Ectopic Pregnancy
Comprising from 1-2% of all pregnancies, an ectopic pregnancy is a form of pregnancy where the embryo implants outside the uterus, often in the fallopian tube.
In normal cases, fertilization of the egg takes place in the fallopian tube. Normally the fertilized egg continues down the Fallopian tube and implants in the uterus, where the placenta will develop and the baby will grow and develop in a healthy way. In the case of an ectopic pregnancy, the fertilized egg may implant in the fallopian tube, it can be aborted out in to the pelvis, where implantation occurs on the ovary, bowel, or other structures, or it goes too far and implants in the cervix, which is rare. In all cases it is important to diagnosis the ectopic pregnancy early when the most treatment options are available, increasing the chance of future successful pregnancies and decreasing the danger to the mother's health.
Signs and symptoms of an ectopic pregnancy are commonly pain and vaginal bleeding. However, some women experience neither of these early in their pregnancy. An examination often reveals a uterus that is smaller than normal given the stage of the pregnancy. Often a pelvic ultrasound is performed to confirm the existence of the ectopic pregnancy.
Some women's bodies may identify the abnormality and the pregnancy will be naturally miscarried. If this is not the case, treatments including medical management or surgery are typically recommended. If the ectopic pregnancy is very early, medical management with the medication Methotrexate is an option. The patient receives a dose of this medication stopping the growth of the pregnancy which will allow the body to absorb the tissue, heal, and prepare for future pregnancies. Methotrexate treatment is a way to avoid surgery and preserve the health of the fallopian tube if that is the location of the ectopic pregnancy.
The second treatment option for an ectopic pregnancy is surgery. Laparoscopy, placing a small scope into the abdomen, with the woman under general anesthesia is the most common approach to an ectopic pregnancy. Through a laparoscope the ectopic pregnancy can be identified and removed.
There have been cases where an ectopic pregnancy ended by delivering the baby through a caesarean section. However, because of the risk to the mother of bleeding and damage to internal organs, continuing an ectopic pregnancy is not recommended by experts.
Risk factors for an ectopic pregnancy include a previous ectopic pregnancy, a history of gonorrhea or Chlamydia infections, cigarette smoking, having a copper IUD, and some infertility treatments. While it is important for all women to seek medical care early in a pregnancy, this is especially important when an increased risk of ectopic pregnancy exists. The earlier an ectopic pregnancy can be diagnosed, the easier it will be to treat. With early treatment the chances for a successful pregnancy in the future are greater.
