Ectopic pregnancy is a condition in which a fertilized egg settles and grows in any location other than the inner lining of the uterus . About 1% of pregnancies are in an ectopic location with implantation not occurring inside of the womb, and of these 98% occur in the Fallopian tubes. In a typical ectopic pregnancy, the embryo does not reach the uterus, but instead adheres to the lining of the Fallopian tube. The implanted embryo burrows actively into the tubal lining. Most commonly this invades vessels and will cause bleeding. This bleeding expels the implantation out of the tubal end as a tubal abortion.
Some women thinking they are having a miscarriage are actually having a tubal abortion. There is no inflammation of the tube in ectopic pregnancy. The pain is caused by prostaglandins released at the implantation site, and by free blood in the peritoneal cavity, which is locally irritant. Sometimes the bleeding might be heavy enough to threaten the health or life of the woman. Usually this degree of bleeding is due to delay in diagnosis, but sometimes, especially if the implantation is in the proximal tube it may invade into Sampson artery , causing heavy bleeding earlier than usual. An ectopic pregnancy can’t proceed normally. The developing embryo can’t survive, and the growing placental tissue may destroy important maternal structures. Without treatment, life-threatening blood loss is possible. About one in every 40 to 100 pregnancies is ectopic. Thanks to earlier diagnosis and treatment, the chance for future healthy pregnancies is better than ever before.
Ectopic means “out of place.” An ectopic pregnancy is a pregnancy where the fetus is not growing in the usual location (the uterine cavity or the womb). Ectopic pregnancies can occur in a number of unusual locations, each with different characteristic growth patterns. Almost all ectopic pregnancies occur in fallopian tubes (tubes from uterus), so this is also known as “Tubal Pregnancy”. Since the fallopian tubes are not large enough to accommodate a growing embryo, the pregnancy cannot continue normally. If identified early, the embryo is removed. In some cases, the embryo grows until the fallopian tube is stretched so much that the tube ruptures. Rupture of the tube is a medical emergency that requires immediate medical attention because it can result in severe hemorrhaging. An ectopic pregnancy is a potentially life-threatening condition.
Causes of Ectopic pregnancy
Ectopic pregnancy is common in women age 20 to 29, but the cause is not always known. However, previous damage to one of the two fallopian tubes may obstruct the passage of the fertilized egg along the tube to the uterus. The egg then implants in the wall of the tube instead of in the uterus. This prior damage may have been caused by an unsuccessful or a reversed sterilization procedure or a fallopian tube infection. Ectopic pregnancies are more common in women using an intrauterine contraceptive device, partly because these devices increase the risk of a pelvic infection in women who exposed to sexually transmitted diseases.
Symptoms of Ectopic pregnancy
1. Nausea, vomiting.
2. Dizziness.
3. Low blood pressure.
4. Breast tenderness.
5. Frequent urination.
Treatment of Ectopic pregnancy
Medicine, surgery, or a combination of the two are usually used to end an ectopic pregnancy before it endangers the mother. In a few cases, very early ectopic pregnancies can be watched closely to see whether the pregnancy will miscarry on its own. Emergency medical help is needed if the area of the ectopic pregnancy ruptured. (Shock is an emergency condition.) Treatment for shock may include keeping the woman warm, raising her legs, and giving oxygen. Fluids by IV and a blood transfusion may be needed. Surgery (laparotomy) is done to stop blood loss (in the event of a rupture). This surgery is also done to confirm the diagnosis of ectopic pregnancy, remove the abnormal pregnancy, and repair any tissue damage. In some cases, removal of the fallopian tube may be necessary. A mini-laparotomy and laparoscopy are the most common surgical treatments for an ectopic pregnancy that has not ruptured.
