Ectopic Pregnancy

Ectopic means any tissue that is supposed to be in one place but is found elsewhere.

Normally, the sperm travels from vagina towards the ovum. The ovum travels towards the sperms. They meet up in the ampulla and forms the embryo.The embryo then travels back to the uterus. The embryo grows into a baby in the womb (uterus).

For this to happen the embryo has to travel from the ampulla to the uterus, where the implantation has to occur. It normally takes 7 to 10 days for the embryo to reach the womb. If the movement slows down due to any reason, the embryo gets implanted wherever it is upon reaching 7th or 10th day. Hence, pregnancy that occurs anywhere other than in the womb is an ectopic pregnancy

Tubal ectopic pregnancy

Causes of Ectopic Pregnancy

Ectopic pregnancy may occur because of various reasons. Among which the most common is infection in the uterus or surrounding structures like ovary and fallopian tube. Some other causes are:

Pelvic Inflammatory Disease

The most common infection is, the one that gets transmitted because of sexual intercourse . When infection sets in the female reproductive organs it is called pelvic inflammatory disease (PID). Ectopic pregnancies are very common in PID.

  • Tumor

    Any tumor (abnormal growth) in fallopian tube or around causes obstruction in the path of the embryo. This does not allow the embryo to reach the womb on time, leading to ectopic pregnancy.

  • Previous Abortion

    Any previous abortion (terminating the pregnancy) that ends up in infection may cause sticking of tube walls blocking the passage of embryo. This will cause ectopic pregnancy.

  • IVF Treatment

    There is a chance of ectopic pregnancy resulting from embryo transfer during IVF treatment as embryos can travel into the Fallopian tube, for example, during the implantation stage.

Symptoms of Ectopic Pregnancy

Patients with ectopic pregnancy experience the three main symptoms:

  • Missed periods
  • Severe pain in lower abdomen
  • Heavy bleeding inside the abdomen which can lead to shock

 

Diagnosing Ectopic Pregnancy

Physical examination

When the doctor touches the abdomen of the patient, she would cry in pain. The doctor would notice that the abdomen would have increased in size, that is because of the bleeding that happened on the inside. And because of the bleeding, she will have a low blood pressure.

Transvaginal ultrasonography

A Transvaginal ultrasonography (ultrasound done through vagina) will confirm the ectopic pregnancy and severity of the rupture if happened. This may not show pregnancy that is not around the womb. Hence a Beta Human Chorionic Gonadotropin (A hormone that increases during pregnancy), also called B-hCG can be tested in blood. A proper diagnosis can be made by assessing the levels. More..

Treatments for Ectopic pregnancy

Medical Treatments

With the help an ultrasound scan, the exact place of the sac of the growing embryo is identified. Then methotrexate (a medicine which would stop the growth of it) is injected inside the sac. This stops the multiplication of cell (structural and functional unit of life) by not allowing it to grow further. This can also be given as a normal injection in the veins, just keep in mind that this method can only be applied before the sac is ruptured. 

If the sac ruptures, it causes bleeding inside the abdomen leading to heavy blood loss which may even lead to death. The spill of the embryo in the abdomen may lead to severe infection as well. Hence, immediate surgery will be needed if the sac ruptures.

Surgical Treatments

If the doctor decides that a surgery will be needed. He will then proceed with either open repair or a Laparoscopic removal of Ectopic Pregnancy.

Prevention of Ectopic pregnancy

  • One should get it treated if they have any reproductive tract diseases.
  • While using Intrauterine Devices, if one decides to get pregnant, then consultation of a doctor and getting opinions on how to proceed is very mandatory. Carelessness can  lead to ectopic pregnancy.

ectopic pregnancy Specialists

Dr. J. S. Rajkumar

CHIEF SURGEON

M.S., F.I.C.S., Dip. N.B. (SURG.), F.R.C.S. (ENG.), F.R.C.S. (EDIN.), F.R.C.S. (GLASGOW), F.R.C.S. (IRELAND), F.I.M.S., F.A.I.S., F.R.M.S. (LONDON), F.A.E. (GASTRO), F.A.C.G. (USA), F.I.C.A. (USA), F.I.A.G.E.S., Dip M.I.S. (FR.)


Dr. Deepa Ganesh

ADVANCE LAPAROSCOPIC GYNECOLOGIST, ROBOTIC SURGEON & COSMETIC GYNECOLOGICAL SURGEON
M.B.B.S., M.S (OBG), F.MAS, D.MAS, FICRS, Dip.MIS (GERMANY), D.ALS (FRANCE), D.ACG (USA)