WOMEN’S BODIES: ECTOPIC PREGNANCY
‘Ectopic’ means ‘out of place’. Ectopic gestation is a pregnancy that implants outside the uterus, usually in the fall tube; rarely, on the ovary or in the abdominal cavity. It is common in women whose tubes been damaged by previous surgery or infection, but often no cause can be found.
Though there are a few bizarre reports of ectopic pregnancy being maintained for long enough for a live baby to be delivered by abdominal surgery, the usual come is rapture of the pregnancy sac or death of the pregnancy within the first three months.
When the ectopic sac ruptures suddenly, it often causes severe abdominal and profuse internal bleeding that can lead to shock. This emergency needs immediate surgery to remove the pregnancy and the damaged part of the tube in order stop bleeding. Blood transfusion may necessary to save the mother’s life.
Sometimes the symptoms may be less
dramatic because blood leaks more slowly from the ectopic or because it just dies slowly without bleeding at all. This can lead to an assortment of puzzling symptoms that may include erratic bleeding from the vagina, dizziness or fainting, recurrent abdominal pain, pain in the shoulder tip and pain on intercourse. Diagnosis can then be particularly difficult in women who don’t suspect that they’re pregnant (the faulty gestation results in lower-than-usual pregnancy hormones in the blood and often no pregnancy symptoms). Today, the use of ultrasound and highly sensitive pregnancy tests make diagnosis easier. If the pregnancy test is positive and ultrasound doesn’t show a pregnancy in the uterus, an ectopic pregnancy must be ruled out (the other possible cause is complete or incomplete miscarriage within the last few days before the test).
Ectopic gestation is one of the few potentially life-threatening complications of pregnancy, and even though it’s not common (about 1 in 150 gestations), it should be excluded in any woman who could be pregnant and who has recent onset of irregular vaginal bleeding, abdominal pain or tenderness, change in pregnancy symptoms, and dizziness or fainting.
An ectopic pregnancy can be very distressing. Not only may there be frightening, severe, sudden symptoms and the need for emergency surgery, there is also anxiety about the consequences. If you lose your tube (not always the case, sometimes the tube can be preserved or repaired) your fertility may be reduced, and women who have had an ectopic are at higher risk of having another than those who have not.
Ask your doctor to explain what happened, what was done during surgery and any future risks. Plenty of women who have had ectopics have later had successful pregnancies.
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March 12, 2009 - 8:26 AM