The most dangerous type of pregnancy among women is ectopic pregnancy. This occurs when a fertilized egg implants and grows outside the uterus, such as in the fallopian tube (the tube connecting the ovary to the uterus). Read on to learn more about ectopic pregnancy and its treatment.
After fertilization, a fertilized egg typically attaches to the inner lining of the uterus and develops into a fetus, a process known as implantation. However, in most ectopic pregnancies, the fertilized egg attaches to the fallopian tube before reaching the uterus. In some cases, it may implant in the ovary, cervix, or even the abdominal cavity. These areas do not have the appropriate tissue or enough space for fetal growth, making ectopic pregnancies non-viable.
If untreated, an ectopic pregnancy can cause a rupture in the fallopian tube, leading to severe internal bleeding and even maternal death. Fortunately, with advances in medical science, many women who experience an ectopic pregnancy can still have healthy pregnancies in the future.
Detecting an ectopic pregnancy can be challenging because its symptoms are similar to early signs of a normal pregnancy, such as:
Missed periods
Breast tenderness
Nausea and vomiting
Fatigue
Frequent urination
The first warning sign is often pelvic pain or light vaginal bleeding. Other symptoms may include:
Shoulder pain
Urge to have a bowel movement
Low blood pressure, dizziness, or fainting (due to blood loss)
In severe cases, an ectopic pregnancy can rupture the fallopian tube. If the resulting blood accumulates and irritates nerves, it may cause pain in the pelvis, abdomen, shoulder, or neck. The pain can range from mild to severe and may be localized on one side of the pelvis or affect the entire region. If you experience these symptoms, seek medical attention immediately. A ruptured ectopic pregnancy is a life-threatening emergency but can be treated if diagnosed in time.
Ectopic pregnancy typically occurs when a fertilized egg fails to move quickly through the fallopian tube into the uterus. Several factors can cause partial or complete blockage of the fallopian tube, including:
Infections
Inflammation
Endometriosis
Scar tissue from previous abdominal surgeries
The following factors increase the risk of ectopic pregnancy:
Age: Women over 35 are at a higher risk.
History of Ectopic Pregnancy: Previous occurrences increase the likelihood of future cases.
Fallopian Tube Abnormalities: Structural issues in the fallopian tubes raise the risk.
Previous Surgeries: Surgery on the fallopian tubes may cause scarring, leading to blockages.
Sexually Transmitted Infections (STIs): The fallopian tubes have small hair-like structures (cilia) that help move the egg into the uterus. Infections can damage these cilia, preventing proper egg transport and leading to ectopic implantation.
Use of Intrauterine Devices (IUDs): Nearly half of pregnancies in women using IUDs are ectopic.
Smoking: Smoking around the time of conception increases the risk.
Congenital Abnormalities or Tumors: These can affect the location of egg implantation.
Miscarriage: Many ectopic pregnancies resolve naturally within a few days. Some women may experience mild pain and slight bleeding, similar to a miscarriage. In such cases, no medical intervention is required.
Ruptured Fallopian Tube: If the fertilized egg continues growing, it may cause the fallopian tube to stretch and rupture, leading to severe internal bleeding and requiring emergency medical attention.
Doctors use the following methods for diagnosis:
Physical Examination: Reviewing symptoms and performing a pelvic exam.
Pregnancy Test: A blood test measuring human chorionic gonadotropin (hCG) levels, which rise during pregnancy.
Transvaginal Ultrasound: A small probe is inserted into the vagina to visualize the uterus, ovaries, and fallopian tubes.
Abdominal Ultrasound: Sometimes used to assess internal bleeding.
Diagnostic Laparoscopy: In rare cases, a small surgical procedure is performed to confirm an ectopic pregnancy by inserting a camera through small incisions in the abdomen.
There are several treatment methods, depending on the severity of the condition:
Methotrexate: This injection stops cell growth and dissolves existing cells. Doctors monitor hCG levels after treatment to ensure its effectiveness. If necessary, additional doses may be administered.
Effectiveness: Methotrexate has high success rates and minimal side effects. Candidates for this treatment are selected based on the size of the ectopic mass and hCG concentration in the blood.
Salpingostomy: The fertilized egg is removed while preserving the fallopian tube.
Salpingectomy: Both the egg and the affected fallopian tube are removed.
The choice between these two depends on the extent of damage and severity of bleeding.
If severe bleeding occurs, immediate surgery is required.
It may be done laparoscopically or through a larger incision (laparotomy).
If possible, the fallopian tube is preserved; otherwise, a ruptured tube must be removed.
Although ectopic pregnancy cannot always be prevented, the risk can be reduced by:
✔ Avoiding smoking
✔ Using condoms to prevent infections
✔ Seeking early treatment for infections
Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, often in the fallopian tube. If left untreated, it can cause life-threatening complications. Early diagnosis and treatment are crucial. Fortunately, various treatment options are available, and many women go on to have healthy pregnancies afterward. If you experience any symptoms, seek medical attention immediately.
