Ectopic or tubal pregnancy  is a noteworthy pregnancy complication. Fortunately it is not common but should be identified and treated as soon as possible.

After fertilization, egg implants to the inside of the uterus. Ectopic pregnancy occurs when egg attaches itself outside of the uterus, most commonly in the fallopian tube(that’s where the term tubal pregnancy comes from). Embryo can not continue proper development outside of the uterus and if left untreated, can be life threatening or cause serious damage to the mother.

Symptoms

As ectopic pregnancy occurs in the beginning of the pregnancy it may happen that a female does not yet know about her condition. Therefore, it is also possible that there are no present symptoms. When the pregnancy test is positive and there are other early pregnancy signs too (sore breasts, nausea..), it is important to watch out for following symptoms:

• Vaginal spotting or bleeding – bleeding might vary from light to heavy. After getting a positive pregnancy test, beginning of red/brown bleeding or spotting should not be left inattentively. Ectopic pregnancy may also cause the fallopian tube rupture which may lead to severe bleeding. In this case doctor should be contacted immediately.
• Pelvic pain
• Abdominal pain  – pelvic or abdominal pain might be of different intensity(mild, sharp,severe) and appear irregularly. Pain may be on the one side of the body.
• Shoulder or neck pain – ectopic pregnancy might cause internal bleeding. Blood will then gather under the diaphragm and irritate the nerves that go in the area.
• Weakness, dizziness
• Fainting

Causes and risk factors

In reality, it might be complicated to find out the cause of ectopic pregnancy. However, commonly, the problem is caused by the damaged fallopian tube that prevents egg from getting into the uterus, leaving it no other way but to implant outside of it. Common causes of blocked tube include:

• Pelvic infection and inflammation
• Scar tissue from previous surgery
• Abnormal growth that changes tube’s shape

Ectopic pregnancy might happen to anyone, however,there are several risk factors that might increase the chances. They include :

• Maternal age above 35
• Having experienced ectopic pregnancy before
• Pelvic inflammatory disease
• Previous pelvic surgeries
• Endometriosis
• Smoking
• Fertility drugs

Diagnosis and treatment

Ectopic pregnancy can be diagnosed through several methods :

• Pregnancy test to confirm the pregnancy
• Ultrasound – is used to check the location of the embryo, whether it is in the uterus or fallopian tube. Because an embryo can not continue proper development anywhere other than uterus, mother might have already miscarried before the exam. It is also possible than a female is on such an early stage of pregnancy that an embryo cannot yet be seen. Swollen fallopian tube or tissues left from the embryo will help to clarify the situation.
• HCG levels – HCG is is a hormone that is produced during pregnancy. Provided that the pregnancy is confirmed, HCG levels should not be lower than expected.
• Pelvic exam – will help to locate pain and check for tenderness in the abdomen.

If ectopic pregnancy is diagnosed, the treatment will vary according to the condition. Unfortunately, there is no way to transplant embryo in the uterus, so removing pregnancy tissues is the only way to support mother’s recovery. Remember that if the fallopian tube ruptures, it will cause severe bleeding and can lead to fatal consequences.

Treatment with Methotrexate

If ectopic pregnancy is identified on the early stage of pregnancy and there has been no damage to fallopian tube, the injection of methotrexate can be performed. It will stop cells from developing and allow the body to absorb remaining tissues instead.

Surgical Treatment

On later stages, medication might not be helpful and a small surgery will need to be performed. Laparoscope, a relatively thin instrument will be inserted through a very small incision in the abdomen. Remaining pregnancy tissues will be removed with the instrument. Surgery itself is called laparoscopy. According to the situation, fallopian tube might need to be removed during the laparoscopy.

When fallopian tube is already ruptured and a woman is experiencing heavy bleeding, emergency surgery will need to be done. It is called laparotomy and is performed through a larger incision.

Future Perspectives

Thinking about future pregnancy can be hard after a painful experience. Doctors may suggest to wait for 6 months approximately until the next try, however the duration may vary according to the treatment and the actual reason that caused the problem. If the fallopian tube was not removed, HCG levels should be checked regularly to see if the ectopic tissue was removed completely. If the results are 0, the recovery is progressing well and there is a good chance to have a successful pregnancy.

When the tubes are very damaged and a woman can not conceive naturally, remember that IVF treatment is a way to successful pregnancy and parenthood.