Ectopic Pregnancy

What Is Ectopic Pregnancy?

Ectopic pregnancy, also called extra uterine pregnancy, is when a fertilized egg grows outside a woman’s uterus, somewhere else in her belly. It can cause life-threatening bleeding and needs medical care right away.

In more than 90% of cases, the egg implants in a fallopian tube. This is called a tubal pregnancy.

Other sites of ectopic pregnancy are cervical, ovarian, abdominal. With increasing Caesarean sections ,scar ectopics are also seen.

Ectopic Pregnancy Signs and Symptoms :

Most of the time, an ectopic pregnancy happens within the first few weeks of pregnancy. You might not even know that you're pregnant and may not notice any problems.

Early signs of an ectopic pregnancy include:

  • Light vaginal bleeding and pelvic pain
  • Upset stomach and vomiting
  • Sharp abdominal cramps
  • Pain on one side of your body
  • Dizziness or weakness
  • Pain in your shoulder, neck, or rectum

An ectopic pregnancy can cause your fallopian tube to burst or rupture. Emergency symptoms include major pain, with or without severe bleeding. Call your doctor right away if you have heavy vaginal bleeding with lightheadedness, fainting, or shoulder pain, or if you have severe belly pain, especially on one side.

Causes and Risk Factors

Ectopic Pregnancy Causes and Risk Factors :

You may never know why you have an ectopic pregnancy. One cause could be a damaged fallopian tube. It could keep the fertilized egg from getting into your uterus.

You’re more likely to have an ectopic pregnancy if you:

  • Have pelvic inflammatory disease (PID)
  • Smoke cigarettes
  • Are older than 35
  • Have a sexually transmitted infection
  • Have scarring from pelvic surgery
  • Had a previous ectopic pregnancy
  • Tried to have tubal ligation (tubes tied) or tubal ligation reversal
  • Use fertility drugs
  • Had fertility treatments such as in vitro fertilization (IVF)
  • It could also happen if you become pregnant while you have an intrauterine device (IUD) for birth control.

Diagnosis :

  • Apart from routine blood test ,
  • Your Doctor may have to do serial
  • S BHCG levels and pelvic sonography to confirm Ectopic pregnancy
Ectopic Pregnancy Treatment

Because a fertilized egg can’t survive outside a uterus, your doctor will need to take it out so you don’t have serious health problems. They’ll use one of two methods: medication or surgery.

Medication :

If your vital parameters are stable ,s.BHCG levels are not high, fallopian tube hasn’t ruptured and your pregnancy isn’t far along, your doctor can give you a inj Methotrexate . It stops the cells from growing. Your body will absorb them.

Sonography guided injection of Methotrexate in the sac can also be done (especially Caesarean scar ectopic)

Surgery :

In other cases, you’ll need surgery. The most common is laparoscopy.

Your doctor will make very small cuts in your lower belly and insert a thin, flexible tube called a laparoscope to remove the ectopic pregnancy.

If your Fallopian tube is intact ,linear Salpingostomy can be attempted to drain the ectopic pregnancy without tube removal .

If your fallopian tube is damaged or ruptured they may have to remove the fallopian tube (Salpingectomy) a If you’re bleeding a lot or your doctor suspects that your fallopian tube is ruptured, you might need emergency surgery with a larger cut. This is called laparotomy.

Laparoscopic Ectopic Surgery

Epictomy Salpingectomy

Epictomy Linear Salpingostomy

After an Ectopic Pregnancy :

Talk to your doctor about how long to wait before trying again. Some experts suggest giving yourself at least 3 months so your body has time to heal.

If you get pregnant again, since one ectopic pregnancy raises your risk of having another one, be mindful of changes in your body until your doctor can confirm that it’s growing where it should.

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Dr. Mandar R Gadgil
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Dr. Maithilee Gadgil
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MON – FRI - 4:30 PM - 07:00 PM w.e.f. 27th August 2022
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