What is Ectopic pregnancy or Extrauterine pregnancy?

English हिन्दी

An ectopic pregnancy or extrauterine pregnancy, also known as a tubal pregnancy, is a medical condition in which a fertilised egg implants and begins to develop outside the uterus, typically within one of the fallopian tubes. In a normal pregnancy, a fertilized egg travels down the fallopian tube into the uterus, where it implants and grows. However, in an ectopic pregnancy, the fertilized egg becomes trapped in the fallopian tube, where it cannot develop properly, and this can be a serious medical emergency.

Ectopic pregnancies are not viable and can be life-threatening for the pregnant person if not detected and treated promptly. The most common symptom is severe abdominal pain, often on one side. Other symptoms may include vaginal bleeding, shoulder pain (due to referred pain from irritation of the diaphragm), and signs of shock, such as lightheadedness and fainting.

If an ectopic pregnancy or extrauterine pregnancy is suspected or diagnosed, medical intervention is necessary. Treatment options include medication to stop the growth of the embryo and/or surgery to remove the ectopic pregnancy. In many cases, the affected fallopian tube may need to be partially or completely removed.

Early detection and medical intervention are crucial to prevent complications, as ectopic pregnancies can lead to ruptured fallopian tubes, severe bleeding, and a life-threatening situation. 

Who is at risk for ectopic pregnancy ?

Ectopic pregnancies can occur in any sexually active person with a uterus, but some factors and conditions can increase the risk. Common risk factors for ectopic pregnancy include:

• Previous Ectopic Pregnancy: A history of a previous ectopic pregnancy increases the risk of having another one.
• Pelvic Inflammatory Disease (PID): Infections of the reproductive organs, particularly chlamydia and gonorrhea, can lead to scarring and damage to the fallopian tubes, making it more likely for a fertilized egg to become trapped there.
• Fallopian Tube Issues: Conditions that affect the structure or function of the fallopian tubes, such as congenital anomalies or previous surgery on the tubes, can increase the risk.
• Intrauterine Device (IUD): While rare, ectopic pregnancies can occur in individuals using an IUD for birth control.
• Endometriosis: This condition can cause scarring and adhesions in the pelvis, which may increase the likelihood of an ectopic pregnancy.
• Smoking: Smoking has been associated with an increased risk of ectopic pregnancy.
• Fertility Treatments: Individuals undergoing fertility treatments, such as in vitro fertilization (IVF), may be at a slightly higher risk of ectopic pregnancy due to the manipulation of the reproductive process.
• Age: Ectopic pregnancy is more common in individuals over the age of 35.
• Tubal Ligation: A surgical procedure to block or seal the fallopian tubes as a form of permanent birth control can occasionally fail, leading to ectopic pregnancy.
• Previous Abdominal or Pelvic Surgery: Surgeries in the pelvic or abdominal area can sometimes result in scarring or adhesions that increase the risk of ectopic pregnancy.

In some cases, ectopic pregnancies occur without any known risk factors. Early detection and prompt medical attention are crucial to minimise the risks associated with ectopic pregnancies, as they can be life-threatening if left untreated.

( Know more about- What is Infertility in Women ? )

How to know if one has ectopic pregnancy ?

Ectopic pregnancy or extrauterine pregnancy can be difficult to diagnose, and symptoms can vary, but there are some common signs and symptoms to be aware of. If you experience any of the following, especially if you suspect you might be pregnant, you should seek immediate medical attention:

• Abdominal Pain: Severe abdominal pain, often concentrated on one side, is one of the most common symptoms of an ectopic pregnancy. The pain may be sharp, stabbing, or cramp-like.
• Vaginal Bleeding: Some vaginal bleeding may occur, which can be similar to a lighter menstrual period or spotting. The bleeding may be continuous or intermittent.
• Shoulder Pain: This can be a referred pain that occurs when blood or fluid from a ruptured fallopian tube irritates the diaphragm, causing pain in the shoulder area.
• Weakness or Dizziness: Due to internal bleeding, you may experience weakness, lightheadedness, or fainting. This could be a sign of shock and is a medical emergency.
• Gastrointestinal Symptoms: Some people with ectopic pregnancies may experience nausea, vomiting, and diarrhea.

 

Remember that not all individuals with an ectopic pregnancy will experience all of these symptoms, and the severity of symptoms can vary. If you suspect you might have an ectopic pregnancy or experience any of the above symptoms, you should immediately contact a healthcare provider or go to an emergency room. Early diagnosis and treatment are critical to prevent complications and protect your health.

Doctors may perform various diagnostic tests, including blood tests to measure human chorionic gonadotropin (hCG) levels and imaging, such as ultrasound, to locate the ectopic pregnancy and assess its severity. 

What next if ectopic pregnancy is confirmed ?

If an ectopic pregnancy or extrauterine pregnancy is confirmed, it is crucial to proceed with immediate medical treatment, as ectopic pregnancies can be life-threatening if left untreated. 

The specific treatment approach may vary depending on the severity of the condition and the patient’s overall health, but there are two primary treatment options:

• Medical Management: In some cases, if the ectopic pregnancy is detected early and is not causing severe symptoms or complications, a medication called methotrexate may be used to stop the development of the pregnancy. Methotrexate works by preventing the rapidly dividing cells of the embryo from growing. Regular monitoring of hCG levels is necessary to ensure the treatment is effective.
• Surgical Intervention: Surgery is often required for cases of ectopic pregnancy. The surgical options include:
  a. Laparoscopy: This minimally invasive surgical procedure involves making small incisions in the abdomen to access the fallopian tube and remove the ectopic pregnancy. Laparoscopy is preferred when the ectopic pregnancy is small and hasn’t caused significant damage to the tube.
  b. Laparotomy: In more severe cases, or if the fallopian tube has ruptured, an open abdominal surgery (laparotomy) may be necessary. During this procedure, a larger incision is made to access and remove the ectopic pregnancy, and the surgeon may also repair or remove the damaged fallopian tube.

After treatment, you will need to follow up with your doctor to ensure that your hCG levels return to normal and to monitor your recovery. It’s important to remember that while the treatment for an ectopic pregnancy can be emotionally and physically challenging, many individuals go on to have successful pregnancies in the future. 

However, your future fertility may be affected, particularly if you had to have one or both fallopian tubes removed.

Discuss your specific situation, treatment options, and potential implications with your gynaecologist , as they will be able to provide you with the most relevant information and support based on your individual circumstances. In such cases, one can plan for IVF treatments, as an option for future pregnancy. Consult with the best IVF Specialist Dr Firuza Parikh for the best results.