Pregnancy is a phase that promises new beginnings and comes with a mixed feeling of excitement, happiness and a bit of anxiety. For many, this phase could be cut short with a rude shock in form of ectopic pregnancy, a type of pregnancy that is doomed from the very beginning.
An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus. While in many cases the ectopic pregnancies resolve on their own and the pregnancy tissue passes out of the cervix on its own, in a lot of cases it doesn’t only to create trouble around the 6th week of pregnancy.
1 in 100 pregnancies are ectopic and considered an emergency situation for the pregnant woman. There are chances of it being missed by patients or doctors, and if not treated on time, it could be life threatening.
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Ectopic pregnancy can happen anywhere in the body, from ovary, fallopian tube, to cervix. The fertilized egg will die if left untreated, and the growing tissue will create a life-threatening haemorrhage.
Signs and symptoms of ectopic pregnancy
One has to be watchful of the signs and symptoms of ectopic pregnancy, especially after 6 weeks or so.
“Whenever pregnancy occurs you can’t differentiate whether it is normal or ectopic. But after 6 weeks or so, patient will have excruciating abdominal pain which is a very classical sign,” says Dr Mayur Das, Senior Consultant Obstetrics and gynaecology, Cloudnine Group of Hospitals, Patparganj, New Delhi.
“Ectopic pregnancy is an emergency and it’s really important to spread awareness about it in patients as well as gynaecologists. Nowadays, we are seeing that ectopic might be missed at times. While in 95% chances, the pregnancy occurs in uterus normally, but there are chances of it occurring outside the uterus in fallopian tube, in the ovary or in the abdominal cavity, maybe in the cervix,” says Dr Das.
“The fallopian tube, which delivers eggs from the ovaries to the uterus, is the most common location of an ectopic pregnancy which is also known as tubal pregnancy,” says Dr Manju Gupta, Senior Consultant Obstetrician & Gynecologist, Motherhood Hospital, Noida.
How to know for sure if it’s an ectopic pregnancy
A urine pregnancy test can be taken using a pregnancy kit readily available in the market to determine pregnancy. However, that does not make it clear whether the pregnancy is normal or ectopic.
It is important to consult with your gynaecologist so that they can get a Beta HCG test done twice 48 hours apart to know whether the pregnancy is inside uterus (a normal one) or not. The diagnosis of ectopic pregnancy can be done through trans vaginal ultrasound, according to Dr Das.
How C-sections can increase risk of ectopic pregnancies
Experts say there is an increased incidence of scar ectopic pregnancies due to increase in caesarean sections as there are more chances that the next pregnancy can occur at the previous scar.
“In normal course of things, eggs come out of the ovary and goes to fallopian tube and fertilisation occurs at the fallopian tube only. If there is any defect in the fallopian tube, then the fertilized egg remains in the fallopian tube and the ectopic pregnancy will occur there itself. This entrapment can happen in case of C-sections as there is a previous scar and it is supposed to be an irregular area,” says Dr Das explaining how an ectopic pregnancy can occur at a scar.
“Previous ectopic pregnancy, abnormal fallopian tubes, maternal DES usage, endometriosis, history of tubal surgery, and use of an IUD device are all high-risk factors. A history of sexually transmitted diseases or pelvic inflammatory disease, infertility, many sexual partners, and cigarette smoke exposure are among the moderate risk factors. Douching, previous abdominal surgery, and elective abortions are all Low-Risk Factors,” says Dr Gupta.
Dr Das says patients more than 35 years of age or those with history of previous surgeries done on fallopian tube or previous caesarean scars are more at risk of an ectopic pregnancy.
How ectopic pregnancy can turn life threatening
Ectopic pregnancy can be life-threatening for the pregnant woman if it is not diagnosed and treated quickly. Treatment will not be able to save the pregnancy.
Ectopic pregnancies can rupture in the fallopian tube or ovary or wherever it is. In such cases, emergency surgeries are to be done, says Dr Das.
“Internal bleeding, which can lead to shock and catastrophic results, is one of the possible problems for the person. When therapy is delayed, the danger increases. Damage to the fallopian tubes is another problem that might make it harder to conceive in the future. The person’s other fallopian tube may be capable of conceiving,” says Dr Gupta.
“Ectopic can turn dangerous if it ruptures because it causes a lot of internal bleeding that is not visible from outside. There is a lot of blood loss inside the body. It diagnosed earlier, this situation is not reached. Patient can go in shock, faint, and have a lot of pain,” says Dr Bhavya Rathore, a senior gynaecologist practicing in Ghaziabad.
What causes confusion in case of ectopic pregnancies
The problem with ectopic pregnancies is that it cannot be detected earlier between the period of 5-6 weeks as no proper pregnancy can be seen in uterus. Still, if you are getting Beta HCG positive, the first thing that has you have to keep in mind is that it could be ectopic. It is the most critical situation anyone can have. You have to be very watchful. One can only know through a scan if it is in uterus, according to Dr Rathore.
Can ectopic pregnancies be avoided
There’s no such way to prevent an ectopic pregnancy, but there are some ways to decrease the risks of it. Some of the ways to reduce these risks are by limiting the number of sexual partners that one indulges in, and by following the basic hygiene of having sexual intercourse, that is using a condom. This will help prevent sexually transmitted infections to women and will reduce the risk of pelvic inflammatory diseases. Not smoking and following a healthy lifestyle is also important, says Dr Gupta.
Does ectopic pregnancy affect fertility of a woman?
“Women who have had an ectopic pregnancy in the past should consider planning a future pregnancy and obtaining fertility expert treatment early in the process. It might be difficult to become pregnant after an ectopic pregnancy. This might be due to scarring in the pelvic area or problems with the fallopian tubes that led to the ectopic pregnancy in the first place. Fertility testing and therapy can help a woman who is having trouble becoming pregnant following an ectopic pregnancy,” concludes Dr Gupta.