What is an ectopic pregnancy?
Ectopic pregnancy happens when a fertilized egg gets stuck in the
fallopian tube and begins to grow there, instead of traveling down the tube and settling in the
uterus. It is also called
tubal pregnancy.
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What's wrong with an ectopic pregnancy?
An ectopic pregnancy is doomed from the start. The
fallopian tube is narrow and can't stretch very well. In a few short weeks the developing
embryo will be too large for the tube and the embryo will die.
An ectopic pregnancy is harmful for the mother as well. When the embryo gets too big for the fallopian tube, the tube will break open, which will cause internal bleeding. That's why it's extremely important to diagnose and treat an ectopic pregnancy.
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Why does an ectopic pregnancy occur?
The most common cause of ectopic pregnancy is scarred
fallopian tubes, which are caused by
sexually transmitted diseases. Extra scar tissue blocks the passageway of the tubes, so there's not enough room for the egg to pass through. If your fallopian tubes are scarred, you have a greater chance of having an ectopic pregnancy. Anyone who has had one ectopic pregnancy is much more likely to have another one.
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Can I prevent an ectopic pregnancy?
Not really. But since we know that certain pelvic infections can scar the fallopian tubes, using a
condom will definitely help. A condom protects you against sexually transmitted diseases (STDs). If you don't get an STD, you have a better chance of having healthy, undamaged fallopian tubes. But not all ectopic pregnancies are caused by STDs.
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What are the symptoms of an ectopic pregnancy?
The most common symptom of ectopic pregnancy is pain. The pain usually is sharp and located on one side of the belly. The pain comes from the stretching of the fallopian tube.
Bleeding from the
vagina can be another symptom of ectopic pregnancy. This bleeding is not a sign of internal bleeding. It means that the levels of pregnancy hormone in the person's body are not normal and are causing problems.
If an ectopic pregnancy breaks open, it causes the person to bleed internally. This causes intense belly pain. The blood in your body may also bother the diaphragm, which is the thin muscle that separates the stomach area from the chest. Pain from the diaphragm is often felt in the shoulder. That's why belly pain with shoulder pain is considered an important sign of internal bleeding.
If you have any of these symptoms, see your health professional right away. You may be pregnant and not know it and have an ectopic pregnancy.
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How does the doctor diagnose an ectopic pregnancy?
An
ultrasound test can show whether a pregnancy is developing normally in the
uterus. But often the ultrasound will give mixed results. It might not find any pregnancy in the uterus. It might not find anything strange or abnormal outside the uterus either. If that happens, other tests must be used. They can tell the difference between a pregnancy that's too early to be seen on an ultrasound and an ectopic pregnancy.
Your health professional may do a blood test to measure the level of pregnancy hormone (
human chorionic gonadotropin or HCG) in your body. In a normal pregnancy, the HCG level should double every 48 hours. In an ectopic pregnancy, the level often does not rise this way.
If your health professional thinks you're bleeding internally, there's no reason to wait 48 hours to figure out if you have an ectopic pregnancy. In that case, the doctor can perform a
laparoscopy. Laparoscopy is a surgical procedure. The doctor makes a tiny cut below your navel. A
laparoscope is inserted through the incision and into the stomach area. The doctor can easily see an ectopic pregnancy with the laparoscope.
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How do you treat an ectopic pregnancy?
Every ectopic pregnancy must be treated. Small ectopic pregnancies without any sign of internal bleeding can be treated with a drug called
methotrexate, which has very few side effects. You'll get a shot of this drug in your health professional's office and do not need to be admitted to the hospital. After treatment you'll need to have a few more blood tests to measure the HCG in your body. When there's no more HCG, that's a sign that the treatment has worked. About 5% of women treated with methotrexate will not be cured and will need to have surgery.
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What happens if you don't treat an ectopic pregnancy?
An untreated ectopic pregnancy will eventually cause the fallopian tube to burst. This can cause severe bleeding in your belly which may be life threatening.
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What are the chances of having another ectopic pregnancy?
A woman who has had an ectopic pregnancy in the past is more likely to have another one. That's probably because one or both fallopian tubes are damaged in some way. A woman who's had one ectopic pregnancy has a 10% chance of having another one.
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