Understanding Ectopic Pregnancy: Risks, Symptoms, Diagnosis and Treatment Options

Pregnancy begins when a fertilized egg, created by the union of sperm and egg, successfully implants in the uterus. However, complications, such as ectopic pregnancy, can occur. An ectopic pregnancy happens when the fertilized egg implants outside the uterus, often in the fallopian tubes, and this condition requires early diagnosis and treatment to prevent serious health risks.

Below are risk factors that may lead to an ectopic pregnancy:

• Previous Ectopic Pregnancy: Women who have experienced one ectopic pregnancy are at higher risk of having another.
• Prior Fallopian Tube Surgery: Previous surgery on the fallopian tubes or damage from infections or conditions like endometriosis can disrupt normal egg movement, leading to ectopic pregnancies.
• Previous Pelvic or Abdominal Surgery: Surgeries in the pelvic or abdominal area can cause scarring or changes in the reproductive organs, leading to an increased risk of ectopic pregnancy.
• Certain Sexually Transmitted Infections (STIs): Infections like chlamydia or gonorrhea can lead to pelvic inflammatory disease (PID) and cause scarring in the fallopian tubes, increasing the likelihood of ectopic pregnancy.
• Pelvic Inflammatory Disease (PID): PID, often caused by untreated STIs, can lead to scarring and damage to the fallopian tubes and surrounding organs, which can block the egg's path to the uterus.
• Endometriosis: A condition where tissue similar to the uterine lining grows outside the uterus. This can cause scarring or blockages in the reproductive system, leading to a higher risk of ectopic pregnancy.

Other factors that may increase a woman’s risk of ectopic pregnancy include:

• Cigarette Smoking: Smoking can damage the fallopian tubes and disrupt normal egg movement, leading to an increased risk of ectopic pregnancy.
• Age: Women over 35 are more likely to experience an ectopic pregnancy due to age-related changes in reproductive health.
• History of Infertility: Women with a history of infertility may have a higher likelihood of developing an ectopic pregnancy.
• Use of assisted reproductive technology, such as in vitro fertilisation (IVF)

It’s important to note that about 50% of women with ectopic pregnancies have no known risk factors. Sexually active women should be aware of changes in their bodies and seek medical attention if they notice symptoms of an ectopic pregnancy.

Most women experience the physical symptoms of an ectopic pregnancy in the 6th week of pregnancy (about 2 weeks after a missed period). You may or may not be aware that you are pregnant if your periods are irregular, or if the contraception you are using has failed.

Due to the wide variation of symptoms, diagnosing an ectopic pregnancy may be challenging. Each woman may experience symptoms differently. Some women do not experience symptoms, some may experience a few symptoms, while others may experience many symptoms.

The symptoms of an ectopic pregnancy may include:

1. Pain in your Lower Abdomen: This may develop suddenly for no apparent reason or may come on gradually over several days. It may be on one side only.
2. Vaginal Bleeding: You may have some spotting or bleeding that is different from your normal period. The bleeding may be lighter or heavier or darker than normal.
3. Pain at the Tip of your Shoulder: This pain is caused by blood leaking into the abdomen and is a sign that the condition is getting worse. This pain is there all the time and may be worse when you are lying down. It is not helped by movement and may not be relieved by painkillers. You should seek urgent medical advice if you experience this.
4. Upset Tummy: You may have diarrhoea or pain during bowel movement.
5. Severe Abdominal Pain: If the fallopian tube bursts or ruptures and causes internal bleeding, you may develop intense abdominal pain or you may collapse. In rare instances, collapsing may be the very first sign of an ectopic pregnancy. This is an emergency, and you should seek urgent medical attention.

Ectopic Pregnancy Diagnosis

Ectopic Pregnancy Treatment

Ectopic pregnancy is treated with one of three main approaches, depending on the severity of the condition and individual circumstances:

1. Expectant Management: If the fertilized egg dissolves on its own, you may be closely monitored with no immediate intervention. If not, one of the following treatments will be applied.
2. Medication: An injection of methotrexate, a medication that stops the growth of the pregnancy, may be used. This is typically recommended when the ectopic pregnancy is detected early.
3. Surgery: Laparoscopic surgery (keyhole surgery) is performed under general anesthesia to remove the fertilized egg and, in some cases, the affected fallopian tube.

Your doctor will explain the benefits and risks of each option, and the treatment choice will be based on your symptoms and test results.

While some treatments may affect future fertility, most women can still conceive naturally. Be sure to discuss any concerns with your doctor.

Make an Appointment for Ectopic Pregnancy Treatment at Gleneagles Hospitals