What is an ectopic pregnancy?
For pregnancy to occur, the follicle that bursts during ovulation will release an egg that will travel down the fallopian tube, hoping to meet a healthy sperm that will fertilize it. Once fertilization takes place, the newly fertilized egg continues its journey towards to uterus, where it will find a good spot to burrow into your uterine lining. This process is called implantation, and once implanted, the embryo starts to grow and develop into a baby.
An ectopic pregnancy occurs when the fertilized egg doesn’t make it to the uterus, and can’t implant properly into your endometrium, which is the only place in your body an embryo can grow and strive. Most ectopic pregnancies, up to 90% happen because the egg gets stuck in one of the tubes. Less often, the fertilized egg may get stuck in the ovary, the abdomen or the cervix.
Regardless of the location, the pregnancy located outside the uterus is not viable, and can’t progress normally. Moreover, as the pregnancy progresses, it may cause the tube to burst, which can cause major internal bleeding and may cause the death of the patient unless immediate action is taken.
Symptoms of ectopic pregnancy
Being in tune with your body and making sure you notice anything unusual going on is always a good idea. Even more so when your attention can help you detect signs of an ectopic pregnancy that might cost you your life.
Most ectopic pregnancies start as a normal pregnancy: a missed period, a positive pregnancy test, enlarged and painful breasts.
You might not have any reason to suspect something is off, which is why the first pregnancy ultrasound’s main purpose is to make sure the pregnancy is well located inside your uterus.
Early signs of ectopic could be:
- HCG levels that don’t double as they should
- Low progesterone levels
- Vaginal spotting and even bleeding
- Mild pain in your lower belly
All of the above may mean nothing or may mean just that the pregnancy is not viable although it is located in the uterus. This is why it’s essential to have good communication with your healthcare provider and report any suspicious signs that might indicate a potentially serious medical issue.
If it goes undetected, the ectopic pregnancy will grow until the tube will be no longer able to contain it. This might cause the fallopian tube to burst, causing life-threatening internal bleeding that will require surgery to save your life.
It is impossible to miss the rupture of a fallopian tube, as the pain is usually severe and occurs suddenly. As the bleeding starts, you might feel weak, dizzy and nauseous. The abdominal pain may be accompanied by shoulder pain, and it may be so severe that it could trigger fainting. Medical intervention is a must, so you will need to be driven to the nearest emergency room as soon as possible.
Who is at risk of ectopic pregnancy?
Technically, an ectopic pregnancy may happen to anyone, but it is a medical fact that some women are more prone to it than others, and some of the main factors include:
- Previous ectopic pregnancies
- Endometriosis
- Pelvic inflammatory disease
- Previous fallopian tube or abdominal surgery
- Having an IUD in place
Also, the risk of having an ectopic is higher if the woman is older than 35, is a smoker or has a previous history of infertility.
This being said, the risk of having an ectopic pregnancy is about 1-2%, and unfortunately, this remains the main cause of maternal death in the first trimester of pregnancy.
It is also very important to note that almost half of the women experiencing an ectopic pregnancy do not present any of the risk factors mentioned above. Which is why it’s extremely important to be aware of any unusual symptoms if you are a woman of reproductive age, whether you are trying to conceive, or not.
What is the treatment for an ectopic pregnancy?
Depending on when the ectopic pregnancy is discovered, its medical management differs and so does its outcome.
Most ectopic pregnancies are diagnosed between 6-8 weeks and if caught early, before the rupture, your doctor may offer you Methotrexate. This is an injectable medicine that stops the fertilized egg from developing and thus the pregnancy doesn’t continue and there is no need for surgery. This is a minimally invasive approach, but you’d need to be monitored carefully afterwards, just to make sure the pregnancy has indeed stopped progressing and your HCG levels are decreasing properly. If this is not the case, a second injection may be recommended.
The Methotrexate option is only viable in case of an unruptured tube, though.
Once the tube has burst, or if the pregnancy has progressed enough to put your tube at risk of bursting, you will be offered surgery. The surgery can be done through laparoscopy under general anaesthesia, and depending on your case, the doctor may try to extract the fertilized egg from the tube and preserve your tube, or just remove the tube completely if the damage is too important and the tube can’t be saved.
Even if women who already had an ectopic pregnancy might be at risk of having another one again, most women end up having normal pregnancies and delivering healthy babies after an ectopic.
Following up with your medical doctor is essential in this case, because although if you can’t precisely “prevent” an ectopic, you can make sure that you’re trying to minimize your risk factors if you are having any.
For women who have had two ectopic pregnancies and had both their tubes removed, IVF is the only solution that may help them get pregnant.
Our experts can shed light on any doubts or concerns you might have regarding this topic and can guide you properly on your path to parenthood.
Book your appointment now in one of our fertility centres in Dubai, Abu Dhabi or Al Ain, and let us be part of your journey to motherhood.
