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What is an Ectopic Pregnancy?

What is an Ectopic Pregnancy?

An ectopic pregnancy occurs when the fertilized egg attaches itself in a place other than inside the uterus. Almost all ectopic pregnancies occur in a fallopian tube, and are sometimes called tubal pregnancies. As the fallopian tubes are not designed to hold a developing embryo; it cannot develop normally and must be treated. An ectopic pregnancy happens in 1 out of 60 pregnancies.

What causes an ectopic pregnancy?

Ectopic pregnancies are caused by one or more of the following conditions:

An abnormal tube shape caused by growths or by birth defect.Previous surgery in the pelvic area or on the tubes that cause adhesions, orScar tissue from a previous infection or surgical operation on the tube may impede the egg's movement,

An infection or inflammation of the fallopian tube can cause partial or entire blockage,

Who is at risk for having an ectopic pregnancy?

Women who are more at risk for having an ectopic pregnancy include the following:

Women who get pregnant after having a tubal ligation or while an IUD is in place Have had several induced abortions, or Have had pelvic or abdominal surgery Have Pelvic Inflammatory Disease (PID), Have had a previous ectopic pregnancy,

Are 35-44 years of age,

What are the symptoms of an ectopic pregnancy?

Although you may experience typical signs and symptoms of pregnancy, the following symptoms may be used to help recognize a potential ectopic pregnancy:

Weakness, dizziness, or faintingGastrointestinal symptoms Vaginal bleeding, heavier or lighter than your normal period

Sharp or stabbing pain that may come and go and vary in intensity. The pain may be in the pelvis, abdomen or even the shoulder and neck (due to blood from a ruptured ectopic pregnancy gathering up under the diaphragm).

How is an ectopic pregnancy diagnosed?

Ectopic pregnancies are diagnosed by your physician, who will probably first perform a pelvic exam to locate pain, tenderness or a mass in the abdomen. Your physician will also use ultrasound to visualize whether the uterus contains a developing fetus.

Hormone levels will be checked as well. An hCG level that is lower than normal is one reason to suspect an ectopic pregnancy. Low levels of progesterone may also indicate an abnormal pregnancy.

Your physician may do a culdocentesis, a procedure where a needle is inserted into the space at the top of the vagina, behind the uterus and in front of the rectum. Blood in this area may indicate a ruptured fallopian tube.

How is an ectopic pregnancy treated?

Ectopic pregnancy may be treated in any of the following ways:

If the ectopic pregnancy cannot be removed by laparoscopy, then a more invasive procedure called a laparotomy may be done. Bleeding needs to be stopped promptly, and emergency surgery is needed. Laparoscopic surgery under general anesthesia may be performed where a laparoscope is used to remove the ectopic pregnancy and repair or remove the affected fallopian tube. When the tube has become stretched or ruptured and is bleeding, all or part of the fallopian tube may have to be removed.

Methotrexate will help the body to absorb the pregnancy tissue and may save the fallopian tube, depending on how far the pregnancy has developed.

What about my future?

Your hCG level will be rechecked on a regular basis until it reaches zero. An hCG level that remains high may indicate the ectopic tissue was not entirely removed. This would require additional surgery or medical management with methotrexate.

The chances of having a successful pregnancy after an ectopic pregnancy may be lower than normal, but this will depend on why the pregnancy was ectopic and your medical history. If the fallopian tubes have been left in place, you have approximately a 60% chance of having a successful pregnancy in the future.

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