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Ectopic pregnancy

Definition


Disease: Ectopic pregnancy Ectopic pregnancy
Category: Gynecological diseases

Disease Definition:

Pregnancy begins with a fertilized egg, which usually attaches itself to the lining of the uterus. In case of an ectopic pregnancy, the fertilized egg implants somewhere else.

 

Almost always, an ectopic pregnancy occurs in one of the tubes that carry eggs from the ovaries to the uterus, called fallopian tubes. This type of ectopic pregnancy is called a tubal pregnancy. In some rare cases, the ectopic pregnancy can occur in the ovary, neck of the uterus called cervix or in the abdomen.

 

It is impossible for an ectopic pregnancy to proceed normally, the fertilized egg can’t survive and the surviving tissue can destroy many maternal structures. When this condition is left untreated, life-threatening blood loss could occur. However, when treated early, the woman could still have a chance for future healthy pregnancies.
 

Work Group:


Symptoms, Causes

Symptoms:

At first, this type of pregnancy could seem like a normal one and the woman has a positive pregnancy test. The signs and symptoms of ectopic pregnancy will be the same as those of a normal pregnancy, including nausea, fatigue, breast tenderness and a missed period.

 

Some of the early warning signs of an ectopic pregnancy are:

 

  • Cramping on one side of the pelvis
  • Light vaginal bleeding
  • Lower abdominal pain

 

Some of the signs and symptoms of a fallopian tube rupture include:

 

  • Dizziness
  • Lightheadedness
  • Sharp and stabbing pain in the pelvis, abdomen or in some cases in the shoulder and neck.

 

A woman should seek emergency care in case she experiences any signs or symptoms of an ectopic pregnancy.
 

Causes:

Usually, when a fertilized egg gets stuck on its way to the uterus because the fallopian tube is scarred, damaged or misshapen, an ectopic pregnancy occurs. However, in some cases, the cause of the ectopic pregnancy is not known.
 

Complications

Complications:

Treatment for an ectopic pregnancy could lead to loss of reproductive organs or infertility. However, if left untreated, the risks will be even higher, for instance, a life-threatening bleeding may result from a ruptured fallopian.
 

Treatments:

Outside the uterus, a fertilized egg can’t develop normally. The ectopic tissue should be removed in order to prevent life-threatening complications.

 

An injection of methotrexate could be used to stop cell growth and dissolve existing cells in case the ectopic pregnancy is detected early. After this injection, the woman’s blood will be monitored for the pregnancy hormone human chorionic gonadotropin (HCG). She may need yet another injection of the drug mentioned above in case her HCG level remains high.

 

A woman with this condition may need laparoscopic surgery in case her ectopic pregnancy doesn’t respond to medication or if she’s unable to use methotrexate or return for monitoring. During this procedure, a small incision is made in the lower abdomen, near or in the navel, and a thin tube equipped with a camera lens and light (laparoscope) is used to view the area. In order to remove the ectopic tissue and repair the fallopian tube, other instruments could be inserted into the tube or through other small incisions. The fallopian tube may need to be removed if it’s significantly damaged.

 

A woman may need emergency surgery through an abdominal incision (laparotomy), in case the ectopic pregnancy is causing heavy bleeding or if the fallopian tube has ruptured. Although in some cases the fallopian tube can be repaired, but usually the ruptured tube is removed.

 

In some cases, after the surgery, an injection of methotrexate may be needed.
 

Prognosis:

Not available

Expert's opinion

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