Tubal Pregnancy - Also Known As Ectopic Pregnancy
Out Of Place
"Out of Place", that's what the word ectopic means and that's exactly what happens in a tubal pregnancy. The embryo does not make it out of the fallopian tube and into the waiting uterus, and begins to grow in the tube - hence the phrase, tubal pregnancy. The definition of an ectopic pregnancy is "a pregnancy that occurs outside a woman's uterus" and it is a potentially life threatening situation for a woman. While most of them occur in the fallopian tubes, they have been known to embed in other places in the pelvic cavity. Ectopic pregnancies are also well-known to be a complication of assisted reproduction techniques.
Feels The Same, But It's Different
Initially, when conception happens, the pregnancy signs for a tubal or ectopic pregnancy are no different than the pregnancy symptoms that accompany a normal pregnancy. However, as time goes on there are some pregnancy symptoms that are inconsistent with a normal pregnancy that show up as ectopic pregnancy symptoms. A tubal pregnancy cannot progress to the healthy growth and delivery of a baby. There is not enough room nor is the environment conducive to the natural development necessary. In many cases, as the ectopic embryo begins to grow, the tube (which is usually where it is lodged) bursts or ruptures, causing severe pain, bleeding and if not treated in time, even death. Today, with the use of ultrasound scans an ectopic pregnancy can be caught early and danger is minimized. But, the loss of a pregnancy, no matter what stage, is devastating. It is important to recognize and grieve the loss, allowing time for healing to happen.
Symptoms of a tubal pregnancy include vaginal bleeding, lower abdominal pain and cramping, dizziness, lightheadedness, or pain predominantly on one side. If a tubal pregnancy is suspected, the health care provider may do a pelvic exam to check for the location of the pain and the presence of a mass in the tube or ovary. Blood tests and ultrasound imaging confirm the diagnosis. If it is too early to identify a pregnancy on ultrasound, the doctor may wait until the pregnancy has progressed to about six weeks and do another scan to ensure the diagnosis is accurate.
Treating An Ectopic Pregnancy
Since a pregnancy cannot be sustained outside of the uterus, an ectopic pregnancy must be removed. If it is detected early enough an injection of a drug to stop cell growth is given. The drug, methotrexate, stops the growth of the embryo and dissolves the existing cells. Monitoring for levels of hCG (human chorionic gonadotropin) the pregnancy hormone, is necessary to ensure the levels lower. If they do not drop enough, then another injection is given. If the ectopic pregnancy does not respond to the injections, surgery is necessary. Laparscopic surgery is the preferred method, wherein the doctor makes a small incision in the abdomen, either near or in the navel, and uses a thin tube equipped with a light and camera to view the area. Other instruments are introduced through the tube in order to remove the ectopic tissue and repair the damaged tube. If the tube is damaged beyond repair, it is removed at this time. If there has been a rupture or there is heavy bleeding, emergency surgery through an incision in the abdomen (laparotomy) may be necessary.
Risk Factors For Tubal Pregnancies
If a woman has had a tubal ligation (had her tubes tied) as a method of birth control, and then decides to have them opened in order to have another child, the chances of a tubal pregnancy after a tubal ligation are quite high. The statistics show that after a non-laparoscopic tubal ligation, about 12% of pregnancies are tubal, and after a tubal coagulation via laparascope, about 51% of pregnancies are ectopic. Other risk factors for an ectopic pregnancy include pelvic inflammatory disease (PID), progestin only contraceptives, including progesterone-bearing IUD's, previous tubal surgery, IVF, ovulation induction or ovarian stimulation, and a previous ectopic pregnancy.