Ectopic pregnancy occurs in 1 in 80 women. Although many cases of ectopic pregnancy are being considered without the need for surgery, you should always consult a doctor urgently if you think an ectopic pregnancy has occurred. Symptoms are listed below, but include pain in the lower abdomen, which can become a serious signal. The rupture of the fallopian tubes threatens the life of a woman, in such cases emergency surgery is needed.
Where ectopic pregnancy develops.
In most cases, an ectopic pregnancy occurs when a fertilized egg is anchored inside the fallopian tubes. Rarely, ectopic pregnancy occurs in other places, such as the ovaries or abdominal cavity. Further, it will only be about the tubal ectopic pregnancy.
Problems associated with ectopic pregnancy.
Ectopic tubal pregnancy never survives. Possible outcomes include:
- Pregnancy is often interrupted for several days. About half of cases of ectopic pregnancy end this way. You may not have any symptoms, and you will never know that you were pregnant. Sometimes there is light pain and some vaginal bleeding, as with a miscarriage. Nothing needs to be done if this happens.
- Pregnancy can develop for a while in the narrow fallopian tubes. This can stretch the tube and cause various symptoms. This is usually diagnosed with an ectopic pregnancy.
- A narrow fallopian tube can stretch very little. If the gestation period becomes longer, it usually breaks down. This can lead to severe internal bleeding, severe pain and even death.
Symptoms of ectopic pregnancy.
Symptoms usually appear at the 6th week of pregnancy. This is approximately 2 weeks after menstruation, if you have a regular cycle. However, the symptoms can develop at any time between 4 and 10 weeks of pregnancy. You may not know that you are pregnant. For example, your cycle is not regular or you use contraceptives that violate it. Symptoms may also resemble ordinary menstruation, so you do not immediately "sound an alarm." The most noticeable can be only symptoms of the late period. Symptoms include one or more symptoms:
- Pain on one side of the lower abdomen. It can be sharp, or can gradually increase over a period of several days. This can have serious consequences.
- Uterine bleeding often occurs with ectopic pregnancy, but not always. Very often it differs from bleeding with menstruation. For example, bleeding may be "heavier", the blood is darker and thicker than usual. However, you can take this for bleeding of a late cycle.
- Symptoms such as diarrhea, a feeling of weakness, or pain during passage of stool (constipation) may occur.
- Pain in the lungs can develop. This is due to some bleeding into the abdominal cavity, which irritates the diaphragm (muscles used in breathing).
- When the fallopian tube ruptures and internal bleeding occurs, severe pain or loss of consciousness may occur. This is a state of emergency.
- Sometimes there are no warning symptoms (eg, pain) before rupturing. Therefore, fainting due to sudden severe internal bleeding is sometimes the first sign of an ectopic pregnancy.
Who is at risk for ectopic pregnancy.
Ectopic pregnancy can occur in any sexually active woman. Nevertheless, the "chances" you have higher, if ...
- If you already had an ectopic pregnancy. Then you have about 1 out of 10 chances that a future pregnancy will be an ectopic. If you had two or more ectopic pregnancies, then your chances for another ectopic pregnancy are much higher.
- If you have kinks, scars, damage, or other abnormalities in the fallopian tubes. In this case, the fertilized egg can "get stuck" in the tube more easily. For example:
- If you have had infections of the uterus and fallopian tubes (pelvic inflammatory disease) in the past. Usually it is caused either by chlamydia or gonorrhea. These infections can lead to the formation of scars on the fallopian tubes. Chlamydia and gonorrhea are common causes of pelvic infection.
- Previous operations for sterilization. Although sterilization is a very effective method of contraception, pregnancy does sometimes occur, but approximately 1 out of 20 cases are ectopic.
- Any previous operations on the fallopian tube or nearby organs.
- If you have endometriosis.
- If you use an intrauterine device (spiral). Again, pregnancy is rare, as this is an effective method of contraception.
