|
Ectopic pregnancy
Ectopic pregnancy: Ordinarily, during very early pregnancy the fertilized egg passes
through one of the Fallopian tubes into the uterus, or womb, and there it becomes
implanted in the uterus wall where it begins to grow as an embryo. In rare instances,
however, the egg does not reach the uterus. Instead it becomes implanted somewhere
else, causing an ectopic (ek-TOP-ik) (out of place) pregnancy. Almost all ectopic
pregnancies occur in the Fallopian tubes, in which case they are also known as tubal
pregnancies, but they can be elsewhere in the abdomen.
Without the support of the uterus the developing embryo cannot survive. But the embryo
may grow large enough to rupture the tube, causing dangerous bleeding in the pregnant
woman.
Causes Many experts believe that the fertilized egg gets blocked by some obstruction
in the tube lining. An ectopic pregnancy is more likely if a woman has had a pelvic
infection, has undergone abdominal surgery, or has had an earlier ectopic pregnancy.
All these conditions can cause scarring of the tubes, and scar tissue may be what
interferes with the passage of the egg. In other cases, however, the cause is unknown.
Incidence About seven in every thousand pregnancies are ectopic. But the rate is rising,
probably because of a rise in sexually transmitted diseases that can cause scarring in
the Fallopian tubes.
Symptoms you are likely to notice The first signs of ectopic pregnancy may be slight
bleeding and mild cramps, which are easily overlooked. The woman affected usually does
not realize that there is a pregnancy of any kind, normal or ectopic. Eventually,
though, the pain and bleeding of an ectopic pregnancy become more severe.
Symptoms your physician may observe Ultrasound examination may reveal an ectopic
pregnancy. The condition is also diagnosed by successive measurements of the hormone hCG,
which increases rapidly during the first weeks of a normal pregnancy, but much more
slowly if the pregnancy is ectopic.
Treatment options Sometimes the drug methotrexate can induce abortion of an ectopic
pregnancy. But surgery is usually necessary to remove the embryo and to repair the
Fallopian tube if that is where the embryo lodged.
Outlook A woman who has had an ectopic pregnancy can have a normal pregnancy afterward,
but she runs a slightly higher than normal risk of another ectopic pregnancy.
|
