An ectopic pregnancy is a potentially life-threatening condition where a fertilized egg has implanted somewhere other than the uterus. Most often, the egg has implanted in the Fallopian tubes, but it can also implant in the cervix, ovaries or abdominal cavity. It may also be called a tubal pregnancy.
During normal fertilization, the egg meets the sperm in the Fallopian tube and, once fertilized, continues to the uterus, where it implants in the uterine lining. However, if the Fallopian tubes are abnormal because of scarring or damage, the egg can stay in the Fallopian tubes and result in an ectopic pregnancy. About one in 50 pregnancies are ectopic.
A ruptured ectopic pregnancy is when the growing fetus has caused the Fallopian tube or other part to rupture; this is a potentially life-threatening emergency and requires immediate medical attention. A rupture of the Fallopian tube or other part can cause a woman to bleed to death.
Risk factors
There are several risk factors for having an ectopic pregnancy; the greatest risk factor is having a history of ectopic pregnancy, according to eMedicineHealth.com. A woman who has had one ectopic pregnancy has a 15-percent chance of having another one; a woman who has had two has a 30-percent chance of having another ectopic pregnancy.
Other risk factors include:
- History of Fallopian tube infections, such as those caused by pelvic inflammatory disease (PID), chlamydia or gonorrhea.
- Abdominal surgery, especially any involving the reproductive organs, lower abdomen or bowels - this includes tubal sterilization and tubal reconstruction
- History of induced abortion
- Congenital abnormalities of the Fallopian tubes
- Tumors in the Fallopian tubes
- Age of the mother – older mothers have a higher risk of ectopic pregnancy
- Cigarette smoking
- Exposure to diethylstilbestrol, a synthetic estrogen prescribed between 1938 and 1971 to help with pregnancy complications
Symptoms
A woman may or may not miss her period with an ectopic pregnancy, according to the Merck Manual. Classic symptoms of an ectopic pregnancy are pelvic pain and unexplained bleeding.
A woman with an ectopic pregnancy may also have classic pregnancy symptoms, such as breast tenderness and nausea. Ectopic pregnancy symptoms are also symptoms of other conditions, like a threatened miscarriage. A physician can use several diagnostic tests to determine if a woman has an ectopic pregnancy; these tests may include pelvic examination, urinalysis, blood work or ultrasound.
A ruptured ectopic pregnancy’s symptoms are similar to those above, but the woman may also be lightheaded, dizzy or sweaty. She may have a rapid heartbeat and be clammy to the touch; these are signs of shock. She also may have severe abdominal pain to the point where she is unable to stand or walk.
Treatment
Depending on the age of the ectopic pregnancy and its location, a physician may choose to remove it via surgery or with injection of methotrexate, an anti-cancer drug. The drug causes the growing cells in the placenta to die, and this causes the ectopic pregnancy to miscarry.
Despite the fact that the ectopic pregnancy could not be carried to term, a woman may feel a sense of loss or sadness. This grief can be compounded by concern that she may have another ectopic pregnancy. Counseling or support groups may be beneficial to help with the emotions of an ectopic pregnancy.
References:
"Ectopic Pregnancy." eMedicineHealth.com
"Ectopic Pregnancy." The Merck Manual
Stoeppler, Melissa Conrad, MD. "Ectopic Pregnancy." MedicineNet.com
Rachel Howard-Collins - Rachel Howard-Collins is a freelance journalist with more than five years of staff reporting experience for regional and national ...
