Ectopic pregnancy

For any woman hoping to conceive, the diagnosis of ectopic pregnancy can be devastating. An ectopic is a non-viable type of pregnancy which refers to the implantation of an embryo outside of the uterus and never results in a live birth.

Ectopic pregnancies account for around 2% of all conceptions in the U.S., or one in 40-100 pregnancies. While relatively rare, ectopic pregnancies are always dangerous and cannot continue to term; 9% of all pregnancy-related deaths are a result of this diagnosis.

Ectopic pregnancies are typically caused by blocked or damaged fallopian tubes. In an ectopic pregnancy, a fertilized egg is stopped from traveling through the fallopian tube into the uterus, where it would normally implant and begin to grow. Fallopian tubes cannot support the growth and development of a healthy embryo and, if the embryo is not removed, will rupture.

Tubal damage is often caused by pelvic inflammatory disease resulting from untreated or undiagnosed sexually transmitted infections (STI's) such as chlamydia or gonorrhea. It can also result from endometriosis, appendicitis, or prior pelvic surgery. Occasionally, an ectopic pregnany will occur after a tubal ligation (tying your tubes) or the removal of an IUD device. Sometimes, the cause remains unknown. Women who have undergone an ectopic pregnancy have a greater risk that it will happen again at a later time. In vitro fertilization also increases this risk to a small extent.

Symptoms include some of the typical markers of pregnancy, such as missed periods, tender breasts, and nausea. In addition, ectopic pregnancy may also present with pain in the lower back, pelvis and/or abdomen and cramping. If your pregnancy has been diagnosed and you are under a doctor's care, a blood test will indicate early, abnormal levels of hCG, or human chorionic gonadotropin and low levels of progesterone. An ultrasound can also show the abnormal implantation of the embryo. Sometimes an outpatient-surgical procedure called a laparoscopy will be required to confirm the diagnosis.

If the ectopic pregnancy is not diagnosed and a tubal rupture takes place, symptoms will escalate to include fainting or feeling faint, intense feelings of pressure in the rectum, pain in the shoulder and severe pain in the abdomen. This requires an immediate visit to an emergency room. If you suspect that you are in this situation, call 911 immediately and remain warm with your legs elevated to alleviate symptoms of shock.

When diagnosed early, a non-surgical treatment utilizing a drug called methotraxcate can be used. The medication is administered via injection and is effective in destroying ectopic pregnancy tissue. In more advanced cases, laparoscopy is utilized to treat as well as diagnose the situation. If a rupture has occured, major types of surgery such as laparotomy or salpingectomy will be required. Any protocol deemed appropriate to end this non-viable type of pregnancy should not be confused with abortion.

Ectopic pregnancy may be rare statistically but you don't want it to happen to you, if you can avoid it. You can reduce your risk by using condoms when you are not trying to get pregnant, in order to lessen the possibility of contracting a sexually transmitted infection. If you suspect you have an STI, see a doctor immediately and make sure that both you and any sexual partner you have receive treatment for the infection. Keeping in mind that STI's are often asymptomatic, make sure that you get tested on a regular basis as well. And, if you are trying to conceive or suspect that you are pregnant, it is good common sense to seek medical support sooner rather than later, in order in ensure the best possible outcome for both you and your baby.

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