Ectopic Pregnancy: Causes, symptoms, and treatments

Ectopic Pregnancy: Causes, symptoms, and treatments

Don't know what an Ectopic Pregnancy is? Don't worry, you aren't alone! Read this for a quick overview as to what it is and how it can affect you.

If you‘re experiencing symptoms like vaginal bleeding or pelvic pain, you may be wondering if you have an ectopic pregnancy. What is ectopic pregnancy? An ectopic pregnancy is one that occurs outside of the womb, usually in the fallopian tubes. While it‘s very dangerous, there are treatments available. 

Ectopic pregnancy meaning: What is ectopic pregnancy?

ectopic pregnancy

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Ectopic pregnancy meaning: According to Dr. Eric Daiter of The New Jersey Center for Fertility and Reproductive Medicine, an ectopic pregnancy, or tubal pregnancy, is one that occurs outside of the womb.

The most common location for a tubal pregnancy is inside one of the fallopian tubes. This can occur when an egg is fertilized and does not implant into the uterus.

The fertilized egg can attach to the inside of the fallopian tube, the ovary, the outside of the uterus, or the intestine. Fertilized eggs that implant outside of the uterus can not grow to become fetuses due to the lack of nutrients and non-accommodating organs.

Ruptured ectopic pregnancy

A tubal pregnancy is very dangerous. As the attached fertilized egg grows, it can damage organs and cause severe internal bleeding.

Ruptured ectopic pregnancy: For example, your fallopian tube isn’t designed to expand and accommodate a growing fetus. Therefore, if a fertilized egg implants there, it can rupture the tube. Arteries that are located nearby can rupture as well.

Signs of ectopic Pregnancy

How to detect ectopic pregnancy early? What are the signs of ectopic pregnancy?

You may not notice any ectopic pregnancy symptoms at first. But how to detect ectopic pregnancy early? Missed periods, breast discomfort, and nausea are common early indications and symptoms of tubal pregnancy in some women.

  • When a fertilized egg grows in the wrong place, the signs and symptoms become more visible.
  • The initial signs of an ectopic pregnancy are usually light vaginal bleeding and pelvic pain.
  • You may have shoulder pain or a strong desire to urinate if blood seeps from the fallopian tube. 

Ectopic pregnancy symptoms

The most common ectopic pregnancy symptoms are vaginal bleeding and abdominal or pelvic pain. Symptoms can become much more severe if the tubal pregnancy ruptures. You may become dizzy or even pass out, and may experience a fast heart rate of over one hundred beats per minute.

You may become pale, clammy, and sweaty. Pain will become so severe that you are unable to stand or walk. Many women go into shock when a tubal pregnancy ruptures.

Other symptoms are:

If you suspect that you have a tubal pregnancy or ectopic rupture, then you should immediately seek medical attention as you could have an immediate life-threatening condition.

First, pregnancy will be confirmed. Second, an ultrasound will be performed to confirm that the pregnancy is ectopic. This will also help locate the developing embryo (fertilized egg).

If the embryo or the gestational sac is too small to be detected by ultrasound, and you are in stable condition, then your doctor may monitor you closely by performing blood tests every two to three days to follow hormone levels.

When the pregnancy (gestational sac, embryo, or fertilized egg) has grown large enough, the ultrasound will be repeated to locate it. If it is confirmed that the pregnancy is tubal, then immediate treatment will be ordered.

Signs of Ectopic pregnancy at 6 weeks: When do ectopic pregnancy symptoms start?

ectopic pregnancy

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When do ectopic pregnancy symptoms start? Symptoms normally appear 6–8 weeks after the last menstrual cycle.  Contact your healthcare provider if you experience any bleeding or pain while pregnant.

Tubal pregnancy bleeding

The fallopian tube may rupture if the fertilized egg continues to develop in the tube. It’s likely that you’ll have a lot of internal bleeding. Extreme lightheadedness, fainting, and shock are all symptoms of this life-threatening occurrence.

Ectopic pregnancy causes

ectopic pregnancy

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Causes of ectopic pregnancy: Tubal pregnancy occurs when a fertilized egg becomes stuck on its way to the uterus. This is usually due to inflammation or a deformed fallopian tube. Hormonal imbalances or insufficient fertilization development could have an influence.

Tubal pregnancy risk factors

  • Previous tubal pregnancy

You’re more likely to have another of these pregnancies if you’ve had one previously.

  • Infection or inflammation

Sexually transmitted illnesses like gonorrhea and chlamydia can cause inflammation in the tubes and other adjacent organs, increasing your chances of having an ectopic pregnancy.

  • Infertility treatments

Several studies have found that women who have had IVF or similar treatments are more likely to develop an ectopic pregnancy. Infertility can also make you more vulnerable to having a tubal pregnancy.

  • Tubal ligation

Surgery to repair a closed or broken fallopian tube may raise the risk of an ectopic pregnancy.

  • Birth control

The pregnancy is more likely to be ectopic if you get pregnant while wearing an IUD. Tubal ligation, sometimes known as “tying your tubes,” is a long-term birth control method that improves your chances of becoming pregnant if you fall pregnant after the procedure.

When you smoke cigarettes before getting pregnant, you increase your chances of having a tubal pregnancy. The more you smoke, the higher the risk.

Aside from the factors stated above, you are more likely to have an ectopic pregnancy if you have a sexually transmitted infection. Furthermore, using fertility drugs or having fertility treatments such as in vitro fertilization (IVF) may also cause ectopic pregnancy.

