This article provides the nuts and bolts of the most common complication in pregnancy namely ectopic pregnancy (or commonly known as tubal pregnancy).
What is Tubal Pregnancy?
With normal pregnancy, women’s eggs are fertilized at the oviduct, and then they travel to the uterus. But, with tubal pregnancies, implantation happens outside of the uterus. In 95% of tubal pregnancies, implantation happens in one of the oviducts, and rarely that happens in the abdominal cavity namely outside of the uterus, in the ovary or in the cervical region. Wherever it happens, in none of the situations, there are no conditions for carrying on a baby successfully with tubal pregnancy. As the embryo is growing, oviduct and some other organ crack which leads to heavy bleeding, and eventually, endangering the life of the mother. Early diagnose and treatment is the only way to keep chances alive for future pregnancies.
Symptoms of Tubal Pregnancy
The challenge with tubal pregnancy is to diagnose it early, as the early symptoms are very similar to normal pregnancy. The following are the common clinical manifestations of ectopic pregnancy:
- Sharp abdominal pain
- Abdominal cramps
- Nausea, vomiting
- Severe discomfort
- Pain in the shoulder
However, what sounds the alarm is bleeding which usually runs for a week after the anticipated cycle. Some women mistake it with normal period, but the blood show in tubal pregnancy is darker color, usually brown. It can also be both more heavily than the normal cycle. Bleeding is usually accompanied with pain in one of the sides of the abdomen, but sometimes the pain can be felt throughout the stomach. Furthermore, the pain is heavy, sudden, and it becomes stronger with activity, or with coughing for example.
More specifically, if the embryo has already cracked, shoulder pain is experienced. This is a result of body’s reaction to bleeding where the embryo is implanted. The accumulated blood irritates nerves and mothers feel the shoulder pain. Low blood pressure, sickness and faint follow as a result of the lost blood.
Causes of Tubal Pregnancy
Tubal pregnancy happens when the fertilized egg is stuck in the oviduct on the way to the uterus. In most cases, the cause behind is inflammatory process in the oviduct, the oviduct is damaged or the organ’s structure is changed. Statistics show that 20 of 1000 pregnancies are tubal. Other causes for tubal pregnancy are the following:
- Infections (gonorrhea or Chlamydia)
- Fertility problems. Some studies show a connection between fertility problems and the use of medications to improve* fertility with tubal pregnancy.
- Structural problems. The risk of tubal pregnancy is higher when certain anomalies are identified within the form of the oviduct (or they are damaged, changed with former surgeries). Even surgeries for reconstruction of the form of the oviduct can also put mothers at risk of acquiring tubal pregnancy.
- Contraception. With the right use of contraception the risk of pregnancy is very small. However, if that occurs, chances are it will be tubal.
- Previous tubal pregnancies
Dangers of Tubal Pregnancy
When tubal pregnancy occurs, there is no way for the fertilized egg to develop outside of the uterus. In order to prevent life-treating complications, tubal tissue needs to be removed. If the tubal pregnancy is early diagnosed, the growth of the cells can be stopped which will preserve the oviduct. This depends how advanced the pregnancy is. Methotrexate is used in this case. Chances for healthy and normal pregnancy after a tubal one are slim. Notwithstanding, if the oviducts are preserved, the chances for normal pregnancy are approximately 60%.
Treatments for Tubal Pregnancy
In the event that you have an ectopic pregnancy that is bringing about severe symptoms, bleeding, or high HCG levels, surgery is typically required. This is because medicine is not liable to work. At the point when conceivable, laparoscopic surgery that uses a little cut is carried out. For a ruptured ectopic pregnancy, emergency surgery is required.