Ectopic pregnancy occurs when the implantation of the fertilized egg happens somewhere else outside the uterine cavity. In Ectopic pregnancy, the normal process of fertilization occurs in the distal part of fallopian tube but there exist another problem which prevent the growing zygote from moving away from the fallopian tube to uterus. Most ectopic pregnancies occurs in the fallopian tube.
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Risks of Ectopic Pregnancy
Ectopic pregnancy risks factors includes;
- A pregnant woman with previous history of infections such as; pelvic inflammatory disease which may have caused adhension of the fallopian tube.
- Scars from previous tubal surgeries.
- Presence of uterine tumors.
- Women born with congenital tubal abnormalities or malfunctions.
- Wome with smoking history - Ectopic pregnancy occures more often to woman who have a smoking history.
- Women who were using intrauterine device (IUD) as a contraception - the IUD is believed to slow down the movement of the zygote hence increasing the chances of developing the Ectopic pregnancy.
Symptoms of Ectopic Pregnancy
After implantation, there is no unusual signs and the woman experience the usual signs associated with normal pregnancy such as; vomiting and nausea, absence of menstrual flow and a positive pregnancy test.
The zygote continues to grow normally until around the 8th weeks. At this time, the zygote has grown large enough and is capable of rupturing the thin part of fallopian tube. As a result of this, tearing of the blood vessels occurs, resulting to bleeding.
The severity of the bleeding depends on total number and the size of the ruptured blood vessels. Incase the affected part is the interstitial part (the part where the uterus and fallopian tube joins together), it can result to massive intraperitoneal bleeding. Luckily, 80% of the ectopic pregnancies occurs in ampulla region, where the blood vessels are usually smaller and less likely to result to massive bleeding.
After rupturing of the blood vessels, the woman may start experiencing a sharp, stabbing pain in one side of her lower abdomen (lower quadrant region), followed by vaginal spotting. With time, the placenta become dislodged and more bleeding continues but since most of the blood is expelled in the pelvic region rather than the uterus, the blood coming out of vagina may be less and instead, internal bleeding continue to happens. When this happens, the woman may start feeling dizzy and a rapid pulse, which may be a sign of shock.
Though in some cases, innocent pain may be caused by sudden movement, it is importance to know that, such pain rarely causes vaginal spotting and any pain accompanied with vaginal spotting or bleeding needs immediate evaluation by a health care personnel.
Delay in seeking medical care leads to the abdomen becoming more rigid due to peritoneal irritation. When this happens, the woman develop a bluish colored tinge along the umbilical area also known as the cullens signs. The pain becomes more tense and excruciating and moves up towards the shoulder and the neck areas due to phrenic nerve irritation.
Ectopic Pregnancy Treatment
Although some ectopic pregnancies my resolve soon requiring no further intervention, it is usually very hard to predict when it can happen. Incase an ectopic pregnancy is suspected, a sonogram test is usually ordered, since it can reveal an ectopic pregnancy before it ruptures.
Before rupturing, ectopic pregnancies are usually treated by use of oral medications like methotrexate (which attack and destroy the growing cells). The treatment continue until when the woman's HCG test is negative. This is the preferred method of treating ectopic pregnancies since the tube is left intact and protected from surgical scarring which can result to another ectopic pregnancy later on.
Incase the ectopic pregnancy has already ruptured, it is usually a medical emergency. The treatment of ruptured ectopic pregnancy includes laparoscopy to close off (ligate) the bleeding blood vessels and to either remove the affected fallopian tube or repair it.
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