Ectopic Pregnancy

The meaning of Ectopic is Out Of Place. A pregnancy that occurs outside the uterus is called an Ectopic pregnancy. During normal course, the fertilized egg is implanted in the uterine wall and the fetus grows there itself. But, in an Ectopic pregnancy, the implantation can take place anywhere outside the uterus either, in the fallopian tubes (tubal pregnancy), ovaries (ovarian pregnancy) or in the abdominal cavity. Out of the Ectopic pregnancies, more than 97% take place in the fallopian tubes.

Causes.

The main reason of Ectopic Pregnancy is the failure of the fertilized egg to reach the uterus for successful implantation. This may be due to the abnormality of the fallopian tubes which avoid the egg from traveling downwards. Risk Factors Increasing Ectopic Pregnancy:

  • Pelvic inflammatory disease
  • Previous Ectopic pregnancy
  • Infertility
  • Abdominal injury
  • Hormonal imbalance leading to impaired fallopian tube contraction
  • Smoking
  • Placement of an intra-uterine device.

Symptoms.

Symptoms found during Ectopic pregnancy may be the same as those which occur during a normal pregnancy, and so may not be immediately detectable. These may be abdominal pain, vaginal bleeding, weakness and dizziness. Along with these, it may also  be accompanied by tenderness in the breasts, nausea, low back pain and stomach cramps.

Diagnosis.

If the doctor finds irregular or missed periods, or at an emergency room with pelvic pain, the basic test a doctor performs is a urine test for pregnancy.

  • A negative pregnancy test cancels the chance of Ectopic pregnancy.
  • A positive pregnancy test assures the presence of a pregnancy but not its exact location.

If the doctor finds the pregnancy to be either Ectopic or otherwise abnormal, then further testing is required. These tests include:

  • Quantitative hCG Test
  • Pelvic Examination and Ultrasound
  • Laparoscopic Surgery
  • Culdocentesis.

Treatment.

The treatment may be either chemical or surgical. The chemical treatment includes medicinal therapy with methotrexate. It is a long term treatment in which the fetus is dissolved without harming the tubes and the surrounding organs. The drug reduces the HCG levels in the blood thus removing the pregnancy. The levels are reduced to zero within four weeks.

The other form of treatment is surgery. Laparotomy is the technique, in which the fetus and other products of conception are removed. The injured surrounding organs are also cleaned and repaired. It involves a 5 cm incision in the abdominal wall through which the fallopian tubes are accessed. The Ectopic pregnancy is then removed and the wound is closed.