Ectopic Pregnancy

Introduction

The word ‘entopic pregnancy’ can be termed as false pregnancy. The egg develops outside the area of uterus. The egg settles in the fallopian tube and hence ectopic pregnancy is commonly referred as tubal pregnancy. In most of the cases of ectopic pregnancy, the egg settles into the fallopian tubes. In rare cases, the egg settles in the areas like abdomen, cervix or in the ovary.

Causes of pregnancy

If the egg develops in the following areas, pregnancy can never be successful. Because, there is no enough space for pregnancy and there is no tissue that helps to develop pregnancy. But the result of ectopic pregnancy can be extremely harmful and it endangers the life of the mother. the fetus grows and the organ that contains the egg eventually bursts out. It leads to severe bleeding and finally this may cause death.  Ectopic pregnancy can never lead to a childbirth.

Usually the doctors cannot diagnose the ectopic pregnancy at an early stage. Usually the woman just feels normal at the beginning. The early symptoms of pregnancy are vomiting, nausea, breast tenderness and frequent urination.

The woman may suddenly feel pain in the areas like pelvis, abdomen or sometimes in the neck and shoulders also. The pain in case of ectopic pregnancy is very severe and often most of the woman describe the pain as ‘stabbing pain’.

Symptoms

Some of the additional symptoms of ectopic pregnancy are vaginal bleeding, dizziness, fainting and low blood pressure.

When the fertilized egg is not able to move from the fallopian tube to the uterus, then it results in ectopic pregnancy. The egg gets stuck up in the fallopian tube only. Some of the causes of ectopic pregnancy is Pelvic Inflammatory disease. Usually when there is an inflammation in the pelvis, the egg tends to stay in the area of the tube. If the woman has undergone pelvic or abdominal surgery in the past, the scar tissues still remain and they cause ectopic pregnancy.

There are many ways to diagnose ectopic pregnancy.

Sometimes, the woman is not aware that she is pregnant. She may suddenly feel a acute pain in the abdomen and may get hospitalized. Then the hospital staff  conducts the urinary test and the woman shall be diagnosed as pregnant.

If the woman already knows that she is pregnant, then if the urine test comes back positive, she has to undergo a HCG test. This test determines the hormone HCG level produced by the placenta. These levels already appear in the blood and urine and if the woman is pregnant, the levels of HCG double after every two days. But if the woman has developed ectopic pregnancy, then the levels of HCG are less than expected.

If you meet the doctor for facing pelvic pain, then the doctor may conduct a pelvic examination to know the causes of pain. Then he may discover that there is a mass growing outside the area of uterus and you may be diagnosed with ‘ectopic pregnancy’.

Culdocentisis is a test conducted by inserting the needle at the top of the vagina into the abdomen and back of rectum. Then the doctors get an idea that the organ is ruptured.

There are different types of treatments available for ectopic pregnancy depending upon the location and size of the uterus. It also depends upon the wish of the woman, if she is ready to conceive again or not.

The early symptoms of ectopic pregnancy can be cured. The doctor can just insert an injection of  methotrexate. The fertilized egg is fertilized is dissolved. This procedure is very simple and does not endanger your pelvis anytime.

If a woman has faced the problem of ectopic pregnancy then she shall have the difficulty of becoming pregnant again. Almost 30 percent of the woman do not have the chance of conceiving again. If the fallopian tube is removed, then new tube can be inserted. But still, a woman cannot be ensured that she shall have a successful pregnancy.

The woman who are most likely to face ectopic pregnancy are:

1. a woman facing PID,
2. a woman who has undergone fallopian surgery.
3. Who has frequently undergone treatment for birth control.
4. Treatment for stimulation of ovulation.

If the result of ectopic pregnancy is become severe, i.e. if the woman is already facing the problem of internal bleeding, then she has to undergo surgical procedure.

There were many death causing due to ectopic pregnancies before the 19^th century. Almost 50 % of the deaths were caused by ectopic pregnancy only. But gradually, the rate of death dropped down by the end of 19^th century. As new surgical procedures were invented and new tools were introduced, the rate of death drastically were declined. Today, the rate of death for ectopic pregnancy are very less i.e. five in 10,000. the deaths caused by ectopic pregnancies are declining but the incidence of ectopic pregnancies are not improving.

These are some of the factors that increase the risk of ectopic pregnancy:

1. a previous fallopian tube surgery.
2. Failure of tubal litigation: a woman may become pregnant after undergoing a sterilization surgery. In such cases the causes for ectopic pregnancy is higher.
3. If the woman has undergone an abortion earlier and the area is still surrounded by infection.
4. Treatments like ART and IVF may cause ectopic pregnancy because the egg may settle into the fallopian tube from the uterus.

In North America today, ectopic pregnancy occurs at 19.7% per 1000 cases. Today, due to the change in lifestyle of woman, the chances of pregnancy has increased. Many woman, especially in the west are become addicted to smoking. Some of them indulge in intercourse with more than one partner. Sometimes, the problem of ectopic pregnancy is resolved even without the intervention of medical therapy. When the size of the egg is very small for about 3.5 cm, the problem of ectopic pregnancy can be resolved automatically.

Today, the procedure of lapratomy  is greatly practiced today more than laparoscopy. When the surgeons do not have specialized training in laparoscopy, they perform lapratomy. When the doctor cannot afford to buy costly equipments the procedure of lapratomy is more easier for him.