The most dangerous type of pregnancy among women is ectopic pregnancy. Occurring when an embryo develops in the wrong place outside the uterus, an ectopic pregnancy always ends in miscarriage. Without in-time treatment, this condition can end in heavy bleeding and even death. However, you don't have to be worried because these days, doctors prescribe different medicines like methotrexate for ectopic pregnancy. Stay tuned to learn more about this pregnancy-related complication.
What is an Ectopic Pregnancy?
Ectopic means "out of place." Ectopic pregnancy is when the fetus grows in the wrong place outside the uterus. An embryo is a fertilized egg created by the combination of egg and sperm. When the egg is fertilized, it usually travels down the fallopian tube and attaches to the uterine wall.
In a typical case, the fertilized egg attaches to the fallopian tube before reaching the uterus. In rare cases, it attaches to the ovary, cervix, or abdomen. These areas do not have enough space or proper tissue for the growth of the child. Without treatment, an ectopic pregnancy can cause heavy bleeding or pain, or rupture of the junction. In some cases, it may even become life-threatening. This unpleasant event always ends with the loss of the fetus.
Symptoms of an Ectopic Pregnancy
First, it is better to know if you have a combination of the following symptoms. Even if you did not have a positive pregnancy test, it’s better to contact your gynecologist as soon as possible.
Any gynecologist can answer many of your questions about ectopic pregnancy. You can, for example, ask, "does your belly grow with an ectopic pregnancy”? Or you can ask about the symptoms of the condition, which usually appear between the fourth and twelfth weeks of pregnancy.
Vaginal bleeding
Vaginal bleeding during pregnancy is slightly different from your menstrual period. This vaginal discharge usually starts and stops temporarily and may be watery and dark brown.
Feeling pain
You may have stomach pain, usually on one side. It may develop suddenly or gradually and may be persistent or temporary.
Shoulder tip pain
Shoulder tip pain is an unusual pain. If experienced, you should seek medical advice immediately. We do not fully understand why this pain occurs. It is thought to be associated with fluid or blood leaking into the pelvis or lower abdomen. There are nerves in this area that connect to your shoulder. Stimulation of these nerves can lead to shoulder pain.
Discomfort urinating
You may have pain when you vomit or have a bowel movement. This is one of the ectopic pregnancy bowel symptoms. You may also have diarrhea or constipation. Some changes in the usual pattern of your bladder and bowels are normal during pregnancy. But it's still best for you to seek medical advice.
The Causes
Usually, an ectopic pregnancy occurs because the fertilized egg cannot move quickly through the fallopian tube. Inflammation or infection in the tube can cause partial or complete blockage. This is usually caused by pelvic inflammatory disease (PID).
Another common cause of tubal blockage is endometriosis. This is when cells from the uterus lining grow outside the uterus. Cells can grow inside the fallopian tube, which can cause a blockage. Scar tissue from previous fallopian tube surgery or abdominal surgery may also block the tube.
Risk Factors
Age
An ectopic pregnancy can occur in any woman of any age who is ovulating and is sexually active. However, the highest probability of this condition occurs in women aged 35 to 44.
History
The most significant risk factor for ectopic pregnancy is a previous history of ectopic pregnancy.
History of gynecological surgeries
Previous surgery on the fallopian tubes may also lead to scarring and disruption of the normal anatomy of the tubes. This can finally increase the risk of ectopic pregnancy.
Infections
Infection in the pelvis is another risk factor for ectopic pregnancy. Pelvic infections are usually caused by sexually transmitted organisms such as chlamydia or the bacteria that cause gonorrhea.
Multiple sexual partners
Having multiple sexual partners increases the risk of pelvic infection in women. So, it is associated with an increased risk of ectopic pregnancy.
Obstetrics and gynecology conditions
Conditions such as pelvic infections, endometriosis, fibroid tumors, or pelvic scar tissue can narrow the fallopian tubes. This can increase the chance of an ectopic pregnancy.
Using the IUD
About half of pregnant women with intrauterine devices (IUDs) are ectopic. However, the total number of women who become pregnant using an IUD is minimal. Therefore, the overall number of IUD-related ectopic pregnancies is meager.
Smoking
Smoking around the time of conception is also associated with an increased risk of ectopic pregnancy. This means the risk depends on the mother's habits and increases with the number of cigarettes smoked.
Possible Complications
Pregnancy often disappears after a few days. About half of ectopic pregnancies probably end this way. You may have no symptoms and may never know you are pregnant. Sometimes there is mild pain and some vaginal bleeding, similar to a miscarriage. In such cases, you don't have to do anything else. A pregnancy may grow in the narrow fallopian tube for some time. This can stretch the tube and cause symptoms. This is when an ectopic pregnancy is usually diagnosed. The narrow fallopian tube can only stretch slightly. The fallopian tube will usually split (rupture) if the pregnancy grows further. This can cause internal bleeding and severe pain. This is a medical emergency.
How is Ectopic Pregnancy Diagnosed?
Examination
The first step in diagnosis is an interview and examination by a doctor.
Ectopic pregnancy hCG levels
The second step is to take a qualitative or quantitative pregnancy test. Sometimes, your doctor may feel a tender lump during a pelvic exam. If an ectopic pregnancy is suspected, a combination of blood tests and pelvic ultrasound can be helpful. Pregnancy tests are specially designed to detect specific hormones. The beta subunit of human chorionic gonadotropin (beta HCG) blood levels is also used to diagnose ectopic pregnancy. Beta HCG levels in ectopic pregnancy are usually increased. An abnormal pattern in the increase of this hormone can be a clue to the occurrence of an ectopic pregnancy.
Transvaginal ultrasound
How early can ectopic pregnancy be detected by ultrasound? Transvaginal ultrasound is the most helpful test to visualize an ectopic pregnancy. Transvaginal ectopic pregnancy ultrasound can show the gestational sac in normal or ectopic pregnancy, but often the findings are inconclusive. Instead of a gestational sac containing a visible embryo, the test may show a lump in the fallopian tubes or elsewhere. This is suggestive of, but not definitive of, an ectopic pregnancy.
Diagnostic laparoscopy
In a few cases, to confirm the diagnosis of ectopic pregnancy, you may need a laparoscopy. During laparoscopy, viewing instruments are inserted through small incisions in the abdominal wall to visualize abdominal and pelvic structures. Thereby, the location of the ectopic pregnancy is revealed.
Conclusion
An ectopic pregnancy occurs when the embryo grows in tissue outside the uterus, often in the fallopian tube. Without prompt treatment, this can cause life-threatening complications for the pregnant mother. However, the treatment cannot save the pregnancy. Signs of an ectopic pregnancy may start from the beginning of the 4th week and the end of the 12th week. Early diagnosis can reduce the risk of complications, including fallopian tube damage and internal bleeding. Treatment may include surgery, but medicine-based treatment may be an option when a doctor detects it early.