Sometimes, ectopic pregnancies result in miscarriages, but more often, the fallopian tube where the fetus is implanted stretches and becomes inflamed and extremely painful. Most cases of ectopic pregnancy require emergency medical treatment because the growing fetus can cause the fallopian tube to rupture and as a result, massive internal bleeding can occur. In developed, high-income countries where emergency health care is easily accessible, severe injury or death is rare.
Prior to the age of modern medicine and even today in countries where safe diagnostic and surgical techniques are unavailable, ectopic pregnancy can result in maternal death in more than 50 percent of cases. When women can access the right healthcare, risk for death drops to less than five in 10, pregnancies. Accurate statistics for maternal outcomes in developing countries are difficult to come by. Can mom get pregnant again? Many women can get pregnant again and go on to deliver healthy babies, but it depends on what caused her ectopic pregnancy in the first place, how much abdominal damage occurred, whether she still has a remaining fallopian tube and her willingness to risk having another complication.
When a woman has had one ectopic pregnancy, she has a 15 percent chance of having another. What happened to our friends? Jennifer Pastiloff, writer, yoga retreat leader and founder of the Manifest Station , experienced pain and bleeding shortly after discovering she was pregnant last year.
She had known from the start that something was wrong and when her doctor diagnosed her pregnancy as ectopic, she was successfully, but painfully treated with methotrexate.
Jennifer wrote an eloquent essay for The Rumpus about hopping on a plane to lead a yoga retreat shortly after receiving the injection. When the pain became too intense for her to continue teaching, she went to the emergency room for pain medication and reassurance that everything would be all right.
If you had no past history of problems conceiving or diseases involving your Fallopian tubes before your ectopic pregnancy, your fertility will not be affected and you should have no more chance of having an ectopic pregnancy than a woman who has not had an ectopic pregnancy.
If you had one of the risk factors above, however, you may be more at risk of problems in the future. If you had to have an operation, you are more likely to have fertility problems and problems with future ectopic pregnancies than if you had medical treatment or no treatment was needed.
Even if one Fallopian tube is completely removed, you have about a 6 in 10 chance of having a future normal pregnancy. The other Fallopian tube will still usually work. However, in 10 future pregnancies may lead to another ectopic pregnancy. It is therefore important that if you have had an ectopic pregnancy in the past you should go to see your doctor early in future pregnancies.
It is common to feel anxious or depressed for a while after treatment. Worries about possible future ectopic pregnancy, the effect on fertility, and sadness over the loss of the pregnancy are normal. Do talk with a doctor about these and any other concerns following treatment.
Diagnosis and management of ectopic pregnancy ; Royal College of Obstetricians and Gynaecologists. Green Top Guideline No November My girlfriend took 6 at home pregnancy tests - 4 were positive. The nurse couldn't give us an exact diagnosis - only her own opinion on whether or not my girlfriend Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions.
Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.
For details see our conditions. In this article Understanding normal early pregnancy Where does an ectopic pregnancy develop? What are the problems with an ectopic pregnancy? Ectopic pregnancy symptoms Who develops an ectopic pregnancy? How is ectopic pregnancy confirmed?
What are the treatment options for ectopic pregnancy? What if I have a pregnancy in the womb at the same time as an ectopic pregnancy? Are there any complications of ectopic pregnancy? In summary. Ectopic Pregnancy In this article Understanding normal early pregnancy Where does an ectopic pregnancy develop? Ectopic Pregnancy Explained Hide videos Show videos. Are you protected against flu? Further reading and references. It is possible to have an ectopic pregnancy without experiencing any symptoms until rupture of the fallopian tube or close organs.
After rupture, signs and symptoms may include: [3]. If you are concerned that you may have an ectopic pregnancy, you can use the Ada app for a free symptom assessment. When a person becomes pregnant, the sperm and the egg, also known as an ovum, join in the fallopian tube, the tube that carries the ovum from the ovary to the uterus.
Usually, the fertilized egg passes along the fallopian tube and into the uterus and implants into the lining of the uterus, known as the endometrium, where it will grow and develop. Ectopic pregnancy occurs when a fertilized egg implants and starts to grow outside the uterus, usually in a fallopian tube.
As the ectopic pregnancy gets bigger, it can run out of space to grow and rupture the fallopian tube, causing severe pain and internal bleeding. Rarely, an ectopic pregnancy can also occur in other places, such as the ovary or inside the abdomen. The following factors may not be the sole cause of a person experiencing an ectopic pregnancy, but they are linked to a heightened risk of ectopic pregnancy: [3] [5].
Previous ectopic pregnancy: If a person has experienced an ectopic pregnancy already, they have an increased risk of having another one. Fertility treatment: Embryo transfer during in vitro fertilization IVF can occasionally result in ectopic pregnancy if, for example, an embryo travels into the fallopian tube.
Infertility: Women with infertility have a two or three times higher risk of ectopic pregnancy, possibly reflecting the increased number of people in this group who have tubal abnormalities, which may also be a cause of infertility.
Pelvic inflammatory disease PID : Previous infection of the pelvic region, commonly chlamydia and gonorrhea, can sometimes damage the fallopian tubes. Tubal sterilization: People who become pregnant after tubal sterilization, either because it has failed or because they have had it reversed, are at higher risk.
