Ectopic Pregnancy- A Threat for Women

 Ectopic Pregnancy

What is an ectopic pregnancy?

The embryo formed by the union of the mother's egg and the father's sperm is implanted in the uterus in a normal pregnancy. If the embryo is implanted outside the uterus for some reason, the condition is called an ectopic pregnancy. 

Implanted outside the uterus (where the fetus grows during pregnancy), the fetus cannot grow and mature. But even in this condition if the fetus continues to grow, then the pregnant woman may die. In the case of ectopic pregnancy, it is not possible to save the fetus. Abortion is done by medication or surgery.

               Symptoms of Ectopic Pregnancy

Symptoms of ectopic pregnancy usually appear between the 4th and 12th week of pregnancy. Some may have no symptoms at first. They may not realize they have an ectopic pregnancy until they have an ultrasonogram or develop serious symptoms.

You may have an ectopic pregnancy if you stop menstruating, have a positive pregnancy test, or have other signs of pregnancy along with any of the following symptoms. Note that if you think you are pregnant even if the pregnancy test is not positive, and you have any of the following symptoms, contact the hospital or your doctor.

1. Menstrual bleeding

This bleeding is different from your normal menstrual bleeding. Ectopic pregnancy bleeding can be watery and dark brown in color; It may start and stop suddenly. Many consider this bleeding to be normal menstrual bleeding, not even realizing that they are pregnant. Menstrual bleeding during pregnancy is relatively uncommon and may not always be a sign of a serious problem. Still, if this problem occurs, you should definitely contact the doctor.

2. Stomach Pain:

Pain can occur on either side of the lower abdomen. It may increase slowly after the onset, and may suddenly start sharply. It can stay forever, it can also come and go. Abdominal pain can also be caused by various digestive problems, bacterial infections, or gas problems. So abdominal pain does not necessarily mean an ectopic pregnancy. But if you think you are pregnant and have such pains then definitely contact the doctor.

3. Pain at the end of the shoulder

An unusual pain may be felt where your shoulder ends and your arm begins. The exact reason behind this is not known, but it can be a sign of internal bleeding due to an ectopic pregnancy. So if you feel this problem, contact the doctor immediately without delay.

4. Discomfort when going to the toilet

You may have pain when urinating or defecating, accompanied by diarrhea. During pregnancy, it is normal to experience some changes in urinary-toilet habits. This can be due to urinary tract infections and various stomach problems, such as diarrhea, and vomiting. Therefore, if such problems occur during pregnancy, it is necessary to consult a doctor.

5. Fallopian tube rupture and its symptoms

The fallopian tubes act as a bridge between the two ovaries (where eggs are normally released each month) and the uterus (where the fetus grows).In some cases, the fetus grows so large in this fallopian tube that it is likely to rupture. This is called the rapture, which means bursting forth. Rapture is very serious. When this happens, surgery is needed as soon as possible to save the mother's life and repair the ruptured fallopian tube.

Symptoms of rupture include:

  • Sudden sharp and intense pain in the abdomen,
  • dizziness or fainting,
  • nausea,
  • Sudden turning very pale.
  • If these symptoms occur, go to the emergency department of your nearest hospital as soon as possible.

When to go to the doctor if ectopic pregnancy?

If you are pregnant and have any of the symptoms of an ectopic pregnancy, you should see a doctor even if the pregnancy test is not positive. Tell your doctor about your symptoms. You will then usually be given a pregnancy test. To confirm whether the fetus is growing outside the uterus and to properly assess your condition, you may be referred to a specialist doctor, who may suggest ultrasound and blood tests to confirm an ectopic pregnancy.

When to go to the doctor on an emergency basis?

If you have any symptoms of a ruptured fallopian tube, don't delay. You should go to the doctor immediately. A ruptured fallopian tube can lead to death. But hopefully, with quick action, complications can be avoided entirely. In developed countries, the mortality rate of mothers in such cases has decreased a lot. 

Treatment of Ectopic Pregnancy

There are basically 3 types of treatment for ectopic pregnancy –

Keep under close observation. You will be monitored carefully and given one of the following treatments if the fertilized egg does not break up on its own.

Medicine A powerful injection called Methotrexate is given to prevent the fetus from growing in the womb.

Operation or surgery. The fertilized egg is removed through laparoscopy surgery, usually along with the affected fallopian tube. This operation is done with the patient completely unconscious. 

The doctor will inform you in detail about the advantages and disadvantages of all the treatment methods. However, depending on your symptoms and test reports, only one particular treatment may be suitable for you.  

Some medical procedures can reduce your chances of conceiving naturally in the future, although most women can conceive again later. Discuss this in detail with your doctor.

Stress and what to do after ectopic pregnancy :

Losing a child after conception puts a lot of pressure on the mind. Many mothers experience the pain of losing a family member or spouse.

Although the pain may lessen over time, the feeling can sometimes persist for months. Give yourself and your partner enough time to come out of this state of mind. If you or your partner cannot slowly come out of this emotional state, seek the help of a doctor.

 How long after an ectopic pregnancy should you try to conceive?

If you both feel physically and mentally ready, you can try to conceive again. After receiving treatment for an ectopic pregnancy, it is recommended to wait until at least two periods before trying to conceive again, so that your body can heal first.

After treatment with methotrexate, it is advised to wait at least 3 months before trying to get pregnant again, as getting pregnant in the meantime can be harmful to your baby. Most women who have had an ectopic pregnancy can get pregnant again if one fallopian tube is removed, but the other fallopian tube is healthy. Overall, 65% of women can successfully conceive again within 18 months of an ectopic pregnancy. However, some may require infertility treatment, such as IVF.

Once you have had an ectopic pregnancy, there is a small risk (about 10%) of it happening again.

If you do get pregnant again, tell your doctor as soon as possible so that everything is fine beforehand.

Why does ectopic pregnancy occur?

Many times the cause of ectopic pregnancy is not clearly understood. Sometimes this can happen if there is a problem with the fallopian tubes, such as if their passage is narrowed or blocked.

The following factors increase the risk of ectopic pregnancy:

  • Pelvic inflammatory disease or PID. Infection anywhere in the female reproductive system, such as the uterus, fallopian tubes, etc., usually due to a sexually transmitted infection;
  • If you have ever had an ectopic pregnancy before, the risk of having an ectopic pregnancy again is about 10%;
  • Any previous uterine surgery, such as an unsuccessful sterilization procedure or ligation;
  • Infertility treatments, such as IVF, often increase the risk of ectopic pregnancy by taking drugs to increase ovulation, which occurs around the middle of the menstrual cycle;
  • Getting pregnant while using an IUD or IUS for birth control Pregnancy while using these is rare, but if you do, ectopic pregnancy is more likely;
  • smoking;
  • Age – Women aged 35 to 40 are at the highest risk of ectopic pregnancy.

You can't always prevent an ectopic pregnancy, but use condoms to prevent sexually transmitted infections when you don't want to get pregnant and try to stop smoking if you smoke.  

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