Symptoms of ectopic pregnancy vary and may not occur until the structure containing the ectopic pregnancy ruptures. Most women have vaginal bleeding or spotting, cramping or pain in the lower abdomen, or both.
Menstrual periods may or may not be late or missed. Some women do not suspect that they are pregnant. When the structure ruptures, the woman usually feels severe, constant pain in the lower abdomen. If the woman has significant blood loss, she may faint, sweat, or feel light-headed.
These symptoms may indicate that she has lost so much blood that she has dangerously low blood pressure shock Shock Shock is a life-threatening condition in which blood flow to the organs is low, decreasing delivery of oxygen and thus causing organ damage and sometimes death.
Blood pressure is usually low Doctors suspect an ectopic pregnancy in women who are of childbearing age and who have lower abdominal pain or vaginal bleeding, faint, or go into shock. In such women, a pregnancy test is done. If the pregnancy test is positive or, rarely, if the test is negative but symptoms still suggest ectopic pregnancy, ultrasonography is done using a handheld device inserted into the vagina called transvaginal ultrasonography.
If ultrasonography detects a fetus in a location other than its usual place in the uterus, the diagnosis is confirmed. If ultrasonography does not detect a fetus anywhere, ectopic pregnancy is still possible, or the pregnancy may be in the uterus but be so early that it cannot be seen. Doctors also do blood tests to measure a hormone produced by the placenta early in pregnancy called human chorionic gonadotropin hCG. This test can help doctors determine whether the pregnancy is too early for the fetus to be visible in the uterus or is an ectopic pregnancy.
If needed to confirm the diagnosis, doctors may use a viewing tube called a laparoscope, inserted through a small incision just below the navel. This procedure enables them to view an ectopic pregnancy directly.
In most women, the fetus and placenta must be removed surgically, usually with a laparoscope Laparoscopy Sometimes doctors recommend screening tests, which are tests that are done to look for disorders in people who have no symptoms.
If women have symptoms related to the reproductive system gynecologic During surgery, doctors remove the fetus and placenta and only the part of the fallopian tube that cannot be repaired. This approach increases the chance that repairing the fallopian tube can enable women to become pregnant. However, sometimes the tube cannot be repaired. For small ectopic pregnancies that have not ruptured, one or more doses of the drug methotrexate , given by injection, can be used instead of surgery.
The drug causes the ectopic pregnancy to shrink and disappear. Doctors do blood tests to measure hCG every week to determine whether treatment with methotrexate was successful. Occasionally, when methotrexate is not used or is unsuccessful, surgery is needed.
Fimbriae, small finger-like projections at the end of the fallopian tube, capture the egg and direct it inside. It is here, inside the fallopian tube, where conception usually occurs. Sperm travel through the female reproductive system and into the fallopian tube, where they eventually join the egg. Only one sperm can fertilize the egg. The newly fertilized egg then travels along the fallopian tube toward the uterus, where it can implant and develop until birth.
Your doctor will give you the best information about your individual circumstances. For medical reasons we usually recommend waiting two months after surgery and three to four months after medication before getting pregnant again.
Because it is possible to become pregnant again straight away, you will need to use contraception. We advise all women wanting to conceive to take folate tablets one month before getting pregnant and for three months into the pregnancy.
It is recommended that anyone who has had an ectopic pregnancy has an early ultrasound examination, at around five and a half to six weeks in all future pregnancies to check that the pregnancy is in the right place.
After an ectopic pregnancy, as with a miscarriage , you may have mixed feelings about becoming pregnant again. You may find it useful to speak about your concerns with your GP or a counsellor.
Women are encouraged to discuss their health needs with a health practitioner. If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest Emergency Dept. Bleeding in early pregnancy Miscarriage Treating miscarriage Ectopic pregnancy Hydatidiform mole Section menu. On this page: What is an ectopic pregnancy? How is an ectopic pregnancy treated? Surgery Medication Wait and see What does this mean for future pregnancies?
What is an ectopic pregnancy? Sometimes an ectopic pregnancy will shrink on its own and miscarry. Often no reason is found, but tubal pregnancy is more common in the following situations: after fertility treatment such as in-vitro fertilisation IVF if there is a history of pelvic infection in women with damaged fallopian tubes in women who have had previous surgery such as caesarean section, ovarian cysts or appendix removed in women who become pregnant while using an IUD or a progestogen only pill.
Return to top How is an ectopic pregnancy treated? There are three options for treatment depending on the severity of your condition. They are: surgery medication wait and see. Return to top Surgery Surgery is recommended if the doctor believes you are bleeding internally or that you are likely to bleed internally. The surgery is usually done using keyhole surgery laparoscopy. Return to top Medication If the doctors think that your risk of internal bleeding is very low, you may have the option of using medicine to stop the pregnancy growing.
A pelvic exam can help your doctor identify areas of pain, tenderness, or a mass in the fallopian tube or ovary. However, your doctor can't diagnose an ectopic pregnancy by examining you. You'll need blood tests and an ultrasound. Your doctor will order the human chorionic gonadotropin HCG blood test to confirm that you're pregnant. Levels of this hormone increase during pregnancy.
This blood test may be repeated every few days until ultrasound testing can confirm or rule out an ectopic pregnancy — usually about five to six weeks after conception. During a transvaginal ultrasound, your doctor or a medical technician inserts a wandlike device transducer into your vagina while you are positioned on an exam table.
The transducer emits sound waves that generate images of your uterus, ovaries and fallopian tubes. A transvaginal ultrasound allows your doctor to see the exact location of your pregnancy. For this test, a wandlike device is placed into your vagina. It uses sound waves to create images of your uterus, ovaries and fallopian tubes, and sends the pictures to a nearby monitor. Abdominal ultrasound, in which an ultrasound wand is moved over your belly, may be used to confirm your pregnancy or evaluate for internal bleeding.
A complete blood count will be done to check for anemia or other signs of blood loss. If you're diagnosed with an ectopic pregnancy, your doctor may also order tests to check your blood type in case you need a transfusion. A fertilized egg can't develop normally outside the uterus. To prevent life-threatening complications, the ectopic tissue needs to be removed. Depending on your symptoms and when the ectopic pregnancy is discovered, this may be done using medication, laparoscopic surgery or abdominal surgery.
An early ectopic pregnancy without unstable bleeding is most often treated with a medication called methotrexate, which stops cell growth and dissolves existing cells.
The medication is given by injection. It's very important that the diagnosis of ectopic pregnancy is certain before receiving this treatment. After the injection, your doctor will order another HCG test to determine how well treatment is working, and if you need more medication.
Salpingostomy and salpingectomy are two laparoscopic surgeries used to treat some ectopic pregnancies. In these procedure, a small incision is made in the abdomen, near or in the navel. Next, your doctor uses a thin tube equipped with a camera lens and light laparoscope to view the tubal area.
In a salpingostomy, the ectopic pregnancy is removed and the tube left to heal on its own. In a salpingectomy, the ectopic pregnancy and the tube are both removed. Which procedure you have depends on the amount of bleeding and damage and whether the tube has ruptured.
Also a factor is whether your other fallopian tube is normal or shows signs of prior damage.
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