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Overview
Early pregnancy that develops outside the uterine lining—the typical place for a developing pregnancy—is referred to as an ectopic pregnancy. The Fallopian tubes are where most ectopic pregnancies take place. Ectopic pregnancies cannot develop normally, and the embryo or fetus usually dies as a result.
A fertilized egg that settles and develops anywhere other than the uterus' inner lining is said to have an ectopic pregnancy (EP). The majority of ectopic pregnancies take place in the Fallopian tube and are referred to as tubal pregnancies. But they can also develop in other places, like the ovary, cervix, and abdominal cavity. In between 1% and 2% of pregnancies, an ectopic pregnancy develops. A molar pregnancy, which can cause pregnancy-related symptoms, differs from an ectopic pregnancy in that it often originates from the growth of a grape-like mass of tissue generated from an egg with insufficient genetic information inside the uterus.
Ectopic pregnancy's main health concern is a rupture that results in internal bleeding Even though the incidence of ectopic pregnancies is rising, the survival rate from these pregnancies is improving. The primary cause of a bad outcome is delaying seeking medical care.
Consulting Doctor
If not treated in a timely manner, ectopic pregnancy may result in several life-threatening problems. It is crucial to speak with a gynecologist who has previous expertise managing such challenging pregnancies if you want to receive effective care. Select a gynecologist who has experience managing the risks and difficulties involved in treating ectopic pregnancies.
Symptoms
It's possible that the woman is unaware of her pregnancy. The following are the three primary indicators of an ectopic pregnancy:
Stomach ache , irregular or absent menstrual cycles (amenorrhea), and spotting or vaginal bleeding.
However, not all females with ectopic pregnancies will exhibit all three symptoms—about 50% of them won't. Both ruptured (those with extensive internal hemorrhage) and non-ruptured ectopic pregnancies exhibit these identifying symptoms. Although these symptoms are typical of an ectopic pregnancy, they do not necessarily indicate that an ectopic pregnancy is present and may instead be a sign of other illnesses. In non-ectopic pregnancies, these symptoms might potentially signal a potential abortion (miscarriage).
The lady is frequently taken to an emergency room before their diagnosis is made until she exhibits shock-related symptoms, such as low blood pressure, a weak and quick pulse, pale skin, and confusion. There is a medical emergency here.Although they may appear later if the ectopic pregnancy is not in the Fallopian tube, the signs and symptoms of an ectopic pregnancy normally appear six to eight weeks after the last regular menstrual period.
Ectopic pregnancy may also be accompanied by additional pregnancy symptoms, such as nausea and soreness in the breasts.
Symptoms of a ruptured ectopic pregnancy include weakness, dizziness, and a feeling of passing out upon standing (also known as near-syncope). These symptoms necessitate prompt medical attention since they can indicate dangerous internal bleeding and low blood pressure.
Causes
Here are 10 variables that could lead to an ectopic pregnancy.
Age: Any woman, of any age, who is ovulating and having sexual activity with a male partner is at risk for developing an ectopic pregnancy. Ages 35 to 44 are when ectopic pregnancies are most likely to occur.
History: Having experienced an ectopic pregnancy before is the biggest risk factor.
Abnormalities of the fallopian tubes: Any change to the Fallopian tubes' typical architecture can increase the likelihood of a tubal pregnancy or an ectopic pregnancy in another organ.
Previous gynecological procedures: Previous procedures involving the Fallopian tubes, such as tubal sterilization or reconstructive procedures, can cause scarring and disturb the normal structure of the tubes, which raises the chance of an ectopic pregnancy.
Smoking cigarettes: Smoking cigarettes right before conception has also been linked to a higher risk of ectopic pregnancy. This risk was found to be dose-dependent, which indicates that it is influenced by the habits of each individual woman and rises with cigarette consumption.
Infertility: An increased risk of ectopic pregnancy is linked to a history of infertility for two or more years.
The likelihood of an ectopic pregnancy can also be increased by infections, congenital anomalies, or cancers of the Fallopian tubes.
Treatment
The following methods of treatment are available for ectopic pregnancy: observation, laparoscopy, laparotomy, and medication. Individuals are responsible for making these decisions.While some ectopic pregnancies resolve on their own without treatment, others necessitate immediate surgery because of life-threatening hemorrhage. However, the majority of women with a confirmed ectopic pregnancy are treated with medication or surgery due to the risk of rupture and very serious repercussions.
The most frequent form of treatment for patients who need intervention is surgery. There are two surgical procedures: laparotomy and laparoscopy.
A transverse incision is created across the lower abdomen during a laparotomy, an open procedure.
Through very small skin incisions, viewing equipment are inserted during a laparoscopy into the pelvis.
Laparoscopy is frequently chosen over laparotomy because of the minimally invasive procedure and quick recovery time. In the best case scenario, the Fallopian tube can be left intact when a minor incision is performed to remove the ectopic pregnancy. Laparoscopy, however, may not be an option or be less successful due to specific disorders. These include a lot of pelvic scar tissue and a lot of bleeding in the pelvis or abdomen. In extreme cases, the location or severity of the damage may necessitate removing all or part of the Fallopian tube.
Tests Required for Diagnosis
The doctor's interview and examination are the first steps in the diagnosing process.
Getting a pregnancy test, either qualitative (which determines whether you are pregnant) or quantitative (which assesses your hormone levels), is typically the second step. Occasionally, while performing a pelvic exam, the doctor could feel a sensitive lump.
The combination of blood hormone pregnancy tests and pelvic ultrasound can typically aid in making the diagnosis when an ectopic pregnancy is suspected.
The most useful test to identify an ectopic pregnancy is transvaginal ultrasonography. An ultrasound probe is put into the vagina during this procedure, and images of the pelvis are displayed on a monitor. Transvaginal ultrasonography is able to detect the gestational sac in both normal (intrauterine) and ectopic pregnancies, albeit the results are frequently inconclusive. The examination might just show a lump near the Fallopian tubes or somewhere else, which is suggestive but not definitive of an ectopic pregnancy, rather than a gestational sac with an apparent embryo.
Additionally, an ultrasound can show that there is no pregnancy inside the uterus.
Human chorionic gonadotrophin (beta HCG) blood levels are also used to diagnose ectopic pregnancy. Pregnancy tests are made to identify specific hormones. During pregnancy, beta HCG levels often increase. This hormone's increase may exhibit an unusual pattern, which may indicate the presence of an ectopic pregnancy.
Laparoscopy may occasionally be required to confirm an ectopic pregnancy diagnosis. In order to inspect the tissues in the belly and pelvis during a laparoscopy and identify the location of the ectopic pregnancy, tiny incisions are made in the abdominal wall.
