Ectopic Pregnancy

Introduction

The word ectopic means abnormally sited. Ectopic pregnancy is therefore a pregnancy that is abnormally sited. It therefore implants outside the womb. What happens is that instead of the woman’s egg that has met with a sperm in the tubes to come down and implant somewhere in the womb, it implants somewhere in the tube. In fact, sometimes it retrogresses backward and comes out of the tube and is implanted in the abdominal cavity. Or it progresses forward and is implanted beyond the womb in the cervix.

What are the causes?

There are factors that increase a woman’s chances of having an ectopic pregnancy and these are; infections in the womb and scarring from previous surgeries or procedures such as vacuum aspiration for incomplete miscarriages (the so-called D&C). Other risk factors include smoking and having a history of multiple sexual partners.

What are the symptoms?

The woman will have the normal symptoms of pregnancy initially, then pain in the lower part of the tummy will follow, and then bleeding follows. This is the classic way this problem presents and any woman who has seen these triads of symptoms MUST be rushed to the hospital as it is a medical emergency.

In some cases, the growing pregnancy ruptures the area it is situated at making the bleeding massive.

Treatment Modalities

Because it is a gynecological emergency, a woman with suspected ectopic or a pregnant woman with any significant vaginal bleeding and severe tummy-ache must be taken to a gynecology emergency of a major hospital, where the loss of blood will be quickly corrected with a drip inside a vein, and if excessive a sample of the woman’s blood is taken for grouping and crossmatching in preparation for transfusion and possible surgery to evacuate the pregnancy.

When these have been done, an ultrasound scan is done to ascertain the cause of the bleeding. Be advised that up to this stage, a diagnosis has not yet been established. By the time the ultrasound scan reveals an ectopic pregnancy (the nearest possible finding might be a miscarriage), there are two options; if it has ruptured, it is treated with surgery straightaway, while if it has not, a watchful waiting is implemented where a medicine will be given to shrink the pregnancy.

Prevention Tips

Abstinence for sexual rendezvous for unmarried women and if not possible, using protection is key to prevent womb infection – what is called sexually transmitted infections or STIs, especially for women with multiple sexual partners, because the major cause of this problem is infection of the womb.