Ectopic Pregnancy

Types of Ectopic Pregnancy | Treatment

Ectopic Pregnancy is one of the serious complications of pregnancy where egg implants outside the uterine cavity. Most of the ectopic pregnancies occur in fallopian tubes and called tubal pregnancy but implantation can also take place in cervix, ovaries and abdomen. A typical ectopic pregnancy does not develop into a live birth. Causes: There are several factors which raise the risk of the ectopic pregnancy:

  1. Fallopian tube problems : If one of the fallopian tubes is damaged or blocked, the embryo cannot reach the womb. The most common causes of tubal damage may be previous pelvic infections, endometriosis and use of intrauterine devices.
  2. Smoking: Smoking is also associated with greater risks of ectopic pregnancy. Nicotine stimulates the contractions in the fallopian tubes resulting in blockage of fallopian tubes.
  3. Surgery: Previous abdominal surgery that involves the reproductive system increases the chances of ectopic pregnancy.
  4. Medications: Many hormonal medications are associated with ectopic pregnancy which includes fertility drugs and contraceptives.

Symptoms:

  1. Irregular bleeding
  2. Missed menstrual period
  3. Shoulder pain
  4. Fainting
  5. Shock as result of low blood Pressure
  6. Excessive Bleeding
  7. Pelvic Pain
  8. Bluish discoloration around the naval.

Types of Ectopic Pregnancy

1.     Tubal Pregnancy: It is the most common type of ectopic pregnancy as it occurs in fallopian tubes.

2.     Nontubal ectopic pregnancy

Nearly two percent of the ectopic pregnancies occur in ovaries, cervix or in intra-abdominal area.

  1. Heterotropic pregnancy

It is very rare occurring pregnancy where there may be two fertilized eggs, one outside the uterus and other inside.

  1. Persistent ectopic pregnancy

It is the continuation of trophoblastic growth after a surgical intervention to remove an ectopic pregnancy. Diagnosis:

  1. Blood Tests for HCG are done to diagnose ectopic pregnancy at an early stage if suspected.
  2. Vaginal Ultrasound can be obtained.
  3. Serum progesterone levels can be checked to rule out the presence of ectopic pregnancy. If these levels are lower that 15ng/ml, then there is the occurrence of ectopic pregnancy.

Treatment:

  1. Medical treatment is also possible. This involves the use of anti-cancer drugs which affect the growth of rapidly dividing cells of tubal pregnancy and kills them thus preventing the pregnancy from growing further. If the diagnosis is made early, this treatment is very successful.

Tubal pregnancies can also be treated under the guidance of ultrasounds. This involves the injections of toxic chemicals, potassium chloride into the fetus in the tube but it is normally done under the proper guidance of ultrasounds. This kills the pregnancy tissue and thus allows the body to reabsorb it. Surgical treatment for early tubal pregnancies can be done through the laparoscope as well; with salpingotomy, the pregnancy can be selectively removed and the tube saved. Emergency surgical treatment is required if the tube has ruptured and the blood has collected in the abdomen because in such cases the tube is extensively damaged that it has to be removed necessarily and entirely. It can also hinder the fertility in future.

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