A SMALL CHANCE OF ABNORMALITY: ECTOPIC PREGNANCY
When a pregnancy begins to develop outside a womans womb, its called an ectopic pregnancy. If a pregnancy is ectopic, which means out of place, it means that the fertilized egg from the ovary didnt implant in the uterus. Unfortunately, a classical ectopic pregnancy does not develop into a fetus or live birth. Only about 1 percent of pregnancies are ectopic.
The most common site for an ectopic pregnancy to occur is within one of the fallopian tubes, which is called a tubal pregnancy. The egg can also implant itself in a womans ovary, cervix, or abdomen, which may be referred to as cervical or abdominal pregnancies. Because none of these areas has space to grow an embryo or tissue to nurture a pregnancy, the fetus will eventually cause the organ that contains it to burst. This can cause severe bleeding and seriously endanger the mothers life.
Signs and symptoms
An ectopic pregnancy can be difficult to diagnose because the signs and symptoms mirror that of a regular pregnancy in its beginning stages: nausea, missed periods, tender breasts, vomiting, and frequent urination. The initial warning signs are often pain or vaginal bleeding, along with possible pain in the abdomen or pelvis. Most women describe the pain as stabbing and sharp, coming and going or varying in intensity, most often concentrated on one side of the pelvis. Even the shoulder or neck can be affected because a ruptured ectopic pregnancy can build up blood and irritate specific nerves. Vaginal spotting, dizziness or fainting, low blood pressure, or lower back pain can also suggest an ectopic pregnancy due to blood loss.
Diagnosis and treatment
An ectopic pregnancy is diagnosed first with a urine pregnancy test, which will show elevated hormone levels indicative of a normal pregnancy. If the hormone levels are lower than expected for your stage of pregnancy, it might point to an ectopic pregnancy. An ultrasound will usually show an unusual mass developing in the abdominal area rather than a fetus in the uterus; however, every ectopic pregnancy may not be detected by ultrasound. A doctor can also determine one by examining the area to find the causes of pain, and check for an enlarged uterus that occurs during pregnancy or any other unusual masses.
An ectopic pregnancy is treated by a variety of different ways, depending on how healthy and medically stable the woman is along with the location and size of the pregnancy. If its early enough in the pregnancy, it can be treated with an injection of methotrexate, which will stop the embryos growth. Surgery to remove the abnormality may be necessary if the pregnancy is further along, and this can be quite a complicated process because it requires a large incision in the pelvic area. On occasion, an ectopic pregnancy can be treated using laparoscopy, which is a less invasive surgical procedure where the surgeon makes a small incision in the lower abdomen, inserts a tiny video camera to project the picture onto a screen in the operating room. This procedure allows the surgeon to see what is happening inside the uterus, abdomen, or pelvic area without making any large incisions; the ectopic pregnancy is then removed without removing or having to repair any other organs damaged in the process. There is a slight chance that you may have to return after the initial surgery if any ectopic tissue was missed; if any tissue was missed, it will show up as elevated hormone human chorionic gonadotropin (hCG) levels and can be removed using additional surgery or a methotrexate injection.
Risk factors and future pregnancies
Any woman can develop an ectopic pregnancy, but it is more common in women who are over age 35 who have had Pelvic Inflammatory Disorder, surgery on a fallopian tube, have taken medication to stimulate ovulation, or infertility problems. If youve had a previous ectopic pregnancy, you are also at higher risk for another. This does not mean that once a woman has experienced an ectopic pregnancy she is going to have difficulty becoming pregnant again, but there is a chance. Its more common for women who have had fertility problems before the ectopic pregnancy, and it depends a lot upon how much damage was done in the first ectopic pregnancy. Once you have had one, there is a 15 percent chance of having another ectopic pregnancy. The likelihood increases with each subsequent ectopic pregnancy.
