Ectopic Pregnancy: Causes, Symptoms, Treatment, And Risks

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What Is An Ectopic Pregnancy?

Ectopic pregnancy is a pregnancy that occurs outside the uterine endometrium. If left unmanaged, there is a risk for rupture and life-threatening bleeding. It is rare, affecting one in every 100 pregnancies(1).

The fertilized egg most commonly attaches to the fallopian tube in such a pregnancy, leading to a tubal pregnancy. It can also attach to the cervix, ovary, or somewhere in the abdominal cavity. In most cases, the fertilized egg cannot survive outside the womb in the gestational sac, and the growing tissue can damage surrounding tissues(2).

Read on to know more about the symptoms, causes, risk factors, diagnosis, and treatment for ectopic pregnancy.

Signs And Symptoms Of An Ectopic Pregnancy

Symptoms develop in the early stages of pregnancy and vary from woman to woman. Some women will develop no symptoms until pregnancy ruptures.

During early pregnancy, some women will begin to experience symptoms similar to that of a healthy pregnancy. They may include:

• Missed menstrual period
• Sore breasts
• Upset stomach
• Lowback painor pelvic pain
• Vaginal spotting or bleeding
• Abdominal painor tenderness
• Mild cramping at one side of the pelvic region

Around this phase, it is not easy to understand if it is a normal or ectopic pregnancy. But as the ectopic pregnancy develops, you could experience certain severe symptoms(3):

• Sudden and severe pain in the abdomen, shoulder, neck or pelvis
• Vaginal spottingor bleeding that is light to heavy
• Dizziness, weakness or fainting
• Rectal pressure

You should see your doctor if you know about the pregnancy and are experiencing these symptoms.

Causes Of An Ectopic Pregnancy

The exact reason for an ectopic pregnancy is unknown. However, the condition is likely to be associated with one or more of the following conditions(4):

• Scarring or inflammation of the fallopian tubes from a previous infection, medical condition or surgery
• Hormonal reasons
• Birth defects
• Genetic abnormalities
• Medical conditions that influence the shape and condition of the reproductive system organs, such as fallopian tubes

Note that only your doctor can make the correct diagnosis and give you specific treatment options based on the probable cause and risk factors.

Risk Factors For Ectopic Pregnancy

Factors that increase the chances of an ectopic gestation include(4):

• Maternal age of 35 years and more
• Previous ectopic pregnancy
• History offallopian tubeⁱXTube-like structures connecting the ovaries and uterus that help transport eggs for the fertilization process., abdominal or pelvic surgeries or multiple abortions
• History ofpelvic inflammatory disease (PID)ⁱXInfection in the female genital tract characterized by pelvic pain, fever, and abnormal vaginal discharge.
• History ofendometriosisⁱXCondition in which tissue that lines a female uterus begins to develop outside the organ leading to pelvic pain and bleeding.
• Sexually transmitted infections (STIs) such aschlamydiaⁱXInfectious, Sexually transmitted bacterial infection causing pain and abnormal discharge in women, sometimes linked to adverse pregnancy outcomes.orgonorrheaⁱXSexually transmitted bacterial infection, which, when untreated, may increase the risk of negative pregnancy outcomes.
• Conception despiteintrauterine device (IUD)ⁱXSmall, contraceptive copper device (in T shape), which, when placed inside the uterus, helps prevent pregnancy.ortubal ligation
• Conception through fertility drugs and procedures
• Cigarette smoking
• Structural abnormalities in the fallopian tubes

If you think you are at risk, discuss with your obstetric or a fertility specialist to minimize the chances of ectopic pregnancies in the future.

How Is An Ectopic Pregnancy Diagnosed?

Diagnosing an ectopic pregnancy is tricky. If the symptoms suggest that you are experiencing an ectopic pregnancy, your doctor may(5):

• Test your blood for the pregnancy hormone,human chorionic gonadotropin(hCG)
• Perform an ultrasoundto check the uterus and fallopian tube condition
• Conduct a pelvic examination

If an ectopic pregnancy is confirmed based on the above findings, your doctor will suggest the best treatment plan.

Treating Ectopic Pregnancy

Ectopic pregnancies can be fatal to a pregnant woman. As the zygote cannot survive outside the uterus, it has to be immediately removed for the safety of the mother. Treatment may depend on the pregnancy stage, hormonal levels, and location of the ectopic pregnancy.

• Medication: If your doctor determines that there are no chances of immediate complications, medicinal treatment is suggested. According to the American Family Physician (AFP), the common medication prescribed is methotrexate (Rheumatrex). This drug inhibits the growth of the quickly dividing cells or ectopic mass in this case.

It is available in the form of an injection and results in miscarriage-like symptoms including bleeding, cramping, and the passing of the trophoblast tissue. But the only downside with this treatment is that you will not conceive for several months after taking medicine(6).

• Surgery: The embryo is removed using a procedure called laparoscopy.A small incision is made near the belly button, into which a tiny camera is passed for a better view.The surgeon then removes the pregnancy using surgical tools. Sometimes, the surgery can scar the fallopian tubes, which will then be either repaired (salpingostomy) or removed (salpingectomy)(7).

• Emergency surgery:如果条件是导致异常沉重的流血ing or damage due to pregnancy loss, you may need immediate surgery using laparotomy. It involves an abdominal incision and removal of the ectopic mass. Also, the tube may be removed if it is ruptured(7).

Are There Any Side Effects Of Surgery?

The possible side effects of surgery for ectopic pregnancy include bleeding, pain, fatigue, and infection(8). Your doctor will discuss these before the procedure.

Home Care After Surgery

Follow the doctor’s instructions to take care of the incision site at home. The primary goal is to keep it dry and clean as it heals. You should also check the incision for signs of infection regularly. This can be:

• Severe and uncontrollable bleeding
• A foul smell at the incision site
• Tender to touch
• Swelling and redness

You may also notice some light spotting and tiny blood clots after the surgery, which could last for nearly six weeks post-surgery.

Here are a few more self-care measures that may help you at home:

• Avoid lifting anything heavy
• Have lots of fluids totreat constipation
• Rest as much as you can
• Avoid sexual intercourse,douchingⁱXA method of cleansing (flushing) the inner vaginal region with water and other liquids., and using tampons to give some rest to the pelvic area

See your doctor if you feel any pain or that something is not right.

Can You Prevent Ectopic Pregnancy?

No, ectopic pregnancy cannot be prevented entirely, but there are certain ways to reduce the chances of developing it(9).

• Use condoms during intercourse to avoid the risk of sexually transmitted infections and pelvic inflammatory diseases.
• Avoid sex with multiple partners.
• Quit smoking before you try for pregnancy.

Next, we address some common queries for your better understanding of the condition

If an infection or sexually transmitted disease were the cause for your ectopic pregnancy, then getting the condition treated improves the chances of conception. But, if the ectopic pregnancy occurs due to tubal ligation or exposure to diethylstilbestrol (DES), the chances of a healthy pregnancy are lesser.

If you’ve had an ectopic pregnancy, check with your doctor before you plan for the next pregnancy. Ensure that you give enough time for yourself to heal emotionally and physically, especially if you’ve had surgery to treat it. Dealing with an ectopic pregnancy, when you want to have a child, is not easy. If necessary, join a counseling group or talk to a therapist.

Do you have any experiences to share? Let us know in the comment section below.

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