Last month a friend of mine telephoned me and said that his wife aged around 34 years suddenly developed, sharp lower abdominal pain associated with fainting and shoulder pain. Though he asked me to suggest some tablets to relieve her abdominal pain I did not recommend them. On the other hand, I asked him to bring her to my clinic immediately. On examining her clinically it was found a low blood pressure. On further inquiry, her periods were stopped for three months. I suspected the cause for such a sharp lower abdominal pain could be an ectopic pregnancy.
What is Ectopic Pregnancy?
An ectopic pregnancy happens when a fertilized egg implants outside of the uterus, most commonly in the fallopian tube. The fallopian tube isn’t made to hold a growing embryo; therefore this condition can lead to bleeding in the pregnant women. An ectopic pregnancy is a life-threatening condition that requires emergency treatment. It is usually detected around 12 weeks after stopping the periods. However, some women don’t experience symptoms until later, or they may not have any symptoms at all. When a tube bursts, usually unbearable abdominal pain with giddiness or fainting is exhibited. Tubes hear refer to fallopian tubes. The uterine tubes or fallopian tubes are paired tubular sex organs in the human female body that stretch from the ovaries to the uterusThe fallopian tubes are part of the female reproductive system.
So by now it is understood that a pregnancy happens outside of the uterus. This occurs when a fertilized egg implants in a location that can’t support its growth. An ectopic pregnancy most often happens in the fallopian tube (a structure that connects the ovaries and uterus). Ectopic pregnancies more rarely can occur in the ovary, abdominal cavity, or cervix. Pregnancies can’t continue if they’re ectopic because only uterus is meant to carry a pregnancy.
Ectopic pregnancies can become life-threatening, especially when the fallopian tube breaks (ruptures). This is a ruptured ectopic pregnancy, and it can cause severe bleeding, infection and sometimes, death. This is a medical emergency. Medical experts/gynecology experts must treat ectopic pregnancies quickly.
Where does an ectopic pregnancy happen?
The egg is meant to travel down from the fallopian tubes and embed itself into the wall of the uterus, where it can develop. In an ectopic pregnancy, the egg implants in one of the structures along the way. The most common place this can happen is inside the fallopian tubes. The majority of ectopic pregnancies happen here which is about 90%. Ectopic pregnancies occur in about 2% of all pregnancies.
What are the symptoms of an ectopic pregnancy?
The early symptoms of an ectopic pregnancy can be very similar to typical pregnancy symptoms. However, one may experience additional symptoms during an ectopic pregnancy, including vaginal bleeding, pain in the lower abdomen, pelvis and lower back, dizziness or weakness.
In most cases, conditions that slow down or block the movement of the egg down the fallopian tube cause ectopic pregnancy. This could happen because due to scar tissue, adhesions, or inflammation from prior pelvic surgery. Or damage to fallopian tubes such as from a sexually transmitted infection STI or congenital which means born with an irregularly-shaped fallopian tube also having a growth-blocking fallopian tube.
Risk factors of Ectopic pregnancy:
Several risk factors could increase the chance of developing an ectopic pregnancy, such as an earlier ectopic pregnancy, a history of pelvic inflammatory disease (PID) which is a bacterial infection that affects the female reproductive organs, including the uterus, fallopian tubes, and ovaries. Such infections can cause scar tissue to form in the fallopian tubes, uterus, ovaries, and cervix, surgery on the fallopian tubes (including tubal ligation) or on the other organs in the pelvic area, and treatment for infertility with in vitro fertilization (IVF), are also the risk factors. Endometriosis is a disease in which tissue similar to the lining of the uterus grows outside the uterus, sexually transmitted infections (STIs), an IUD (intrauterine device) in place at the time of conception, a history of smoking tobacco also a threat. As a whole ectopic pregnancies are more common in these situations. Further risk can also increase with age, and people over age 35 have a higher risk than people less than 35 years. Nevertheless, up to 50% of women who experience an ectopic pregnancy may not have any of the above risk factors.
The complications of an ectopic pregnancy, diagnosis and relevant tests management and treatment and prevention aspects will be discussed in the coming issues (to be concluded).