|
Tubal Pregnancy
An ectopic pregnancy is a pregnancy that takes
place outside the uterus, and is a life threatening condition that
must be ended as soon as possible. The most common sites of ectopic
pregnancy are the fallopian tubes. Sometimes the pregnancy develops
in the ovary and, rarely, in the abdominal cavity or cervix.
How does it occur?
An ectopic pregnancy is usually associated with some condition
that blocks the passage of the fertilized egg into the uterus. These
conditions include:
- A previous infection in the fallopian tubes
- Surgery on the tubes, ovaries, or ruptured
appendix
- Abnormalities in the fallopian tubes or the
genitourinary tract you may have had at birth
- A previous ectopic pregnancy
- A pelvic tumor that interferes with the fallopian
tubes
- Certain birth control methods, such as IUDs
If you know you have any of these conditions, you should see your
doctor as soon as you think you might be pregnant.
What are the symptoms?
Ectopic pregnancies are usually diagnosed within the first 2
months of pregnancy, possibly before a woman realizes that she is
pregnant. The symptoms may be mild or they may be severe and dangerous.
They can be the same as the symptoms of other conditions that are
less serious. Possible symptoms of an ectopic pregnancy are:
- Missed period or abnormal vaginal bleeding
- Pain in the lower abdomen or pelvis
- Symptoms of pregnancy such as breast tenderness,
morning sickness, etc.
Rupture of an ectopic pregnancy is life threatening. The symptoms
include:
- Sudden increase in pain
- Symptoms of oncoming shock: pale skin, fast
heart rate, and dizziness from low blood pressure caused by bleeding
- Shoulder pain from irritation of the diaphragm
caused by bleeding into the abdomen
How is it diagnosed?
The doctor will perform blood tests and a pregnancy test. The
following procedures may also be performed:
- Ultrasound scan to see if the fertilized egg
is in the uterus or the fallopian tube
- Culdocentesis, which is the insertion of a
needle through the vagina behind the uterus, to look for blood
in the pelvis that could a indicate ruptured fallopian tube
- Laparoscopy, which is the insertion of a lighted
instrument into the abdomen through an incision in the belly button
to look at the pelvis and tubes. An ectopic pregnancy can be seen
even before it ruptures and may be removed with laparoscopy instruments
How is it treated?
In an emergency, the doctor will perform surgery to remove the
pregnancy. Abdominal surgery (laparotomy) may be needed if there
is heavy bleeding into the abdomen and if the tube has ruptured
and needs repair. In some cases this surgery can be done through
the laparoscope. Any damaged tissue, such as all or part of the
fallopian tube, will be repaired or removed.
If you are in shock and very sick or unstable, you must have surgery
immediately to stop internal bleeding. If you lose a lot of blood,
you may need blood transfusions. If you meet certain criteria, you
might be a candidate for medical therapy and avoid surgery.
How long will the effects last?
The effects last as long as the ectopic pregnancy exists. Without
treatment this condition can cause serious problems, including death.
How can I take care of myself?
The best way to take care of yourself is to pay close attention
to you health. Monitor physical changes and symptoms related to
your menstrual cycle, and tell the doctor about any abnormal bleeding
or unusual pain between cycles.
How can I prevent an ectopic pregnancy?
Pelvic inflammatory disease is the most common, preventable
factor associated with ectopic pregnancy. Sexually transmitted diseases,
such as gonorrhea and chlamydia, can cause pelvic inflammatory disease.
Infection can damage the fallopian tubes and make an ectopic pregnancy
more likely. Avoid such infections by following safe sex practices.
Not all ectopic pregnancies can be prevented, but reporting any
suspicious symptoms immediately to a doctor can help prevent serious
problems and complications if an ectopic pregnancy does occur.
|
