The What and Why of an Ectopic Pregnancy

An ectopic pregnancy is a pregnancy in which the fertilized egg has implanted itself outside of the uterine wall where it would normally affix itself. It can implant itself in the fallopian tube or sometimes in the ovary, abdomen, or cervix. When the fertilized egg implants itself in the abdomen it is called an abdominal pregnancy, and when implanted in the cervix is known as a cervical pregnancy. This type of pregnancy can be very serious and can endanger the mothers' life. AS the fetus grows it will stretch the organ where it has implanted itself, eventually causing the organ to burst. This in turn can cause severe bleeding. Ectopic pregnancies never develop into a live birth.

An ectopic pregnancy can be caused by a number of reasons. One reason is the fertilized egg is unable to move down the fallopian tube quick enough and so it becomes implanted before it can reach the uterine wall. Infection or inflammation in the ovary or fallopian tube can also cause a blockage causing the fertilized egg to be unable to pass into the uterus and implant itself in the uterine wall. Pelvic Inflammatory Disease, also knows as PID, which is caused by gonorrhea or Chlamydia is another known cause of an ectopic pregnancy. Previous surgeries to the abdomen or fallopian tubes can cause scar tissue which can also block the fertilized eggs path into the uterus. Some women have Endometriosis, and this is another cause of ectopic pregnancies among many women. Some women may have birth defects or abnormal growths that can alter the shape of the fallopian tube also allowing the fertilized egg to become implanted outside of the uterus. Women who have had an ectopic pregnancy are more likely to have another one in the future. This chance increases 15% after the first ectopic pregnancy occurs.

Women with PID, who have already had an ectopic pregnancy, who have had surgery on a fallopian tube, who have infertility problems or are taking medication to stimulate ovulation, and are over 35 are at higher risk than women who have had none of these occurrences. Some birth control methods can also put you at higher risk. Getting pregnant while using a progesterone only oral contraceptive, IUD's, or the morning after pill, are some of the birth control methods that may increase your risks. Smoking and having multiple sex partners can also put you at higher risk for ectopic pregnancies.

Signs and symptoms of an ectopic pregnancy should be taken seriously. These symptoms during pregnancy include, pain, vaginal bleeding, pain in pelvis or abdomen and in extreme cases in the shoulder or neck, vaginal spotting, dizziness or fainting, low blood pressure, and lower back pains. If you have any of these symptoms while you are pregnant you should see a doctor immediately, even if it means going to the ER.

To diagnose an ectopic pregnancy you will be given a urine test to confirm pregnancy. You will then receive a quantitive hCG test. The hCG test measures the level of hormone human chorionic gonadotropin. This hormone is produced by the placenta and shows up in blood and urine as early as 8 to 10 days after conception. It then doubles every 2 days for the first several weeks. If the hCG levels are lower than they should be for your stage of pregnancy it could mean an ectopic pregnancy has occurred. The doctor may then perform an ultrasound in order to see where the fetus is in the uterus, or if it is outside of the uterus. The ultrasound may not detect the fetus at first. Your doctor may require you to come back every 2 to 3 days to test your hCG levels and to determine whether it is ectopic or not.

If an ectopic pregnancy does occur there are several treatment options. The treatment options vary depending on the mothers' state of health, the size, and the location of the fetus. If the pregnancy is detected early enough it can sometimes be treated with an injection of methotrexate. The methotrexate will stop the growth of the embryo. If it is detected in later stages of the pregnancy, surgery may be required to remove the abnormal pregnancy. It is sometimes removed using a less invasive procedure called a laparoscopy. The doctor will require you to return after treatment to make sure that your hCG levels have retuned to zero. The hCG level not returning to zero could mean that some of the tissue was missed and may need to be removed using the injection or additional surgery.

You can protect yourself from having an ectopic pregnancy by not smoking and always using condoms. The condoms will help prevent you from getting the STD's that can cause PID.