Ectopic Pregnancy Symptoms and Treatment

Implantation is the beginning of pregnancy. After fertilisation of the egg, it attaches to the lining of the uterus. The implantation occurs within the uterus normally. On the contrary, in ectopic pregnancy fertilised eggs get implanted outside the uterus within the fallopian tubes, ovary, abdominal area or lower part of uterus (cervix). When implantation occurs in fallopian tubes, it is called tubal pregnancy.


Ectopic pregnancy does not result in normal development of the fetus. The fertilised egg may not survive and leads to severe bleeding which can be threatening. Untreated ectopic pregnancy is a medical emergency. Prompt treatment prevents complications and increases chances of future healthy pregnancy. Consult the best infertility doctor.
Causes of ectopic pregnancy: There are a variety of conditions that can lead to ectopic pregnancy.
(1). Hormonal imbalance
(2). Inflammation and scarring of fallopian tube due to infection, history of surgery or medical condition
(3). Genetic defect
(4). Birth anomalies
(5). Medical disorders that alter the shape and condition of fallopian tubes and other reproductive organs.

Symptoms of an Ectopic Pregnancy:

There are some common signs of ectopic pregnancy as in normal pregnancy. Nausea and breast soreness are primary signs In ectopic pregnancy. Other signs may include:
(i). Severe pain in the abdomen, pelvic area,
(ii). Severe pain felt on either side of the abdomen
(iii). Mild to severe spotting or bleeding
(iv). Rectal pressure
(v). Dizziness or fainting.
(vi). Pain in shoulder, and neck These signs are suggestive of medical emergencies and should not be ignored. If you notice any of the above symptoms seek medical attention.

Diagnosis of an ectopic pregnancy:

Ectopic pregnancy cannot be confirmed by physical examination. Doctors will ask about the history and symptoms to rule out other factors.
Transvaginal ultrasound is helpful in diagnosing ectopic pregnancy. An instrument is inserted into the vagina that produces sound waves to bounce off organs inside the pelvis. It is used to examine the vagina, uterus, fallopian tubes, ovaries, and bladder.
Pregnancy test is recommended that determines the level of hCG and progesterone in the blood. If the levels of these hormones lower down or remain same over the period and if gestational sac is not present on ultrasonography, then it is likely ectopic pregnancy.
Sometimes pain and bleeding starts suddenly. In the worst case scenario, fallopian tubes rupture and may give rise to severe bleeding. In such cases there is no time to perform any of the tests, doctors will perform direct surgery to provide prompt treatment.

Treatment of ectopic pregnancy

Ectopic pregnancies are harmful for the mother as well as the embryo cannot develop completely. It needs treatment as early as possible for mothers’ safety and at the same time preserving fertility for future pregnancy . Treatment depends on the location of pregnancy and development status of the embryo.

Medication

Methotrexate is a drug of choice to cease the growth of rapidly dividing cells of ectopic mass. Methotrexate injection is given to patients and its effectiveness is determined by conducting regular blood tests. It result in miscarriage like symptoms such as cramping, bleeding or elimination of tissue. It is beneficial to prevent surgery as well as it does not cause damage to fallopian tubes like in surgery. Women cannot get pregnant for a few months after taking this medication.

Surgery

Another option for ectopic surgery is removal of part of tube containing the embryo and then repairing the damage caused to fallopian tubes. The surgery is called laparotomy. Surgeon will insert a small camera through a small incision to visualise the working field. The surgeon will remove the embryo and try to fix the fallopian tubes. Surgery is not successful for the first attempt; surgeons will repeat the surgery through larger incisions. Fallopian tubes may also need to be removed in case of excessive rupture or damage.
Post operative care after surgery: Doctors will advise some of the precautions after surgery. The objective is to keep the incision dry and clean, which will promote better healing and control infection. Light vagina bleeding and small blood clot can occur up to six weeks after laparotomy. Always notice for
(i). Persistent bleeding
(ii). Heavy bleeding
(iii). Foul smelling discharge from the site of incision
(iv). Increased temperature at the site of incision
(v). Redness or swelling

Precautions

(i). Take proper rest in the first week after laparotomy, start routine activities gradually as per tolerance.
(ii). Do not lift heavy objects weighing more than 10 pounds
(iii). Keep yourself hydrated to avoid Constipation
(iv). Do not indulge in sexual intercourse, using tampons or douching.

FAQS:

What are the risk factors for ectopic pregnancy?

Risk of ectopic pregnancy is associated with:
(i). Advanced maternal age 35 years and above
(ii). Endometriosis
(iii). Structural abnormalities in fallopian tubes that hinders the path of egg
(iv). History of infection like pelvic inflammatory disease (PID)
(v). History of previous surgery such as pelvic or abdominal surgery, multiple miscarriage
(vi). History of ectopic pregnancy
(vii). Conception after tubal ligation or insertion of intrauterine device
(viii). Conception occurred by fertility drugs or procedures
(ix). In chronic smokers
(x). Sexually transmitted disease such as gonorrhoea and chlamydia

How to prevent ectopic pregnancy?

Self-care and hygiene is important during active sex life. Sex with multiple partners may poses risk of sexually transmitting diseases like gonorrhoea and chlamydia. It leads to pelvic inflammatory diseases and fallopian tube scarring. Use condoms while having sex and limit your partners. Regular gynaecological visits and screening for STDs can prevent Ectopic Pregnancy.
To know more about ectopic pregnancy, consult Dr. Richa Singh, the best infertility doctor in Lucknow.