According to a study, the occurrence of ectopic pregnancy (EP) in India ranges from 0.91% to 2.3%. A study conducted at a tertiary care centre in South India reported an EP rate of 0.91% among pregnant women, with no maternal deaths. However, other studies indicate a higher EP incidence, ranging from 1% to 2%. One should know that ectopic pregnancy if left untreated, can turn out to be a fatal condition. In this article, let’s learn what ectopic pregnancy is, its causes, symptoms and treatment options.
What is Ectopic Pregnancy?
An ectopic pregnancy happens when a fertilized egg implants outside the uterus, usually in a fallopian tube. Normally, a fertilized egg attaches to the uterus lining, but with ectopic pregnancy, it implants and grows outside of the uterus.
Typically, ectopic pregnancy occurs in a fallopian tube that plays a key role in carrying eggs from the ovaries to the uterus. It is also known as a tubal pregnancy.
Why is Ectopic Pregnancy Dangerous?
Ectopic pregnancy is dangerous and must be terminated as soon as it gets diagnosed to prevent serious health risks to the woman. As the pregnancy grows outside the uterus, it can lead to the rupture of the fallopian tube or other tissues, causing severe internal bleeding and potentially life-threatening complications.
Causes of Ectopic pregnancy
Some of the significant causes of ectopic pregnancy include:
- Damaged Fallopian Tubes: Scarring or damage to the fallopian tubes from previous surgeries, infections (such as pelvic inflammatory disease), or endometriosis can disrupt the normal passage of the fertilized egg.
- Abnormal Fallopian Tube Structure: Congenital abnormalities or structural issues with the fallopian tubes can prevent the fertilized egg from reaching the uterus.
- Hormonal Factors:Certain hormonal imbalances or medications that affect hormone levels can impair the movement of the fertilized egg through the fallopian tube.
- Intrauterine Device (IUD) Use: Although rare, pregnancies can occur with an intrauterine device (IUD) in place, and they are more likely to be ectopic.
- Smoking: Tobacco use increases the risk of ectopic pregnancy.
- Pelvic inflammatory disease (PID): This disease, caused by genital tract infection, increases a woman’s risk of ectopic pregnancy as the infection spreads to the uterus, ovaries, and fallopian tubes from the vagina.
- Sexually transmitted diseases (STDs):Infection with STDs like chlamydia or gonorrhoea can raise the risk of ectopic pregnancies.
Symptoms of Ectopic pregnancy
Ectopic pregnancies can be challenging to detect early because their symptoms can mimic those of normal pregnancies. A pregnacy test will show positive results. However, symptoms can worsen as the fertilized egg grows outside the uterus over time. A few signs and symptoms of early ectopic pregnancy include:
- Missed period
- Nausea
- Tender and swollen breasts
- Tiredness and fatigue
- Increased urination
- Light vaginal bleeding
- Pelvic pain
- Sharp abdominal cramps
- Dizziness
Once the fertilized egg begins to grow in the fallopian tube, you will start experiencing more severe ectopic pregnancy symptoms, including:
- Heavy bleeding if the fallopian tube ruptures
- Low blood pressure (hypotension)
- Rectal pressure
- Shoulder and neck pain
Different Types of Ectopic Pregnancy
Refer to the below-table outlining different types of ectopic pregnancy (EP) based on their characteristics:
| Type of EP | Characteristics |
| Tubal Ectopic Pregnancy | Most common type, where the fertilized egg implants in the fallopian tube |
| Abdominal Ectopic Pregnancy | Rare type, where the fertilized egg implants in the abdominal cavity outside the uterus |
| Ovarian Ectopic Pregnancy | Rare type, where the fertilized egg implants on the surface of an ovary |
| Cervical Ectopic Pregnancy | Rare type, where the fertilized egg implants in the cervix |
| Cornual or Interstitial Pregnancy | Rare type, where the fertilized egg implants in the cornual region of the uterus, which is the area where the fallopian tubes enter the uterus (cornua of the uterus) |
Ectopic Pregnancy Treatment
In an ectopic pregnancy, the developing embryo is not viable and cannot grow into a full-term baby. Ectopic pregnancy treatment involves termination to prevent health risks. Depending on the severity of the condition, the doctor may determine the most suitable technique, some of the common treatment options are:
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Expectant Management
If a woman shows minimal symptoms of an ectopic pregnancy, her doctor might opt for close monitoring, as there’s a chance the pregnancy could resolve naturally. This approach involves regular blood tests to monitor hormone levels. Mild vaginal bleeding and stomach cramps may occur but for severe symptoms, one should seek immediate medical attention.
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Medication
For early ectopic pregnancy, medication like methotrexate is often prescribed to stop further development. This treatment involves injections and regular blood tests to monitor its effectiveness. If the initial dose doesn’t work, a second dose may be required. Side effects may include stomach cramps, dizziness, and nausea.
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Ectopic pregnancy surgery
Laparoscopic surgeries, including salpingostomy and salpingectomy, are used to treat ectopic pregnancies.
- Salpingostomy:
During salpingostomy, only the ectopic pregnancy is removed, leaving the fallopian tube intact. This procedure is chosen when the fallopian tube is healthy and can be preserved.
- Salpingectomy:
Salpingectomy involves removing both the ectopic pregnancy and a portion or all of the affected fallopian tube. It is necessary when the fallopian tube is severely damaged or ruptured, or if future ectopic pregnancies are a concern.
Conclusion
Ectopic pregnancies can pose considerable risks to a woman’s health if not treated on time. Also, it is considered fatal in rare cases. However, timely intervention and dedicated medical care can treat ectopic pregnancies with minimum damage to a woman’s reproductive organs. A healthy pregnancy is possible a few months after treating an ectopic one. To get the best treatment options for ectopic pregnancies, consult our fertility specialist today.
