- What is Ectopic Pregnancy?
- How Does It Happen?
- Risk Factors Ectopic Pregnancy
- Symptoms and Signs Ectopic Pregnancy
- What Kind of Pain Can Woman Experience During an Ectopic Pregnancy?
- Treatment Ectopic Pregnancy
- Consequences Ectopic Pregnancy
What is Ectopic Pregnancy?
Ectopic pregnancy is a pregnancy where the fertilised egg-cell continues to develop outside of the uterus. Often the embryo implants itself in one of the fallopian tubes, or sometimes in the abdomen or in the ovary. Quite possibly the embryo might end up in such specific areas as the broad ligament or the cervix of the uterus. Whatever the case is, the main idea is that during the ectopic pregnancy the embryo implants in the wrong location.
How Does it Happen?
Naturally, ovulation, which is the middle of the period, is the best time for fertilization. During this time, the fertilized egg moves further by the help of mucous membrane cilia and peristaltic contraction of the smooth muscle fibres of the tube. It moves into the uterus directed by the fluids flow. This process is quite lengthy and takes about a week. During this journey the egg transforms into a zygote and the cell division starts. More often the egg reaches its point of destination by the end of the cycle. However sometimes the fertilized egg can’t reach the uterus within the time, then due to the limited supply of nutrients, it has to attach itself to whatever place it reached.
Usually in the case of ectopic pregnancy, it is one of the fallopian tubes that become the home for the fertilized egg. Unlike the uterus, the tubes don’t stretch. They have thin walls, tender lining and are not meant for the embryo to develop. Doctors can identify the ectopic pregnancy only during the fourth week of gestation because the pregnancy is impossible to detect before the period.
Ectopic Pregnancy: Risk Factors
To prevent ectopic pregnancy you have to follow important rules. We will talk about the main ones. Very often new technology interfering with the female reproductive system is to blame for an ectopic pregnancy. About 30-50 % of women with ectopic pregnancy were diagnosed with either acute or chronic pelvic inflammatory disease. The main causes are trichomoniasis, gonorrhoea and ureaplasmosis.
Inflammatory conditions cause the edema of the fallopian tubes, which leads to the formation of adhesions and might disrupt the peristaltic contraction (moving action) of the cilia in the tubes. Thus, all these factors make it difficult for the fertilized egg to move along in a fallopian tube, causing it to attach in a wrong place. Often women who undergone a sterilization return to the idea of having children. They have to go through a reversal surgery to restore tubal patency. This also affects the tube’s ability to channel the fertilized egg.
Symptoms and Signs Ectopic Pregnancy
Are there any symptoms of the ectopic pregnancy? Can one detect it before paying a visit to the doctor? Unfortunately there are no obvious signs. Woman can have no clue for a long time. The signs can be those of a normal pregnancy, and sometimes women can still have a period.
Usually during the ectopic pregnancy only one side of the body is in pain, where the affected fallopian tube is located. Sometimes, when the fertilized egg attaches either in the abdominal cavity or cervix of the uterus, the middle of the abdomen is pain. Changing the position of the body can cause a sharp pain, which can increase if walking or turning the torso. These factors depend on the fetus’s location and gestational age.
If the embryo develops in the ampulla of the fallopian tube, which is the widest part of the tube, then the pain starts after about 8 weeks of being pregnant. If the embryo is in the smallest region of the tube called the isthmus, then the pain will start as early as 5 or 6 weeks of gestational age.
Bleeding at an early stage is also one of the symptoms of the ectopic pregnancy. Sometimes bleeding can be excessive and a women’s life is in danger. There is also a high risk that the uterus will need to be removed in order to save the woman’s life in this case.
What Kind of Pain can Woman Experience During an Ectopic Pregnancy?
Very often woman can experience a constant dull or nagging painful sensation, that can progress into a stabbing pain. However, a painful sensation alone is not an obvious sign of the ectopic pregnancy. Women can experience that during the normal pregnancy as well, as the fetus grows bigger, causing the uterus to stretch. If it is the first pregnancy, a woman might not get suspicious at all. A painful sensation on one side of the body only should be a warning sign, as the uterus stretching normally causes the pain on both sides of the body.
Treatment Ectopic Pregnancy
If ectopic pregnancy diagnosed early in the gestational age, it is likely to be successfully treated with medication. Usually mifegyne, methotrexate, and mifepristone are used. When an ectopic pregnancy is confirmed during the late stage, surgery will be required. Very often that would be a laparoscopic surgery. If the fallopian tube hasn’t ruptured it will be preserved, though another ectopic pregnancy, parallel to the existing, is quite likely to develop in it. The best decision is to remove the fallopian tube before it rupture, which can be done during laparoscopic surgery.
Ectopic Pregnancy: Consequences
Ectopic pregnancy involves negative implications. Even if it is diagnosed early and treated successfully, there is a high risk of it happening again if the causal factors are not addressed. Pooling of blood in the abdominal cavity can cause formation of adhesions, which will block the way for the fertilized egg again.
On the other hand, an ectopic pregnancy experience doesn’t mean a woman can’t have a healthy baby in future. About 50% of women who had an ectopic pregnancy get pregnant again, and deliver babies naturally. It is recommended to have a break for about a year, though woman can get pregnant again after 6 months.
After surgery, women have to strictly follow the doctor’s recommendations and go through rehabilitation. It is a heavy and lengthy process, which includes physiotherapy and regular medication treatment. The medication prevents adhesions in the tubes and improves general health condition.
If the ectopic pregnancy was diagnosed early and treated with medication only, women have fewer chances to experience it again in future. And conversely, women have more chances to have an ectopic pregnancy if one of the fallopian tubes was removed previously.
It is very important to use contraceptives after an ectopic pregnancy, as it is highly likely to happen again. It is also important to avoid removing both tubes, as natural pregnancy will be impossible after that. In this case the only way to get pregnant will be to use in-vitro fertilization (IVF). That’s why you have to responsibly plan your pregnancy.