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Ectopic Pregnancy | Infertility

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Ectopic Pregnancy

An ectopic pregnancy happens when the fertilized egg attaches itself in a place, other than the uterus. In most cases, ectopic pregnancies occur in the fallopian tubes. That’s why these pregnancies are often called “tubal pregnancies”. They can also take place in the cervix, ovary or abdomen.

A baby cannot grow inside any of these areas as there’s no space for the foetus to develop normally. As the baby grows, it could eventually burst the organ housing it, causing the mother to bleed and endangering her life.

What causes an ectopic pregnancy?

According to the American Pregnancy Association, ectopic pregnancies are caused by:

  • an infection or inflammation of the fallopian tube, causing it to become partially or entirely blocked
  • an infection or inflammation of the fallopian tube, causing it to become partially or entirely blocked
  • scar tissue left behind from a previous infection or operation on the tube
  • previous surgery in the pelvic area or on the tubes, which can cause adhesions
  • an abnormality in the tube’s shape
  • IVF and ovulation induction are associated with increased chances of ectopic pregnancies

What are the symptoms of an ectopic pregnancy?

It may be difficult to diagnose an ectopic pregnancy, because the symptoms are often similar to those of a normal pregnancy. This would include a missed period, nausea, tender breasts and frequent urination.

A sharp, stabbing pain that comes and goes and varies in intensity could be one of the first signs that you have an ectopic pregnancy. The pain can be felt in the abdomen, pelvis, or even the shoulder and neck.

You may also experience vaginal bleeding, gastrointestinal symptoms, dizziness, fainting or lower back pain.

It’s crucial that you phone your doctor immediately if you start bleeding.

How is an ectopic pregnancy diagnosed?

Your doctor will perform a pelvic exam to establish where the pain is, if there’s any tenderness or if there’s a mass in your abdomen.

He may then do an ultrasound scan, to find out whether there’s a foetus in your uterus. This will also show if there are any masses growing in other parts of your abdomen. If you are in the very early stages of your pregnancy, the scan may not be able to detect a pregnancy.

The doctor may also measure your hCG (human chorionic gonadotropin) levels. A low level could indicate an abnormal pregnancy.

How is an ectopic pregnancy treated?

Treatment really depends on how far your pregnancy is and where the foetus is located.

Your doctor may opt to give you an injection of methotrexate which allows the body to absorb the pregnancy tissue.

Surgery may be an option if the tube has stretched or has ruptured. If there’s bleeding, your doctor may have to perform emergency surgery.

Less invasive laparoscopic surgery, under general anaesthesia, may also be an option. The surgeon will make small incisions in your lower abdomen and remove the foetus through these incisions.

Once the ectopic pregnancy has been removed, your doctor will probably want to see you regularly until your hCG level is back to normal. This could take several weeks.

Who is more at risk of having an ectopic pregnancy?

Any woman, having unprotected sex, risks having an ectopic pregnancy. However, the risk is higher for women who:

  • are over the age of 35
  • have had a previous ectopic pregnancy
  • have had surgery to a fallopian tube
  • shave had Pelvic Inflammatory Diseae
  • have had infertility problems in the past
  • have had several induced abortions

Certain contraceptives may also affect your risk of having an ectopic pregnancy. If you fall pregnant while using progesterone-only oral contraceptives, intrauterine devices (IUD’s) or the morning after pill, you could more likely have an ectopic pregnancy.

Does one ectopic pregnancy mean another?

If you’ve had one ectopic pregnancy, chances are you’ll have another. This will however depend on why your pregnancy was ectopic in the first place and whether there was any damage to your fallopian tubes.

Your history of fertility problems will also play a role in whether or not you’ll carry a baby to full term.

If your fallopian tubes have been left in place after your ectopic pregnancy, you’ll have a 60 percent chance of having a successful pregnancy in future.

Emotional aspects of an ectopic pregnancy

After undergoing several procedures to end the ectopic pregnancy, many may forget that this was initially a pregnancy that you really wanted. All the hopes and dreams that came with the news that you were pregnant, will now be dashed. You may feel a sense of loss and even grief.

Your body will also probably go through hormonal changes, as it returns to its pre-pregnancy state. This may increase your feelings of loss and cause a few tears.

This sense of loss is entirely natural and you should allow yourself to grieve this baby’s loss.

Sources

Womens-health.co.uk
American Pregnancy Association
Kidshealth.org

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