Ectopic Pregnancy

Definition

An ectopic pregnancy is an abnormal pregnancy that occurs (grows) outside the uterus (womb).  It accounts for about 1% of all pregnancies and remains the leading cause of maternal death in the first 12 weeks of pregnancy.

Causes

Genital infections associated with fallopian tube infection such as chlamydia, gonorrhea and pelvic inflammatory disease increase the risk of Ectopic pregnancy.  The other causes are surgery in the past, birth defects, and invitro fertilization.  Most causes of ectopic pregnancy occur in the fallopian tube (and the other sites are abdomen, ovary, cervix).  This happens when the embryo stops in the fallopian tube and starts growing.

Symptoms

Up to 50% of women with ectopic pregnancy are asymptomatic (has no revealing signs).  Sometimes the signs and symptoms are non specific (vague).  Patient with ectopic pregnancy may present with history of missing menstrual period, symptoms of pregnancy, lower abdomen pain, vaginal bleeding, painfull intercourse and positive pregnancy test.  As it progresses, she will experience sharp pains in the lower abdomen, shoulder tip pains, dizziness and feeling faint from internal bleeding.

Complications

Untreated ectopic pregnancy may rupture causing massive internal bleeding, that may lead to a fatal outcome (death).

Diagnosis

An ectopic pregnancy should be considered in any woman with abdominal pain or vaginal bleeding who has a positive pregnancy test. Ultra sound scans and blood tests will confirm the diagnosis.

Treatment

Treatment is managed in the hospital.  It may be managed conservatively with medical treatment or surgical removal depending upon how the ectopic presents itself.

Hetero tropic pregnancy is the co-existence of intra-uterine pregnancy (pregnancy in womb) and an ectopic pregnancy.  The incidence of this occurring is rare.

The finding of a pregnancy in the uterus almost always excludes the possibility of ectopic pregnancy.