Pregnancy normally begins with a fertilized egg which attaches to the lining of the uterus. However, In an ectopic pregnancy, the fertilized egg implants and grows outside the main cavity of the uterus.
Mostly it occurs in the fallopian tube which carries eggs from the ovaries to the uterus. This type of ectopic pregnancy is called a tubal pregnancy. Other times, an ectopic pregnancy occurs in other areas of the body, such as the ovary, abdominal cavity or the lower part of the uterus (cervix), which connects to the vagina.
An ectopic pregnancy can't proceed normally. The fertilized egg can't survive, and the growing tissue may cause life-threatening bleeding, if left untreated.
Symptoms
At first, the symptoms are not noticeable and only usual early signs or symptoms of pregnancy occur, such as missed period, breast tenderness and nausea. A pregnancy test result will be positive but ectopic pregnancy can't continue as normal.
As the fertilized egg grows in the improper place, signs and symptoms become more noticeable, such as
• Light vaginal bleeding and pelvic pain.
• If blood leaks from the fallopian tube, one may feel shoulder pain or an urge to have a bowel movement.
• The specific symptoms depend on where the blood collects and which nerves are irritated.
Emergency Symptoms
If the fertilized egg continues to grow in the fallopian tube, it can cause the tube to rupture casing heavy bleeding inside the abdomen. Symptoms will include extreme lightheadedness, fainting and shock.
Treatments
A fertilized egg can't develop normally outside the uterus. To prevent life-threatening complications, the ectopic tissue needs to be removed. Depending on your symptoms and when the ectopic pregnancy is discovered, this may be done using
• Medication
• Laparoscopic surgery
• Abdominal surgery
Medication
An early ectopic pregnancy without unstable bleeding is most often treated with a medication called methotrexate is given by injection which stops cell growth and dissolves existing cells. It's very important that the diagnosis of ectopic pregnancy is certain before receiving this treatment.
After the injection, the doctor will order another HCG test to determine how well treatment is working and if any more medication is needed.
Laparoscopic Procedures
Salpingostomy and salpingectomy are two laparoscopic surgeries used to treat some ectopic pregnancies. In these procedure, a small incision is made in the abdomen, near or in the navel and a thin tube equipped with a camera lens and light (laparoscope) are inserted to view the tubal area.
- In a salpingostomy, the ectopic pregnancy is removed and the fallopian tube is left to heal.
- In a salpingectomy, the ectopic pregnancy and the fallopian tube are both removed.
The type of procedure done depends on the amount of bleeding and damage and whether the tube has ruptured. Also a factor is whether the other fallopian tube is normal or shows signs of prior damage.
Emergency surgery
If the ectopic pregnancy is causing heavy bleeding, you might need emergency surgery. This can be done laparoscopically or through an abdominal incision (laparotomy). In some cases, the fallopian tube can be saved. Typically, however, a ruptured tube must be removed.
