Ectopic Pregnancy
Ectopic pregnancies occur outside of the uterus. They commonly implant in the fallopian tubes which is potentially life threatening. Less than 2% of all pregnancies are ectopic. Normal growth and development of the foetus cannot proceed in an ectopic pregnancy.
Signs & symptoms
- Vaginal bleeding, most commonly light or spotty, accompanied by cramping, abdominal or pelvic pain.
- Any pain that accompanies nausea and vomiting, as well as dizziness or fatigue. If the fallopian tube ruptures, it can cause sudden and severe pain in the abdomen and the internal bleeding.
- Light internal bleeding can cause nerve irritation which can lead to pain in other parts of the body, most commonly in the right shoulder.
- Extensive bleeding in the abdomen can cause an increased heart rate, lightheadedness, fainting and shock.
Causes
Most of the time no cause is found. Normally conception happens in the fallopian tube and later the pregnancy travels down to and implants in the uterine cavity. Anything which delays this process can lead to an ectopic pregnancy.
Diagnosis of ectopic pregnancy is made with an ultrasound.
Treatments
Laparoscopic surgery is usually required for an ectopic pregnancy. Many women need a salpingectomy (removal of a fallopian tube). In some cases, a ‘wait and watch’ management plan can be utilised as some ectopic pregnancies can resolve spontaneously. Occasionally an injection of methotrexate is used in treatment of ectopic pregnancy.
Risk Factors
Women are at an increased risk of ectopic pregnancy if they have:
- previously had ectopic pregnancies are more likely to have another as their chance of having another ectopic pregnancy is increased by ten-fold.
- inflamed or damaged uterine tubes or an infected uterus, uterine tube or ovary, usually due to diseases such as gonorrhea or chlamydia, or history of pelvic inflammatory diseases.
- fertility issues
- had invitro fertilisation (IVF)
- fell pregnant with an intrauterine device or have previously had tubal device
- become pregnant after using an emergency contraception (morning after pill)