What is ectopic pregnancy

In a normal pregnancy, the recently fertilized egg travels through the fallopian tube to the uterus where it will implant and begin its growth. However in an ectopic pregnancy, the fertilized egg attaches to a location besides the uterus; most often the fallopian tube. An ectopic pregnancy is also called a tubal pregnancy. There are also cases of ectopic pregnancy where the egg implants in the cervix or ovary, which can be just as dangerous.

An ectopic pregnancy can never be rescued. Unfortunately, there is no way that it can turn into a normal pregnancy. If the fertilized egg continues to grow in the fallopian tube, there is a large possibility that it can damage or burst the fallopian tube and cause severe bleeding in the mother. This is often fatal. For this reason, ectopic pregnancies are taken very seriously.

Why does an ectopic pregnancy occur

If the fallopian tube has sustained damage in any way, it can impede the movement of the fertilized egg resulting in implantation before it gets to the uterus. The most common factors that contribute to an ectopic pregnancy are

  • Endometriosis – that causes tremendous scarring in and around the fallopian tubes
  • Pelvic inflammatory disease – often resulting from sexually transmitted diseases such as gonorrhea or Chlamydia (not common among Indian women)
  • Fertility treatments – that may involve procedures such as in vitro fertilization and ovarian stimulation.

What are the symptoms of ectopic pregnancy

There is no blood test that will tell you if your pregnancy is ectopic or not. However blood tests performed in 2-day intervals that show hCG levels not rising predictably may suggest an ectopic pregnancy. In a normal pregnancy, these levels are expected to double every day.

An ultrasound that shows an image of in utero content and activity can be performed as early as six weeks after one’s last menstrual period. A transvaginal ultrasound that shows an empty uterus can point to an ectopic pregnancy. Even a pelvic exam that can feel for growth of the uterus with increasing gestational age can be used as a way of confirming an ectopic pregnancy.

How is an ectopic pregnancy treated

Most physicians will treat a woman for an ectopic pregnancy rather aggressively. Allowing the pregnancy to progress once it has been determined that the pregnancy is outside of the uterus, is not recommended. If an ectopic pregnancy is detected early, a methotrexate injection will terminate the pregnancy even before any damage to the fallopian tube is done. This medicine does allow you to avoid surgery but comes with its own set of side effects. A woman may have to undergo follow-up tests to make sure that the medication worked.

If the pregnancy has progressed beyond the initial stages or first few weeks, many physicians prefer surgery to medication. A laparoscopy will be performed by making small incisions in your belly to remove the embryo. This is considered safer than medication as fallopian tube rupture may occur at any time as the embryo continues to grow.

What are your thoughts of getting pregnant after an ectopic pregnancy

Losing a pregnancy at any stage is always hard. If you have been trying to conceive for a while, this can be very distressing as your elation may be soon replaced by profound grief. You may also worry about your fertility after this event. Know that this is perfectly normal and that most women go on to have normal pregnancies even if they have had a few ectopic pregnancies in the past. However, since a history of ectopic pregnancy has been established, your doctor will follow your subsequent pregnancies carefully to ensure that the pregnancy is within the uterus.

Regular checkups in the early weeks will eliminate any doubts about the location of the pregnancy. They key is that you are now better informed and know exactly what signs to be aware of.

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