What is an ectopic pregnancy?
All natural pregnancies start in the same way. Egg and sperm meet in the fallopian tubes. After that, in a normal pregnancy, the fertilized egg will travel down to the uterus and implant there. An ectopic pregnancy is a pregnancy that develops outside of the uterus, in other words in the wrong place.
The most common type of ectopic pregnancy is a tubal pregnancy. This type of ectopic pregnancy occurs in around one in 50 pregnancies. In a tubal pregnancy, a fertilized egg will remain inside the fallopian tubes and continue there because of blocked fallopian tubes, for example. A tubal pregnancy will quickly put the life of the pregnant mother at risk, as the embryo grows and the affected tube will start rupturing.
Any rupture will lead to internal hemorrhage, which is extremely dangerous and requires immediate surgical intervention to remove the fallopian tube in question. Tubal pregnancies are usually discovered by the eighth week of pregnancy, during a routine ultrasound or because the women starts experiencing symptoms.
A tubal pregnancy may not involve your usual pregnancy symptoms, and tubal pregnancies can result in a negative pregnancy test. Non-tubal ectopic pregnancies are much rarer, but they can happen. The ovaries, cervix, and even abdominal cavity are all locations in which an ectopic pregnancy can occur. It is even possible for an ectopic pregnancy and a normal, uterine pregnancy to occur simultaneously.
What are the symptoms you may experience?
Here are the symptoms you can expect to have with a tubal pregnancy:
- Pain in the lower abdomen, which can be located in one side of the body.
- Cramps in the lower abdomen.
- Irregular vaginal bleeding, light or heavy.
- Pregnancy nausea.
- Feeling weak, dizzy, and like fainting.
- A painful feeling in your neck and shoulders.
If you are experiencing these symptoms, you should head to the ER or call emergency services right away, regardless of whether you suspect an ectopic pregnancy. Remember that you do not need to have all, or indeed any, of the regular pregnancy signs to suffer from an ectopic pregnancy. A tubal pregnancy can never, under any circumstances, be carried to term or even to the stage at which the baby would be viable. Those tubal pregnancies that are detected earlier are treated more easily, meaning the woman's fertility (fallopian tube) has a higher chance of being preserved. Other types of ectopic pregnancies may have other symptoms. In some cases, women with sharp pains in their abdomen were dismissed by their OBGYNs as complaining about regular pregnancy symptoms, only to find out late into their pregnancies that they were suffering from an ectopic pregnancy in their abdominal cavity. A British baby who nestled into the outside of a bowel was safely delivered by c-section after six months of pregnancy a few years back.
How is an ectopic pregnancy diagnosed?
A urine pregnancy test and blood pregnancy test, both to determine levels of the hormone hCG, are usually carried out first when an ectopic pregnancy is suspected. Blood tests are more sensitive than urine pregnancy tests. Next, you will receive an ultrasound and a physical examination of the pelvis.
Ectopic pregnancy treatment options
There are four separate treatment options for ectopic pregnancies that develop inside the fallopian tubes. They are not all suitable for all circumstances. The treatment options are:
- Expectant management, or doing nothing. This may be an option for women whose tubal pregnancies are detected very early on. In some cases, the embryo is reabsorbed by the body. Expectant management of a tubal pregnancy should include very thorough monitoring to assess the risk of the fallopian tube rupturing. This option should be discussed in great detail, and is not usually recommended.
- Medication to prevent the embryonic tissue from growing further. In this case, the embryo will be reabsorbed by the body if everything goes well.
- Laparascopic surgery to remove the embryo from the affected fallopian tube. This option aims to leave the fallopian tube intact, making future pregnancy easier.
- Removing the fallopian tube along with the embryo, when there is immediate risk of rupture or the fallopian tube has already started rupturing.