anyone, certain factors can increase the likelihood:

• Previous ectopic pregnancy.
• Past pelvic inflammatory disease (PID), which can damage your fallopian tubes, uterus, ovaries, and cervix.
• Fallopian tube (including tubal ligation) or pelvic organ surgery.
• Infertility history.
• Treatment for infertility with IVF.
• Endometriosis.
• Sexually transmitted diseases.
• IUD at conception.
• A tobacco history.

How is it Diagnosed?

Because an ectopic pregnancy can mimic a normal early pregnancy or even an upset stomach, doctors rely on specific tests to confirm a diagnosis:

1. Pregnancy test : Your doctor monitor the levels of hCG (the pregnancy hormone). In an ectopic pregnancy, these levels often rise much slower than they should.
2. Transvaginal Ultrasound: Through the use of a transvaginal ultrasound, your doctor will be able to determine the precise placement of your pregnancy.

Management and Treatment

The goal of treatment is to safely resolve the pregnancy and protect your health.

• Medication: If diagnosed early and the tube has not ruptured, your doctor may use a medication called methotrexate. This stops the cells from growing, and your body naturally absorbs the pregnancy tissue over time.
• Laparoscopic Surgery: If the pregnancy is further along, or if there is a risk of (or actual) rupture, a minimally invasive surgery called a laparoscopy is usually performed. The surgeon will make a tiny incision near your belly button to remove the ectopic pregnancy and, if necessary, repair or remove the affected fallopian tube.