DEFINITION– An ectopic pregnancy is a pregnancy that grows in a location other than the lining of the uterus. Most ectopic pregnancies (95%) occur within a fallopian tube.
Rare locations include on the cervix, in the abdomen, or on an ovary. An ectopic pregnancy cannot survive because only the uterus can support the growth of a fetus and its placenta.
CAUSES-
• An infection or inflammation of the fallopian tube can cause it to become partially or entirely blocked.
• Scar tissue from a previous infection or a surgical procedure on the tube may also impede the egg’s movement.
• Previous surgery in the pelvic area or on the tubes can cause adhesions.
• Abnormal growths or a birth defect can result in an abnormality in the tube’s shape.
• Maternal age of 35-44 years
• Previous ectopic pregnancy
• Previous pelvic or abdominal surgery
• Pelvic Inflammatory Disease (PID)
• Several induced abortions
• Conceiving after having a tubal ligation or while an IUD is in place
• Smoking
• Endometriosis
• Undergoing fertility treatments or are using fertility medications
TYPES-
1) Tubal pregnancy
2) Abdominal pregnancy
3) Cervical pregnancy
SIGN AND SYMPTOMS-
• Sharp or stabbing pain that may come and go and vary in intensity. (The pain may be in the pelvis, abdomen, or even the shoulder and neck due to blood from a ruptured ectopic pregnancy gathering up under the diaphragm).
• Vaginal bleeding, heavier or lighter than normal period
• Gastrointestinal symptoms
• Weakness, dizziness, or fainting
DIAGNOSIS-
Vaginal ultrasound
Blood tests
Laparoscopy
MANAGEMENT-
The main treatment options are:
• expectant management – your condition is carefully monitored to see whether treatment is necessary
• medication – a medicine called methotrexate is used to stop the pregnancy growing
• surgery – surgery is used to remove the pregnancy, usually along with the affected fallopian tube
A laparoscopic approach is preferable. A salpingectomy should be performed, unless the woman has other risk factors for infertility, in which case a salpingotomy should be undertaken.