Complications of tubal pregnancy

When the embryo implants in the fallopian tube, it does not have enough room to grow or enough blood flow to keep it alive, therefore it dies.

The tube may cause some tissues to leak or bleed. Some embryos continue to grow, and the fallopian tube may eventually burst. This can lead to a lot of bleeding and shock.

Ectopic pregnancy is the leading cause of pregnancy-related mortality in the first three months of pregnancy in the United States.

Ectopic pregnancy diagnosis

ectopic pregnancy

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The hormone hCG will be tested in your blood by your healthcare provider (human chorionic gonadotropin). They’ll utilize ultrasound to look for a fetus or other pregnancy tissue in the uterus. 

Your doctor may use laparoscopy to detect and treat an ectopic pregnancy in some instances. In this surgery, a lighted tube is placed into your abdomen to check the inside of your pelvis. It frequently provides the most precise diagnosis.

Ectopic pregnancy treatment

 If your fallopian tube has ruptured, the stage of your pregnancy and your hormone levels all play a role. In diagnosing ectopic pregnancy, you will need to undergo certain tests, such as a pregnancy test and a pelvic exam. Your healthcare provider may also order you to have an ultrasound so they can look further at your uterus and fallopian tubes.

Options for ectopic pregnancy treatment include:

  • Allow the body to naturally heal and absorb the ectopic pregnancy. This is only applicable in specific situations.
  • Using Methotrexate – a medication to prevent a pregnancy from continuing.
  • Use surgery to create a tiny hole in the fallopian tube (typically laparoscopy). The surgeon removes the pregnancy and, in some situations, the tube.
  • A larger abdominal incision to remove an ectopic pregnancy or a damaged fallopian tube (in some cases).

According to Web MD, before you can take a medication to prevent pregnancy from continuing, your doctor will need to run blood tests first to measure your human chorionic gonadotropin (hCG) levels.

You will only be allowed to take methotrexate if you are not breastfeeding. Your overall health condition will also be taken into consideration whether you will be given this medication or not.

You only need one dose of injection and once you get the shot, your hCG levels will be checked again during follow-up appointments with your doctor.

This medicine is necessary to take before the egg ruptured to lower the risk of death and other serious complications that the mom may experience.

Moreover, in some cases, surgery is necessary. The surgery needed for an ectopic pregnancy is called laparoscopy. How is it done? Your healthcare provider will make small incisions in your belly and a thin, flexible tube called a laparoscope will be inserted into the small cuts to remove the ectopic pregnancy.

Furthermore, if the fallopian tube is damaged, it will be removed as well. On the other hand, if there’s excessive bleeding, which is a sign of a ruptured fallopian tube, then you might need laparotomy, an emergency surgery with a larger cut.

You may experience pain, fatigue, bleeding, and infection as side effects of surgery. Whatever ectopic pregnancy treatment is done to you, whether through medication or surgery, you may feel discomfort in your belly and may feel tired for a few weeks. Pregnancy-like symptoms may also be felt until a few period cycles when you feel normal again.

Can tubal pregnancy be saved?

It’s extremely rare that a tubal pregnancy will be saved. Insufficient space exists in the fallopian tubes for any ectopic pregnancy to occur. The tube will eventually rupture if not addressed. If the pregnancy develops outside of the uterus, there is no way to save it without putting your life at risk.

  • If fetal growth is uncontrolled, it will involve more tissue and vascular structures. Any rupture will almost certainly result in a big bleed.
  • Fetal death is almost certain and the risk to the mother is high. Thus, there will be termination of pregnancy through surgery or abortive medicines.
  • The mother is at risk because the placenta does not generally separate and release as it would in a uterine pregnancy.

Unfortunately, no medical equipment exists that can transfer a tubal pregnancy from the fallopian tubes to the uterus.

According to Web MD, this condition is the leading cause of pregnancy-related deaths in the first trimester. Aside from that, it is impossible for the egg to survive and be saved which is why the result of ectopic pregnancy is always pregnancy loss. If the egg cannot get the blood supply it needs, it is impossible to grow into a baby.

How to prevent tubal pregnancy

There is no way to prevent a tubal pregnancy. However, there are certain steps you can do to lower your risk:

  • Having fewer sexual partners and using a condom during sex can reduce the risk of sexually transmitted infections and pelvic inflammatory disease.
  • Do not smoke. If this is the case, you should not try to conceive.

Can I get pregnant again after a tubal pregnancy

After a tubal pregnancy, some women opt to avoid becoming pregnant again.

  • To avoid pregnancy, you can begin taking any sort of birth control. To discover which choice is best for you, consult your doctor.
  • It will depend on how you handled the ectopic pregnancy.
  • If your tubal pregnancy did not require treatment, you can try for pregnancy if a healthcare provider determines that the ectopic pregnancy is no longer present and you are emotionally and physically ready.
  • Your chances of becoming pregnant again are slim if you have surgery to remove the tubal pregnancy. The scarring from the procedure and the removal of the fallopian tube can make it more difficult to conceive in the future. Talk to your doctor about your specific situation to discover if you can get pregnant again.
  • People who have had one tubal pregnancy before have a 10% probability of having another. But this does not rule out the likelihood of miscarriages of various types in later pregnancies.

How long does it take to heal after an ectopic pregnancy?

Mommy, it may be sad, but it is important to know that after a tubal pregnancy, it might be hard for you to have a normal pregnancy. You may talk to a fertility specialist to know what to do, especially if your fallopian tube has been removed. 

You will need to give your body at least 3 months to heal before trying to get pregnant again. 

 

Updates by Margaux Dolores and Jobelle Macayan

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