- If you use medicines (some types of infertility treatment).
- The risk of ectopic pregnancy increases in women over the age of 40, as well as in female smokers.
If you are in any of the above groups, consult your doctor as soon as you think you can be pregnant. Tests can detect pregnancy after 7-8 days after fertilization, which may already be before menstruation.
How can an ectopic pregnancy be confirmed?
If you have symptoms that may indicate an ectopic pregnancy, you will usually be placed in the hospital right away.
- A urine test can confirm that you are pregnant.
- Ultrasound can confirm ectopic pregnancy. This is usually a transvaginal (internal) scan, which is not painful and allows a good examination of the fallopian tubes. However, the check can not be clear if the pregnancy has occurred very early. If this is the case, repeat the scan after a few days.
- Blood tests show changes in hormones during pregnancy (human chorionic gonadotropin and hCG)
What are the options for treating an ectopic pregnancy?
At break .
An emergency operation is required when the fallopian tube ruptures with severe bleeding. The main goal is to stop the bleeding. The rupture of the fallopian tubes is eliminated, the fetus is removed. This operation often saves a life.
With ectopic pregnancy in the early stages - before the rupture.
Ectopic pregnancy is often diagnosed before the break. Your doctor will give advice on treatment, which can include the following.
- Surgery: Removal of tubes (or the entire tube or part of it) with ectopic pregnancy is the most often performed operation. Salpingectomy (removal of the fallopian tubes containing the fetus) is performed if other options are no longer possible. Salpingolotomy (removal of only a part of the tube with the fetus) is performed if the other tubes are unhealthy (for example, there are scars from a previous infection).
- Medical care: Treatment of ectopic pregnancy is now more common and avoids the need for an operation. A drug called methotrexate is often given, usually in the form of an injection. It works by killing the cells of the fetus growing in the fallopian tubes. As a rule, it is recommended only if the pregnancy is very early. The advantage is that you do not need an operation. The disadvantage is that you will need careful monitoring for several weeks with a repeat blood test and a scan to make sure that the medicine worked. Women, as a rule, take a blood test for hCG (human chorionic gonadotropin) every 2-3 days to low levels. Ultrasound is usually repeated every week. Methotrexate can cause side effects, which include nausea and vomiting in some women. Very often, women experience abdominal pain 3-7 days after the start of taking methotrexate.
- Waiting for the result ("wait and see"): Not every ectopic pregnancy threatens life or leads to danger for the mother. In many cases, ectopic pregnancy is resolved by itself without any problems in the future. Pregnancy is often interrupted, that is, miscarriage occurs. A possible option is to "see how things go" if you do not have any symptoms. You will need treatment if symptoms become worse. In addition, careful observation and repetition of ultrasound and a blood test is necessary to check how things are.
Most often women are concerned about one common question: "What is the probability of having a future normal pregnancy after an ectopic pregnancy?" Even if you remove one of the fallopian tubes, that is about 7 out of 10 chances of having a normal pregnancy in the future. (The other of the fallopian tubes will still work). However, there is a probability (1 case out of 10) that this can lead to another ectopic pregnancy. It is therefore important that women who have had an ectopic pregnancy in the past consult a doctor at the beginning of a future pregnancy.
It's normal to feel anxious or depressed for a while after the treatment. Anxiety about a possible future ectopic pregnancy affects fertility, and sadness about the "death" of pregnancy is normal. Talk with your doctor about this and other problems after treatment.
Finally.
- Ectopic pregnancy is common. This pregnancy can not be saved!
- A typical first symptom is pain in the lower abdomen after recent menstruation.
- The development of pregnancy can lead to rupture of the fallopian tubes, which requires urgent surgery.
- The planned treatment in advance (before the break) is much better than on the field of late timing.
- Most women with an ectopic pregnancy do not need surgery.
- Tell your doctor if you are in a "risk group" as soon as you decide that you are pregnant.