What is Ectopic Pregnancy? Can it be prevented? Expert reveals details
In an exclusive chat with Asianet News, Dr. Sameena, Consultant- Obstetrics and Gynaecologist KMC Hospital, Mangalore, spoke about ectopic pregnancy, its complication, cure and much more.
Motherhood is one of the most beautiful and valuable experiences of a woman's life. But sometimes, the process of being pregnant is not an easy one. The journey of becoming a mother can sometimes face biological problems and hindrances. One such type of pregnancy is Ectopic pregnancy. Let's learn in detail about this pregnancy with the help of an expert.
Q: What is Ectopic pregnancy?
A: Ectopic pregnancy occurs when a developing embryo implants at a site other than the inside wall of the uterus.
Q: What causes ectopic pregnancy?
A: It happens because of the altereo motility of fallopian tubes.
Q: By any means, can this type of pregnancy be prevented?
A: By avoiding repeated infections and avoiding the self-intake of abortion, pills can prevent this type of pregnancy.
Q: How can one know about such pregnancy without an ultrasound, are there any symptoms?
A: Usually, the symptoms appear early in pregnancy, sometimes before the woman realizes she is pregnant. The most common symptoms are: Abdominal pain, a missed menstrual period, vaginal bleed, Pregnancy symptoms (breast tenderness, frequent urination or nausea). However, some women have no symptoms until the fallopian tube ruptures. Following this, the woman may experience severe pain, vaginal bleeds, lightheadedness, followed by a drop in blood pressure, fainting and shock.
Q: Is ectopic pregnancy one of the factors for infertility?
A: Yes. Infertility is one of the moderate risk factors of ectopic pregnancy.
Q: What are the doctor-recommended treatments for such pregnancy?
A: Treatment starts as soon as a diagnosis of ectopic pregnancy is confirmed and includes either medication or surgery.
Medical management: A medication called Methotrexate, which grows the embryo, is given as an intramuscular injection (IM). It is given to women with ectopic pregnancy with minimal symptoms such as pain and whose HCG level and ultrasound results fall within the specified limits. If treatment with Methotrexate is unsuccessful, then tubular ruptures can occur. This complication can be avoided with close monitoring and surgical management ,if needed.
Surgical management: Ruptured ectopic pregnancy; surgery needs to be done immediately, especially if the woman's blood pressure has fallen and unstable. A woman who is unstable or unwilling to return for monitoring after Methotrexate.
Q: Can ectopic pregnancy ever lead to a healthy pregnancy, or its a myth?
A: An ectopic pregnancy can never lead to a healthy pregnancy
Q: How is an ectopic pregnancy different from normal pregnancy?
A: In a normal pregnancy, an egg and a sperm join to form the embryo and normally implants on the inner lining of the uterus called the endometrium. In an ectopic pregnancy, the embryo attaches to some other surface outside the uterus. If it is in the fallopian tube, it's called a tubal pregnancy. If it is at the site where the fallopian tube and the uterus joins, it's called an interstitial pregnancy.The embryo can also attach to the cervix, ovary, abdominal wall, or previous caesarean scar.
Q: Why is ectopic pregnancy dangerous?
A: Ectopic pregnancy is unable to develop normally. It can rupture the organ on which it is implanted, resulting in severe internal bleeding, shock, and woman's death in rare cases. Hence, it needs to be diagnosed and treated at the earliest.
Q: Who is at risk of ectopic pregnancy?
A: Strong risk factors: Since birth abnormalities of fallopian tubes due to previous infections/surgeries/malfunctions. Previous ectopic pregnancy.
Moderate risk factors: Previous genital infections, infertility, multiple sexual partners.
Other risk factors: IVF treatment (in vitro fertilization) Tubal ligation Intrauterine contraceptive devices.
Q: How can one know if they have an Ectopic pregnancy?
A: There are two tests to diagnose ectopic pregnancy.
Ultrasound: Preferably, a transvaginal ultrasound is done to visualize a foetal heartbeat or an embryo outside the uterus.
Serum Beta hCG: It is a blood test that measures the pregnancy hormone - Human chorionic gonadotropin (hCG). It is a substance secreted by the developing embryo/placenta. The hCG blood level is estimated to confirm a pregnancy and monitor the progress of the pregnancy.
Q: What surgery is recommended by the doctor?
A: Surgery will be performed using a laparoscopic approach or through an abdominal incision. In laparoscopy, instruments are inserted into the abdomen through a fine small incision. These instruments are used to see and remove the ectopic pregnancy and control bleeding. Compared with abdominal surgery, laparoscopy causes less pain and allows for a faster recovery.In an abdominal procedure, a surgeon opens the abdomen using a single larger incision to see and remove the ectopic pregnancy directly.
Q: Can a Fallopian tube be removed?
A: It is sometimes possible to remove the ectopic pregnancy during surgery and repair the Salpingostomy tube. In other cases, it is necessary to remove the fallopian tubes. This is required if there is uncontrolled bleeding, recurrent ectopic pregnancy in the same tube, a severely damaged tube, or a large tubular pregnancy called Salpingectomy. It may also be preferred in women who have completed the family.
Q: What are the chances of normal pregnancy in future following an ectopic pregnancy?
A: If the remaining opposite tube is normal, the chances of live birth are good.