Pregnancy and child birth are very complex biological processes. These are very important steps in the reproduction of the species. But as in the case of any other systems, this system is also vulnerable to anomalies. There are many types of abnormalities that can occur during the process of pregnancy. Ectopic pregnancy which is otherwise known as the tubal pregnancy is one such disorder which can occur during pregnancy.
An ectopic pregnancy is one, which occurs outside the womb in several places like the ovary, the abdomen, the cervix, but the most common place is in the fallopian tubes. This abnormality most often causes the death of the fetus and so it is considered as a dangerous abnormality.
Ectopic pregnancy is the leading cause of maternal deaths in the first trimester of pregnancy. Generally ectopic pregnancy occurs in the fallopian tubule and hence the name tubal pregnancy. The word “ectopic” means out of pace, so it indicates the implantation of the fetus anywhere outside the uterus.
Ectopic condition is lethal not only to the fetus but also to the mother. Forty to fifty women die each year due to this condition in the United States. But now since lot of information like ours is available online to help expecting women, hence there has been a large drop in the death/ectopic rate since 1970s.
There are certain factors, which are known to increase the risk of an ectopic pregnancy such as – advancing age, tubal surgery, pelvic inflammatory disease, ovulation induction, previous ectopic pregnancy termination, a previous ectopic pregnancy and IVF (test tube baby).
Today there are several methods by which we can identify and ectopic pregnancy successfully. One of the most used methods is vaginal ultrasound method. This can be done in about 4-5 weeks onwards.
It can also be detected by the scanning. The sensitive urinary ELISA test is another form to help identify an ectopic pregnancy.
Some of the common symptoms are Severe pain, generally one sided around the uterus, Slow rise in hCG levels, Shoulder pain and severe vaginal bleeding. You may experience one, all or none of these symptoms. If you have any reason to suspect that your pregnancy is ectopic you should call your doctor or midwife immediately.
The progesterone hormone level can also acts as an indicator of ectopic pregnancy, progesterone level of less than 15( ng/ml) is seen in 81% of ectopics, 93% of abnormal intrauterine pregnancies and 11% of normal intrauterine pregnancies.
There are various treatments once an ectopic pregnancy is diagnosed. There is however no possibility of taking the pregnancy from the tube and putting it into the womb. The possible procedures for ectopic pregnancy can all be done by laparoscopy (same day surgery) or by laparotomy (bigger incision).
Usually, if the tube is not ruptured it is done by laparoscopy. Cases of rupture with significant hemorrhage into the abdomen are almost always done by laparotomy because it can be done much faster.
If the tube is saved at surgery, there is some risk that some of the pregnancy remains in the tube. This tissue can persist and resume growing. A mass can form with subsequent rupture and hemorrhage.
Another treatment method is by using a chemical known as Methotrexate. It has got the capacity to arrest the growth of rapid growing cells such as a pregnancy or some cancer cells. Most side effects seen with low-dose MTX therapy have been mild and transient.
The sooner an abnormal pregnancy is diagnosed; it increases the survival chances of the mother. So it is important not to overlook the possibility of an ectopic pregnancy.