Ectopic pregnancy: Treatment, symptoms, advice and help

About ectopic pregnancy

Ectopic pregnancy is an abnormal condition in which the fertilized egg gets implanted outside the uterus. The most common ectopic sites are the fallopian tubes which connect the ovaries to the uterus. Ectopic pregnancy occurring in the fallopian tubes is also termed as ‘tubal pregnancy’. Other uncommon sites include ovary or very rarely the cervix. Ectopic pregnancy has no future since the foetus is unable to survive.

Ectopic pregnancy: Incidence, age and sex

Ectopic pregnancy is not an uncommon occurrence. One in hundred pregnancies may be an ectopic pregnancy.

Signs and symptoms of ectopic pregnancy: Diagnosis

The clinical features of ectopic pregnancy are initially same as that of first trimester symptoms including amenorrhea, nausea and breast tenderness. However, suspecting symptoms like vaginal spotting or heavy bleeding and pain in pelvic region and lower back may point towards some abnormality.

A detailed gynaecological investigation in the first trimester generally helps in diagnosing most of the cases. A urine pregnancy test is the first investigation advised to confirm the diagnosis of pregnancy. The next step of investigation is ultrasonography of uterus which may not show any sign of foetus. Transvaginal ultrasonography may be required to establish that the fertilised egg is not in the uterus. Invasive procedure like diagnostic laparoscopy is then usually done to establish the diagnosis of ectopic pregnancy.

Causes and prevention of ectopic pregnancy

Ectopic pregnancy is thought to result from slow movement of fertilized egg through the fallopian tubes to the uterus. This may in turn, result from various factors which cause scarring or damage to fallopian tubes. Such risk factors include infection of fallopian tubes, history of sterilisation or reversal of sterilisation procedure, displaced intrauterine device and endometriosis. Increasing maternal age and in vitro fertilisation have high chances of ectopic pregnancy. Early diagnosis and management of gynaecological disorders especially sexually transmitted infections may help in preventing such incidents. Cessation of smoking is also recommended especially during the reproductive years.

Ectopic pregnancy: Complications

The most dreaded complication of ectopic pregnancy is its rupture which results in massive bleeding. The individual may go into shock due to extensive and sudden blood loss. Rupture of ectopic pregnancy is a medical emergency and must be handled without any delay.

Ectopic pregnancy: Treatment

The main goal of treatment of ectopic pregnancy is to remove the products of conception and terminate the pregnancy. This can be done medically by prescribing methotrexate which dissolves the fertilized egg. Alternatively it can be removed by laparotomy or laparoscopy. In instances of rupture of ectopic pregnancy, immediate infusion of fluids and blood is needed to maintain the fluid balance of body. There are high chances of recurrence of ectopic pregnancy in affected women.