Exploring Ectopic Pregnancy
Ectopic pregnancies are extremely dangerous to the mother. A fetus needs the nourishment and room of the uterus to grow properly. Being implanted anywhere other than the uterus is a major cause for concern. As the fetus continues to grow, it will eventually become so large that it will burst the organ. This burst can leads to bleeding which can lead to maternal death In fact, the classical case of ectopic pregnancy never develops into a live birth.
Ectopic pregnancies can be very difficult for health care provider to diagnose. This is because the symptoms of ectopic pregnancy can be very similar to early pregnancy symptoms. Nausea and vomiting, missed periods, and breast tenderness are among these often misdiagnosed symptoms. One of the first indicators of an ectopic pregnancy is pain. Pain associated with ectopic pregnancy varies from person to person. Most women complain of pain the abdomen or pelvis. Some women describe a referred pain the neck or shoulder regions. Ectopic pregnancy pain is often described as very severe as wells as sharp and stabbing. Lower back pain, lowered blood pressure, dizziness, and vaginal bleeding may all be indicative of ectopic pregnancy.
Protocol at many emergency rooms requires that any woman of childbearing arriving complaining of abdominal pain is automatically given a urine pregnancy test. After the urine pregnancy test comes back, you will be given an HCG test. This test measures the level of HCG(human chorionic gonadotropin). HCG is produced by the placenta and increases steadily during pregnancy. A level of HCG that is lower than expected for your pregnancy level may be a further indication of ectopic pregnancy. A pelvic exam will be completed by the health care provider . This pelvic exam will be used to evaluate any pain and tenderness. The pelvic exam will also be used to check for an enlarged pregnant uterus and any other masses in the abdomen or pelvic cavities.
PID (pelvic inflammatory disease) and endometriosis are the most common causes of ectopic pregnancies. Ectopic pregnancies happen because the fertilized eggs can not travel through the fallopian tubes and enter the uterus quickly enough. In cases of PID, the fallopian tubes are blocked due to varying degrees due to infection. In cases of endometriosis, scar tissue from previous fallopian tube surgery contributes to tubal blockages. Birth defects and abnormal growths affecting the fallopian tubes can also lead to ectopic pregnancy. An ultrasound or other more advanced tests may be ordered. It is very difficult to diagnose an ectopic pregnancy that is less than 6 weeks old. Because ectopic pregnancy is a potentially life threatening disease, you may be asked to return to have HCG every two days until ectopic pregnancy is ruled out.
Treatment of ectopic pregnancies is important for maternal wellness. Early ectopic pregnancies may be treated with an injection of methotrexate. Methotrexate allows the fertilized egg to be reabsorbed into the mother’s body. Using this method is non invasive and reduces the scarring other organs. Ectopic pregnancies that are further along will require surgical removal. The surgical removal method may be done by laparoscopy or general surgery. The removal method will be based on ectopic pregnancy age, location, and urgency. You will need to make regular visits to your health care provider following ectopic pregnancy removal to ensure that your HCG levels return to zero. If your HCG level does not return to zero, you may need to have additional surgery or methotrexate to remove any missed ectopic tissue.
It is possible to have a normal healthy pregnancy after having an ectopic pregnancy. If the fallopian tubes are left intact, the chances of having a normal pregnancy are 60%. There is still a 40% chance of having a normal pregnancy with one available fallopian tube. Only 30% of women who have had one ectopic pregnancy will have much difficulty becoming pregnant again. Today, there are options like IVF(in vitro fertilization) to assist people unable to conceive due to ectopic pregnancy.
Because of the increased risk of repeat ectopic pregnancies, high risk patients should consult with their health care provider as soon as pregnancy is suspected. This early monitoring can increase the chances of maternal and fetal health.
