Ectopic Pregnancy



Ectopic means abnormal place or position. So when a pregnancy implants at a place other than the uterus it is called ectopic pregnancy. Almost all ectopic pregnancies occur in the fallopian tube and so they are commonly referred as tubal pregnancies.


The fallopian tubes are thin and not the suitable location for pregnancy to grow. All ectopic pregnancies have to end. An ectopic pregnancy happens in 1 out of 50 pregnancies.


There are few outcomes whenan ectopic pregnancy develops

  1. Diagnosed early can be treated with medical treatment
  2. Can result into a tubal abortion
  3. Ruptures inside the abdomen and then requires immediate surgery to save maother's life
  4. Diagnosed before rupture and then the pregnancy is removed either along with the tube or from the tube while trying to save the fallopian tube.

Risk factors for an ectopic pregnancy

  1. Maternal age of 35-44 years
  2. Previous ectopic pregnancy
  3. Pelvic inflammatory disease
  4. Previous pelvic or abdominal surgery
  5. Smoking
  6. Endometriosis
  7. Fertility treatment

Symptoms of an ectopic pregnancy?

These can be variable and one needs to be alert to diagnose ectopic pregnancy before it ruptures and causes bleeding inside abdomen. Once this happens there is an emergency to reach hospital as fast as possible and undergo a sugery within matter of minutes. Infact this is one condition where we undertake the surgery as we are resucitating the patient to prevent further blood loss.
However today we diagnose ectopic pregnancy before it ruptures with help of blood tests (HCG) and ultrasound examination.

Some symptoms if present can suggest ectopic pregnancy are as follows

  1. Stabbing pain that maybe spasmodic or continuous. The pain is usually in lower abdomen, or back. Rarely near shoulder and neck due to blood from a ruptured ectopic pregnancy collecting under the diaphragm.
  2. May or maynot miss the period. But the last period is usually light.
  3. Gastrointestinal symptoms, bloating, constipation or intestinal hurry
  4. Weakness, dizziness, or fainting

Treatment

  1. Medical- Un-ruptured early ectopic pregnancy can be treated by Methotrexate injection. With this treatment the pregnancy in the tube shrivels and is absorbed by the body preventing the need for surgery.
  2. Surgery to stop the bleeding by removing the tube (Salpingectomy) or removing the pregnancy from the tube and saving it (Salpingostomy)

Laparoscopic surgery under general anesthesia is the method of choice for treating ectopic pregnancy. This is done in both situations whether there is rupture or not. In our unit @ Apollo Hospitals we treat ectopic pregnencies exclusively by minimally invasive surgery.




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