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Pregnancy and child
birth are very complex biological processes. These are very important
steps in the reproduction of the species. But as in the case of any
other systems, this system is also vulnerable to anomalies. There are
many types of abnormalities that can occur during the process of
pregnancy. Ectopic pregnancy which is otherwise known as the tubal
pregnancy is one such disorder which can occur during pregnancy.
An ectopic pregnancy is one, which occurs outside the womb in several
places like the ovary, the abdomen, the cervix, but the most common
place is in the fallopian tubes. This abnormality most often causes
the death of the fetus and so it is considered as a dangerous
abnormality.
Ectopic pregnancy is the leading cause of maternal deaths in the first
trimester of pregnancy. Generally ectopic pregnancy occurs in the
fallopian tubule and hence the name tubal pregnancy. The word
“ectopic” means out of pace, so it indicates the implantation of the
fetus anywhere outside the uterus.
Ectopic condition is lethal not only to the fetus but also to the
mother. Forty to fifty women die each year due to this condition in
the United States. But there has been a large drop in the death/ectopic
rate since 1970. In other words, it is much safer to have an ectopic
than it was in 1970.
There are certain factors, which are known to increase the risk of an
ectopic pregnancy such as – advancing age, tubal surgery, pelvic
inflammatory disease, ovulation induction, previous ectopic pregnancy
termination, a previous ectopic pregnancy and IVF (test tube baby).
DIAGNOSIS
Today there are several methods by which we can identify and ectopic
pregnancy successfully. One of the most used methods is vaginal
ultrasound method. This can be done in about 4-5 weeks onwards.
It can also be detected by the scanning. The sensitive urinary ELISA
test is another form to help identify an ectopic pregnancy.
Some of the common symptoms are Severe pain, generally one sided
around the uterus, Slow rise in hCG levels, Shoulder pain and severe
vaginal bleeding. You may experience one, all or none of these
symptoms. If you have any reason to suspect that your pregnancy is
ectopic you should call your doctor or midwife immediately.
The progesterone hormone level can also acts as an indicator of
ectopic pregnancy, progesterone level of less than 15( ng/ml) is seen
in 81% of ectopics, 93% of abnormal intrauterine pregnancies and 11%
of normal intrauterine pregnancies.
There are various treatments once an ectopic pregnancy is diagnosed.
There is however no possibility of taking the pregnancy from the tube
and putting it into the womb. The possible procedures for ectopic
pregnancy can all be done by laparoscopy (same day surgery) or by
laparotomy (bigger incision).
Usually, if the tube is not ruptured it is done by laparoscopy. Cases
of rupture with significant hemorrhage into the abdomen are almost
always done by laparotomy because it can be done much faster.
If the tube is saved at surgery, there is some risk that some of the
pregnancy remains in the tube. This tissue can persist and resume
growing. A mass can form with subsequent rupture and hemorrhage.
Another treatment method is by using a chemical known as Methotrexate.
It has got the capacity to arrest the growth of rapid growing cells
such as a pregnancy or some cancer cells. Most side effects seen with
low-dose MTX therapy have been mild and transient.
The sooner an abnormal pregnancy is diagnosed; it increases the
survival chances of the mother. So it is important not to overlook the
possibility of an ectopic pregnancy.
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