What is an Ectopic Pregnancy?

An ectopic pregnancy is a pregnancy in which the fertilized egg implants outside the uterus, typically in a fallopian tube.

All pregnancies begin with a fertilized egg. In normal cases, the fertilized egg gets attached to the uterus lining. However, in the case of an ectopic pregnancy, the fertilized egg implants and grows outside the uterus.

Such pregnancies mostly occur in a fallopian tube since the fallopian tubes carry eggs from the ovaries to the uterus. In such cases, it is known as a tubal pregnancy.

Sometimes, the fertilized egg might implant in other areas of the body, such as an ovary, cervix, or abdominal cavity. An ectopic pregnancy is not viable as the fertilized egg can’t survive outside the uterus.

Ectopic pregnancy causes

The most common type of ectopic pregnancy is a tubal pregnancy. It occurs when a fertilized egg fails to travel all the way to the uterus and gets implanted somewhere else.

Sometimes the fertilized egg gets stuck in the fallopian tube if it is damaged or blocked. Abnormal development of the fertilized egg may also play a role in leading to an ectopic pregnancy.

Hormonal imbalances are also among the causes of ectopic pregnancy. Any condition that slows down the movement of the fertilized egg from the ovary to the uterus can cause an ectopic pregnancy.

Ectopic pregnancy symptoms

Ectopic pregnancies might be hard to detect in the early stages as the symptoms are similar to normal pregnancies. You will get a positive result if you take a pregnancy test.

The symptoms become more severe with time as the fertilized egg continues to grow outside the uterus.

Early ectopic pregnancy symptoms

• A missed period
• Nausea
• Tender and swollen breasts
• Tiredness and fatigue
• Increased urination
• Light vaginal bleeding
• Pelvic pain
• Sharp abdominal cramps
• Dizziness

Severe ectopic pregnancy symptoms

Once the fertilized egg begins to grow in the fallopian tube, you will start experiencing more severe symptoms, including:

• Heavy bleeding if the fallopian tube ruptures
• Low blood pressure (hypotension)
• Rectal pain
• Shoulder and neck pain

Risk factors for ectopic pregnancy

Several factors can increase the risk of ectopic pregnancy in a woman. These include:

– Pelvic inflammatory disease (PID)

PID, a disease caused by genital tract infection can increase a woman’s risk of ectopic pregnancy.

The infection usually spreads to the uterus, ovaries, and fallopian tubes from the vagina.

– Sexually transmitted diseases (STDs) 

Being infected with STDs, such as chlamydia or gonorrhoea, can increase the risk of ectopic pregnancies.

– Undergoing fertility treatments 

Women who undergo fertility treatments to stimulate ovulation are at a higher risk of an ectopic pregnancy.

– A history of ectopic pregnancy

If you have already gone through an ectopic pregnancy, you are at a slightly higher risk of experiencing another such pregnancy.

– Contraceptive device failure 

Some women using the coil or intrauterine device (IUD) for contraception can still get pregnant. In such cases, there is a greater risk of an ectopic pregnancy.

– Fallopian tube abnormalities 

If your fallopian tubes are inflamed or damaged by any previous infection or surgery, your chances of having an ectopic pregnancy increase.

– Smoking 

If you smoke, you are at a greater risk of an ectopic pregnancy.

– Age 

Women who are older than 35 years of age are at a greater risk of an ectopic pregnancy.

Types of ectopic pregnancy

There are different types of ectopic pregnancy classified according to the body part the fertilized egg implants, as described below:

1. Tubal pregnancy 

An ectopic pregnancy that occurs when the fertilized egg has been implanted in the fallopian tube is known as a tubal pregnancy. Most ectopic pregnancies are tubal pregnancies.

Tubal pregnancies can occur at different spots inside the fallopian tube:

• In 80% of all cases, an ectopic pregnancy grows in the ampullary section
• In around 12% of the cases, a pregnancy grows in the isthmus of the fallopian tube
• In around 5% of the cases, a pregnancy grows in the fimbrial end
• In around 2% of the cases, pregnancy occurs in the cornual and interstitial part of the fallopian tube

2. Non-tubal ectopic pregnancy 

While most ectopic pregnancies occur in the fallopian tube, around 2% of such pregnancies occur in other areas, such as an ovary, cervix, or the abdominal cavity.

3. Heterotopic pregnancy

This is a rare occurrence wherein two eggs are fertilized, of which one implants inside the uterus while the other implants outside it. In such cases, the ectopic pregnancy is often diagnosed before the intrauterine one.

In some cases, both pregnancies are terminated, while the intrauterine pregnancy may still be viable in some cases.

Ectopic pregnancy treatment

The developing embryo in an ectopic pregnancy is not viable and doesn’t have the potential to grow into a full-term baby. Ectopic pregnancy treatment entails terminating the pregnancy before it causes much harm to the woman.

These are the common treatment options available:

Expectant management 

If the woman exhibits little to no symptoms despite having an ectopic pregnancy, her doctor may monitor her closely for some time as there is a good chance of the pregnancy dissolving by itself.

In expectant management, there will be regular blood tests to check the level of hCG and other hormonal levels in your blood. Some vaginal bleeding and mild stomach cramps are expected. You will be asked to consult your doctor if you develop more severe symptoms.

Medication 

In cases of early detection of an ectopic pregnancy, you may be treated with medication if expectant management is not deemed enough.

Doctors generally prescribe methotrexate, which prevents the pregnancy from developing further. This medicine is given as an injection.

You will need to take regular blood tests to check if the treatment is working. If the first dose fails, you will be given a second dose of the injection. Side effects of this medicine include stomach cramps, dizziness, and feeling sick.

Ectopic pregnancy surgery

Two kinds of laparoscopic surgeries, salpingostomy and salpingectomy, are used to treat some ectopic pregnancies. These procedures entail making a small incision near the naval region and using a laparoscope to view the tubal area.

In a salpingostomy, only the ectopic pregnancy is removed while the tube is left to heal. In a salpingectomy, both the ectopic pregnancy and the tube are removed. The severity of the situation determines which of these methods is used.

Wrap Up

Ectopic pregnancies can pose considerable risks to a woman’s health if not treated on time. 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, visit Birla Fertility & IVF Clinic in Lucknow to book an appointment with Dr. Vinita Das.

FAQs:

1. Is an ectopic pregnancy a baby?

No, an ectopic pregnancy is simply an unviable embryo that doesn’t have any potential of growing into a full-term baby.

2. Can a baby survive ectopic pregnancy?

No, an ectopic pregnancy can’t develop into a full-term baby. Such pregnancies are unviable and usually dissolve by themselves or have to be medically terminated.

3. How is ectopic pregnancy removed?

In some cases, ectopic pregnancies dissolve by themselves. In other cases, they have to be removed by administering medication or performing surgery.

4. Can sperm cause ectopic?

Sperm is necessary to cause any kind of pregnancy. Ectopic pregnancies also start with the process of a sperm cell fertilizing an ovum as do uterine pregnancies.