Ectopic Pregnancy

One of the main complications in early pregnancy is ectopic pregnancy. This is when a fertilized egg implants itself somewhere other than in the uterine lining. The majority of the time, the egg will implant itself in the fallopian tubes, which is why ectopic pregnancies are also known as tubal pregnancies. However, the egg may also implant itself in the ovary, cervix or abdomen. Ectopic pregnancies never result in a live birth.

When the fertilized egg begins to grow in the wrong place, it can cause the organ in which it has implanted itself to burst. This is what makes ectopic pregnancies potentially life threatening for the women that have them. But they don't have to be. Recognizing the symptoms of an ectopic pregnancy early on can not only help save your life, but it can also decrease your risk of scarring and future fertility problems.

Signs and Symptoms
Unfortunately, some of the main ectopic pregnancy symptoms are similar to the signs of a regular pregnancy, making it easy to ignore the potential red flags. The most common symptoms of an ectopic pregnancy are:

• a late period
• unusual vaginal bleeding (unusual color, flow, or consistency)
• a positive pregnancy test
• fainting, lightheadedness, or dizziness
• pain in your lower abdominal
• shoulder pain
• bladder or bowel pain

Feeling sharp, stabbing pain, especially in your abdomen, is a big warning sign that you may be having an ectopic pregnancy. If you experience a combination of any of these symptoms, make an appointment with your health care provider as soon as you can and ask them to test you for an ectopic pregnancy.

Diagnosing an Ectopic Pregnancy
Although the rates of ectopic pregnancy are on the rise, more and more health care providers are screening their female patients for ectopic pregnancies. This means that more women can be diagnosed and treated earlier, resulting in fewer deaths from this complication.

If you do not already have a confirmed pregnancy, your health care provider will offer you a urine pregnancy test. If this comes up positive, a blood test will be ordered to measure your levels of hCG (human chorionic gonadotropin). Based on the date of your last menstrual period and the approximate length of your pregnancy, an appropriate hCG levels can be assumed. HCG levels in an ectopic pregnancy tend not to rise as quickly as they would in a regular pregnancy. If your bloods tests show that your hCG levels are lower than they should be, there is a very good chance you are experiencing an ectopic pregnancy.

Your health care provider will probably also do a pelvic exam to see if there are any signs of pregnancy. She or he will also be checking for anything that seems unusual. Alternatively, an ultrasound can also be used to check for and confirm an ectopic pregnancy. However, getting an accurate visual diagnosis of an ectopic pregnancy is not always easy.

Since it is hard to visually detect any kind of pregnancy before six weeks, if you suspect you are experiencing an ectopic pregnancy early on, you may require regular monitoring of your hCG levels until you reach the six-week mark. If, by this time your hCG levels are still not rising as fast as they should be, an ultrasound can be used to determine the likelihood of an ectopic pregnancy.

Treatment
If it is caught early enough, ectopic pregnancy treatment can be quite simple. Methotrexate is administered to women who have been diagnosed with an ectopic pregnancy in the early stages. This is an injected drug that will dissolve the fetus and allow the body to reabsorb it. It is a noninvasive procedure and reduces the amount of scarring to your reproductive organs.

More advanced cases of ectopic pregnancies require surgery to end the pregnancy. While in the past this was major surgery and required a large incision to be made, today the procedure has been simplified into laparoscopic surgery.

A laparoscope is a long and hollow tube that has a light on the end, allowing the doctor to see inside and insert telescopic surgical tools. This procedure is not very invasive; only a small incision (big enough for the laparoscope) is made in your lower abdomen. Sometimes, another small incision is made for the surgeon's tools. If there is extensive internal damage or bleeding, a more invasive procedure may be required.

After your treatment, you will require further monitoring and a follow-up to ensure that your hCG levels return to zero. If the levels do not decrease, you may require further treatment, usually with methotrxate to dissolve any residual pregnancy material.

It is important to receive treatment for an ectopic pregnancy as soon as possible. If left untreated, an ectopic pregnancy can result in the mother's death.

In the Future
Many women who have experienced an ectopic pregnancy worry about their chances of successfully conceiving later on. Although experiencing an ectopic pregnancy puts you at a greater risk of having the same complication in the future, many women go on to successfully conceive a child a year after their ectopic pregnancy. However, if your reproductive organs have been severely damaged, either by the ectopic pregnancy itself or by the surgery required to treat it, then your fertility may be hindered. Speak with your health care provider about any concerns you may have regarding your fertility after treatment for an ectopic pregnancy.

Risks and Prevention
Damage to the fallopian tubes, either through scarring or a blockage, is one of the main causes of an ectopic pregnancy. Scarring can be caused by surgery but it can also be caused by infections, like pelvic inflammatory disease, gonorrhea and chlamydia. Seeking immediate treatment for these problems can minimize your risk of scarring and help prevent an ectopic pregnancy.

Other factors that can increase your risk for ectopic pregnancy include becoming pregnant after the age of 35, previously experiencing an ectopic pregnancy, and having surgery on your fallopian tubes. Unfortunately, these risk factors are not always preventable.

Additionally, if you have an IUD in place when you become pregnant, there is a good chance the pregnancy will result in an ectopic pregnancy. Receiving fertility treatments can also increase your risk.

Identifying the signs of an ectopic pregnancy early on will not only minimize any scarring incurred by the treatment, it may also save your life. If you think you may be pregnant, or if you know you're pregnant, and feel any discomfort or pain (especially in your stomach), make an appointment with your health care provider right away.

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