Ectopic Pregnancy - A Better Understanding

WHAT IS AN ECTOPIC PREGNANCY?

The dictionary definition of the word ‘Ectopic’ is an organ or body part existing in an unusual position or form. In simple terms, an ectopic pregnancy is a pregnancy, which is developing in the wrong place. An ectopic pregnancy occurs when the fertilized egg (or ovum) fails to move down the fallopian tube and into the womb (or uterus) in the normal manner. Instead, the egg or ovum implants itself outside of the womb. Most often, (in 95% of cases), ectopic pregnancies develop in a fallopian tube and rarely, elsewhere in the abdominal cavity or pelvic area. For example, an egg can attach itself on an ovary, on the neck of the womb (cervix) or on another organ within the pelvic or abdominal area (1.5% abdominal, 0.5% ovarian & 0.03% cervical). Ectopic pregnancies do not usually survive and many will result in a spontaneous miscarriage, others will develop until a serious problem becomes apparent, which will require immediate medical attention.

WHAT CAUSES AN ECTOPIC PREGNANCY?

Sometimes the ovum fails to implant itself and it becomes fertilised outside of the reproductive system. More commonly, the fertilised ovum is trapped, in the fallopian tube and the baby continues to grow inside the tube where it can cause the tube to burst or otherwise severely damage it. A burst tube is life threatening and requires urgent medical attention.

In many cases, ectopic pregnancies occur when the expectant mother has damaged fallopian tube(s). Tubes damaged, by infections such as pelvic inflammatory disease or by previous surgery, scar tissue, endometriosis or previous ectopic pregnancies are a high-risk factor, which significantly, increase the likelihood of a pregnancy being ectopic. Another risk factor associated with ectopic pregnancies is becoming pregnant, whilst using a contraceptive-coil or a progestogen only contraceptive pill. Pregnancies resulting from in vitro fertilisation (i.e. test-tube methods) can be ectopic - even though, the fertilised egg is placed directly into the womb, it may still attach itself elsewhere. In some cases, none of the above risk factors are present in the expectant mother.

WHAT ARE THE WARNING SIGNS OF AN ECTOPIC PREGNANCY?

Pain In the Abdomen - The first sign of an ectopic pregnancy can be a pain on one side of the abdomen. This pain can be constant and severe and its onset, sudden.

Pain in the Shoulder - An alternative warning sign could be a pain in the shoulder, which intensifies when breathing in and out.

Pain Using the Lavatory - If you suspect you are pregnant and experience pain during visits to the bathroom you should report this to your medical practitioner.

Other Warning Signs

Vaginal bleeding or unusual periods, lighter or heavier than normal, or a strange colour etc
Sickness
Diarrhoea
Pallid complexion (paleness)
Light-headedness
Collapse
Increasing pulse rate
Falling blood pressure

DIAGNOSING AN ECTOPIC PREGNANCY

Ectopic pregnancies can be hard to detect as in many cases, the symptoms are no different from those of a normal, early pregnancy, i.e. tender breasts, nausea, vomiting, missed periods or frequent urination. If you are a sexually active woman of childbearing age and you experience symptoms of an early pregnancy plus any, of the above warning signs, of an ectopic pregnancy, contact your medical practitioner immediately.

A urine pregnancy test will usually be positive but is not always apparent. However, a specialised hCG blood test will always show a positive result. If a pregnancy is ectopic, the womb will often be smaller than the average womb at that stage of pregnancy and this will be detected during an internal pelvic examination. A doctor can sometimes detect a swelling, during an internal examination, which is evidence of an ectopic pregnancy existing.

An ultrasound scan will differentiate between a possible miscarriage, a normal pregnancy and an ectopic pregnancy.

The majority of women diagnosed with an ectopic pregnancy will require surgical intervention and/or medication. In the worst-case scenario, without this intervention, an ectopic pregnancy can be fatal to the mother. Medical and technological advancements mean that ectopic pregnancies are easier to detect than ever before and therefore, they carry less risk than they did in previous years. Technological advancements have significantly improved the treatment of ectopic pregnancies - keyhole surgery is just one example of this.

It is vital to seek the opinion of a medical practitioner if you suspect you are carrying an ectopic pregnancy.

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