Cesarean section: An embryo can implant in the scar tissue of the uterus lining, caused by cesarean section. However, if a person does conceive, the probability of the pregnancy being ectopic is higher than in women not using an IUD. Smoking tobacco: This can hinder the transfer of the ovum to the uterus by decreasing the ability of the muscles in the fallopian tube walls to contract. In-utero diethylstilbestrol DES exposure: Exposure before birth to DES, a synthetic form of the female hormone estrogen that was prescribed to pregnant women from the s to s to prevent pregnancy complications, has been found to increase the risk of ectopic pregnancy by about four times.
Also known as tubal pregnancy, a fallopian ectopic pregnancy can be further divided into three sub-types:. The tube has a delicate structure made up of cilia, which are tiny hair-like projections, and mucus-producing cells, which work together to propel an ovum, fertilized in the fallopian tube, to the uterus to implant, over the space of about four days.
Sometimes, the transportation of the developing embryo is slow, perhaps for reasons of inflammation or infection of the fallopian tube or for no obvious reason. In such cases, it can implant in the fallopian tube. There are other types of ectopic pregnancies, all of which are rare. These include: [7]. Interstitial pregnancy: This occurs in the part of the fallopian tube embedded in the uterus wall. It is typically hard to diagnose and can therefore be particularly dangerous, as it may progress further and rupture later, damaging both the fallopian tube and the uterus wall.
Cervical ectopic pregnancy: Pregnancy in the cervix — the passage between the womb and vagina — is one of the rarest forms of ectopic pregnancy and carries a risk of life-threatening vaginal hemorrhage. This is due to the possibility of heavy bleeding when the ectopic pregnancy tissue separates from the cervix, which contains many blood vessels.
Ovarian ectopic pregnancy: This is typically difficult to diagnose, as it can appear very similar to a tubal ectopic pregnancy that is stuck to the ovary.
It is usually not diagnosed until surgery, when partial or complete removal of the ovary will usually be necessary. Cesarean scar ectopic pregnancies: This occurs when a fertilized egg implants into the scar from a cesarean section. The pregnancy can grow out of the uterus or into the cervix, which can lead to massive internal or vaginal bleeding. In some cases, the fetus may be able to survive until birth, but with the risk of significant maternal bleeding and removal of the womb, known as hysterectomy, at delivery.
Intramural pregnancy: This is a difficult-to-diagnose pregnancy that implants outside of the womb cavity, but within its muscular wall. It may occur if the uterus is scarred from surgery or if a condition called adenomyosis is present, in which the inner lining of the uterus breaks through the muscle wall of the uterus.
Abdominal pregnancy: Pregnancies in the abdomen are thought to start as tubal pregnancies, before separating from the wall of the fallopian tube and passing into the abdominal cavity, where they reattach.
These can take many weeks before showing symptoms. Heterotopic pregnancy: This term describes the co-existence of an intrauterine pregnancy and an ectopic pregnancy. The intrauterine twin is able to survive until birth in about one third of cases, after surgical treatment of the ectopic pregnancy.
A person may be referred to a gynecology clinic for further assessment. Good to know: Diagnosis of ectopic pregnancy can be delayed because the symptoms are often similar to other, more well-known conditions, such as gastroenteritis, appendicitis or miscarriage. For more information, see the resource about signs of miscarriage. Ultrasound is an imaging technique which uses soundwaves to create an image of the developing pregnancy.
It is a painless and non-invasive procedure which can be performed in two different ways: [8]. In diagnosing an ectopic pregnancy, doctors will look for where the pregnancy is located in the ultrasound images. Ultrasound indicators for ectopic pregnancy include: [9]. No pregnancy in the uterus, or a gestation sac in the uterus missing an embryo: This is a pregnancy of unknown location PUL. This is a label given until the pregnancy location can be found, and a diagnosis can be given.
Many of these will not be ectopic and will not need treatment. No pregnancy in the uterus and a possible mass in the area of a fallopian tube: This would likely lead to diagnosis of a possible ectopic pregnancy. Human chorionic gonadotropin hCG is a hormone produced by the placenta, an organ that develops in the womb during pregnancy.
A beta hCG blood test can detect hCG in the blood approximately 11 days after conception and establish the precise amount of hCG present. This might be used if a person has been pregnant for six weeks, but an ultrasound scan does not show a developing pregnancy in the uterus.
The test may be repeated at intervals to measure changes in hCG levels. Possible indicators for ectopic pregnancy from a beta hCG blood test include: [11]. In a healthy pregnancy, hCG levels in the blood double about every two to four days throughout the first trimester, reaching their peak after weeks and then decreasing before plateauing during the second trimester. Rarely, laparoscopy, a type of keyhole surgery, is used to confirm the diagnosis, if hCG and ultrasound results are ambiguous.
Under general anesthetic, a laparoscope, a narrow instrument with a camera and light on the end, is inserted through a small cut, usually into the belly button, to look at the pelvis.
If an ectopic pregnancy is found, treatment to remove it may take place during the same operation. An ectopic pregnancy can be life threatening if left untreated and normally requires medical or surgical intervention to remove it. However, in some cases, when it is diagnosed early, ectopic pregnancy may be monitored to see if it will resolve on its own. Treatment options depend on: [12]. Also known as conservative or wait-and-see management, expectant management involves waiting to see if the ectopic pregnancy tissue passes out of the cervix on its own, instead of undergoing immediate treatment.
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