What no woman wants - Ectopic pregnancy (extrauterine pregnancy)
An ectopic pregnancy is something no woman wants, regardless if it was a planned pregnancy or not. In either case this is a pregnancy in which the fertilised egg has implanted outside the uterus instead of in the lining of the uterus (called the endometrium).
A normal pregnancy
In a normal pregnancy the female egg is fertilised in the fallopian tube, then passes through the tube and into the uterus where it implants into the endometrium lining.
Who is at risk?
Females who have multiply partners
Females who have had pelvic inflammatory disease
Females who have had major bowel surgery
Females who have had a previous ectopic pregnancy.
So where does the egg implant occur?
The most typical place for an ectopic pregnancy to occur is in the fallopian tubes. The fallopian tubes are the passage for the unfertilised egg to become fertilised. If this egg in the tube becomes fertilised and does not move out of the tube, then an ectopic pregnancy results. A fallopian tube pregnancy is the most common places for an ectopic pregnancy to occur.
An ectopic pregnancy can also occur in:
On one of the ovaries (where the egg is developed).
The peritoneal cavity (in the abdomen - where the reproductive organs sit).
Cervix uteri
A tubal pregnancy (a pregnancy occurring within the fallopian tubes) is as high as 95% for ectopic pregnancies).
What happens if the egg implants in the wrong place?
Fewer than 2% of pregnancies can be ectopic. In an ectopic pregnancy a spontaneous abortion is likely to occur, as the only environment for a fertilised egg to implant is in the uterus lining. A spontaneous abortion is similar to a miscarriage. The body cannot grow an egg in these other regions, so the body rejects it, and a spontaneous abortion is likely.
So what happens if there is no spontaneous abortion?
If a spontaneous abortion does not occur, the fertilised egg can begin to grow. The women will show some signs of being pregnant; this includes a delay of periods or irregular periods, and some abdominal pain. Any women experiencing these symptoms whilst believing she is pregnant should see her doctor immediately.
If the pregnancy is in the fallopian tubes, and the pregnancy enlarges, the tube can rupture, causing profuse bleeding into the abdomen. Surgery at this point is essential and needs to be performed immediately. The pain will be a good indication that something is wrong, as this pain will be quite severe.
Examination by your doctor.
A pelvic examination by your doctor may reveal a lump or mass beside the uterus. A pelvic ultrasound may also help confirm diagnosis, as the mass will be visual on screen. If the results of the pregnancy remain inconclusive, then a laparoscopic procedure may be needed. This requires a light general anaesthetic, and a small incision with a tiny microscope attached to view the area thought to be affected. The findings of this test will definitely determine whether the pregnancy is ectopic or not.
Treatment
The pregnancy must be terminated. Unfortunately science has not advanced enough to replace the growing embryo into the endometrium lining. Therefore surgery is required. This can usually be done through laparoscopic surgery (using small incisions into the abdomen to remove the embryo). If the pregnancy has remained within the fallopian tube, then the most likely scenario is that the tube will be removed along with the foetus. In rare cases the damaged tube containing the fertilised egg can be attempted to be salvaged, however there is a risk of infection, bleeding and another change of an ectopic pregnancy occurring at a later point is possible. If the affected tube is removed, it will then leave the women with one healthy fallopian tube, however this does not mean she will become infertile, there is still one fallopian tube, therefore in the future the women can still become pregnant.
There is also the development of drugs that can dissolve the ectopic pregnancy, however this can only be achieved in certain cases.
- Louise Ganey
A normal pregnancy
In a normal pregnancy the female egg is fertilised in the fallopian tube, then passes through the tube and into the uterus where it implants into the endometrium lining.
Who is at risk?
So where does the egg implant occur?
The most typical place for an ectopic pregnancy to occur is in the fallopian tubes. The fallopian tubes are the passage for the unfertilised egg to become fertilised. If this egg in the tube becomes fertilised and does not move out of the tube, then an ectopic pregnancy results. A fallopian tube pregnancy is the most common places for an ectopic pregnancy to occur.
An ectopic pregnancy can also occur in:
A tubal pregnancy (a pregnancy occurring within the fallopian tubes) is as high as 95% for ectopic pregnancies).
What happens if the egg implants in the wrong place?
Fewer than 2% of pregnancies can be ectopic. In an ectopic pregnancy a spontaneous abortion is likely to occur, as the only environment for a fertilised egg to implant is in the uterus lining. A spontaneous abortion is similar to a miscarriage. The body cannot grow an egg in these other regions, so the body rejects it, and a spontaneous abortion is likely.
So what happens if there is no spontaneous abortion?
If a spontaneous abortion does not occur, the fertilised egg can begin to grow. The women will show some signs of being pregnant; this includes a delay of periods or irregular periods, and some abdominal pain. Any women experiencing these symptoms whilst believing she is pregnant should see her doctor immediately.
If the pregnancy is in the fallopian tubes, and the pregnancy enlarges, the tube can rupture, causing profuse bleeding into the abdomen. Surgery at this point is essential and needs to be performed immediately. The pain will be a good indication that something is wrong, as this pain will be quite severe.
Examination by your doctor.
A pelvic examination by your doctor may reveal a lump or mass beside the uterus. A pelvic ultrasound may also help confirm diagnosis, as the mass will be visual on screen. If the results of the pregnancy remain inconclusive, then a laparoscopic procedure may be needed. This requires a light general anaesthetic, and a small incision with a tiny microscope attached to view the area thought to be affected. The findings of this test will definitely determine whether the pregnancy is ectopic or not.
Treatment
The pregnancy must be terminated. Unfortunately science has not advanced enough to replace the growing embryo into the endometrium lining. Therefore surgery is required. This can usually be done through laparoscopic surgery (using small incisions into the abdomen to remove the embryo). If the pregnancy has remained within the fallopian tube, then the most likely scenario is that the tube will be removed along with the foetus. In rare cases the damaged tube containing the fertilised egg can be attempted to be salvaged, however there is a risk of infection, bleeding and another change of an ectopic pregnancy occurring at a later point is possible. If the affected tube is removed, it will then leave the women with one healthy fallopian tube, however this does not mean she will become infertile, there is still one fallopian tube, therefore in the future the women can still become pregnant.
There is also the development of drugs that can dissolve the ectopic pregnancy, however this can only be achieved in certain cases.
- Louise Ganey