Ectopic ectopic pregnancy or, simply, ectopic pregnancy (GEU) is defined as pregnancy in which the implantation of the embryo takes place outside the uterus, excluding all intrauterine ectopic pregnancies, which, although implantation is still in the uterus, are still abnormalities.
In 90-95% of cases in ectopic pregnancy the fertilized egg implants in the fallopian tubes (tubal pregnancy). In rarer cases, ovarian pregnancies, abdominal pregnancies (peritoneal), interstitial pregnancies, cervical canal pregnancies, scar pregnancies of a caesarean section and heterotopic pregnancies may occur. In the very rare cases of heterotopic pregnancies, the presence of a normal intrauterine pregnancy is combined with ectopic pregnancy.
Ectopic pregnancy symptoms
Most of the time, an ectopic pregnancy occurs within the first 5-6 weeks of pregnancy.
You may not even know you’re pregnant and you may not notice any problems. The most frequent symptoms, when present, are:
- pain when urinating,
- pain in the lower abdomen,
- absence of menstrual cycle,
- back pain
- light vaginal bleeding and pelvic pain
- pain in one shoulder, in rare cases
An ectopic pregnancy can cause rupture or rupture of the fallopian tubes. In that case the pain is stronger: go to the emergency room immediately if you have severe vaginal bleeding with dizziness, fainting or shoulder pain or if you have severe pain in the belly, especially on one side. Rupturing a tube can be a serious risk to your health.
Diagnosis
The diagnosis of an ectopic pregnancy is made by analyzing a series of examinations:
- transvaginal ultrasound, with which the appearance of the endometrial rhyme is observed in particular
- blood test on serum blood hCCG assay
Risk factors
One of the possible causes of an ectopic pregnancy could be damage to the fallopian tube that prevents the fertilized egg from entering the uterus.
You are more likely to have an ectopic pregnancy if:
- you suffer from pelvic inflammatory disease (PID)
- Smoke
- you have more than 35
- you have a sexually transmitted infection
- you have scars from pelvic surgery
- you have had a previous ectopic pregnancy
- you have performed a tubal ligation
- have used medications or had fertility treatments (such as in vitro fertilization)
Treatments and therapies
About 70 – 75% of ectopic pregnancies are terminated by a miscarriage if this does not occur or if the diagnosis is made before the 4th week you have 3 possibilities:
- monitoring, together with weekly ultrasound investigations for patients for whom spontaneous resolution of tubal pregnancy is expected;
- medical therapy with methotrexate, which blocks the growth of the embryo;
- surgery (usually laparoscopy). Your doctor will make very small cuts in your lower belly and insert a thin, flexible tube called a laparoscope to remove the ectopic pregnancy. If your fallopian tube is damaged, it may need to be removed. If you’re bleeding a lot or your doctor suspects your fallopian tube is ruptured, you may need emergency surgery with a larger cut. This is called a laparotomy.
Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.
She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform, Maternicity.com.