Definition In about 1% of all pregnancies, the egg will stay out of the uterus into the abdominal cavity, ovaries or fallopian tubes. This is called ectopic pregnancy (EP), that is to say that pregnancy occurs outside the uterus. Most often, they are tubal pregnancies.
An ectopic pregnancy can be life-threatening to the mother. With new examination techniques, the USG is usually already detected during the first inspection of pregnancy and the doctor can then initiate treatment.
Causes
In about half the cases, tubal pregnancy is due to a disturbance in the transport of the egg in the fallopian tubes. The egg is not routed to the uterus and lodges in the fallopian tubes. The causes are inflammation of the fallopian tubes (often by Chlamydia bacteria) or regulation disorders of the egg.
Risk factors that may cause tubal pregnancy:
surgery of the abdomen or pelvis
abdominal pregnancy or a history of tubal pregnancy
Contraceptive IUD or intrauterine device
artificial inseminations
Lesions of the fallopian tubes caused by abortions, ligatures or surgeries
Morning after pill
Initially, an ectopic pregnancy is developed like a normal pregnancy. Often the signs of pregnancy pass totally unnoticed. The signs are a lack of rules with pain in the lower abdomen and test positive pregnancy.
Immediate medical attention is required in case of:
and severe abdominal pain of unknown origin, especially in cases of suspected pregnancy (missed period, positive pregnancy test)
vaginal bleeding (spotting or bleeding similar to those rules)
Malaise, dizziness, fainting
Symptoms that may indicate a rupture of the fallopian tube (medical emergency)
growing pains and of undetermined origin in the lower abdomen
swollen belly
Dizziness up to fainting (for internal bleeding)
General malaise important
growing pains and of undetermined origin in the lower abdomen
swollen belly
Dizziness up to fainting (for internal bleeding)
General malaise important
Examinations (diagnosis)
History taking into account the patient’s symptoms
Pregnancy test
gynecological examination
Ultrasonic examination (through the vagina)
Blood test: measurement of the pregnancy hormone (HCG)
treatment options
An ectopic pregnancy is detected and supported as soon as possible by removing the embryo.
Surgical intervention
Laparoscopy: in most cases, during the minimally invasive surgery (small incision), the embryo is located and removed.
Laparotomy (abdominal incision) in the case of risk of rupture of the fallopian tube or in the presence of a rupture (severe blood loss), it is necessary to open the abdominal cavity. Laparotomy will also be necessary if the doctor fails to eliminate the embryo by laparoscopy, for example due to adhesions.
pharmaceuticals
In some cases, a methotrexate infusion can block cell division. In this case, the embryo dies and is removed spontaneously. However, this method is only possible in very early pregnancy.
possible complications
In most tubal pregnancy, the embryo does not continue to grow. This often results in spontaneous abortion (miscarriage).
The pursuit of an ectopic pregnancy can be life-threatening to the mother.
In the most severe cases, rupture of the fallopian tube accompanied by internal bleeding occurs. In this case, the life of the mother is threatened (shock, circulatory collapse).
After acute complications, the fertility of the patient is often reduced and the risk of another ectopic pregnancy is high.
Anna Leake is a health blogger that focuses on topics related to nutrition, fitness, and mental health. She was born in New York City but at age 6 moved to the Midwest where she spent her childhood exploring nature with friends and family. Anna graduated from University of Michigan-Ann Arbor with degrees in psychology & human development.
