Ectopic Pregnancy – Part II

Ectopic Pregnancy Causes:

Ectopic pregnancy occurs when the fertilized egg gets lodged on its course to the uterus. This normally takes place due to scarring, anomalous shape or damage of the fallopian tubes. In several instances, the precise reason behind this occurrence is unknown.

Diagnosis & Tests:

• Blood Analysis – A blood test helps in detection by observing the levels of the hormone HCG or chorionic gonadotropin that is produced during pregnancy. Higher HCG levels point to normal pregnancy while a lesser than normal level is an indicator of an ectopic pregnancy.
• Urine Function Test – A urinalysis could detect only the presence of pregnancy and not the type of pregnancy.
• Ultrasound Scan – A trans-vaginal ultrasound scan could at times aid in ectopic pregnancy confirmation.

If the ectopic pregnancy is in its preliminary stages and the diagnosis is dubious, then the doctor would observe the patient’s condition with the aid of blood analysis till either it could be corroborated or ruled out by carrying out later ultrasound scans.

Ectopic Pregnancy Treatment:

If diagnosis points to an ectopic pregnancy, there are many treatment alternatives available to avert fallopian tube rupture. They include:

• Surgical intervention – The surgical excision of the embryo employing key-hole or belly button laparoscopic surgery wherein an illuminated camera-fitted probe is passed through small incisions in the navel, through which surgical instruments are inserted for removal of the ectopic tissue. In the case of damaged fallopian tube it could be either treated or removed.
• Medicines – In cases of preliminary diagnosis, intravenous methotrexate injections are administered into the fallopian tube to stop cell proliferation and disband existent cells. The HCG levels in the blood are then observed. If there is no plummet in blood HCG levels then another injection might be given. This medicine might lead to abdominal pain.
• Wait and observe – If symptoms are quite mild, then the doctor might suggest a watchful wait period to observe how matters are progressing. Mostly ectopic pregnancies self-terminate naturally.
• Emergency surgical intervention is needed in the case of burst fallopian tubes. The fallopian tubes could either be fixed or if not possible removed.

Possible Complications:

If diagnosis or treatment is postponed or not undertaken, then the woman can face grave bleeding that could lead to shock that might become fatal in certain occasions.

Deterred treatments could lead to damaged fallopian tube that could raise the likelihood of future ectopic pregnancies.

There are chances of depressive tendencies and grief in women apprehensive of impossibility of a normal pregnancy. Despite the removal of fallopian tubes, pregnancy is still possible. If both the fallopian tubes need to be removed, still in-vitro fertilization is a viable choice.

Prevention:

Although there is no preventive strategy, a woman can lower her risk of getting PID that could have a marring effect on the fallopian tubes. STDs like Chlamydia and gonorrhea are the chief reasons behind the occurrence of PID. Hence, it is crucial to follow safe sex practices –always using condoms prior to sexual contact to lower the risk of contracting STDs.

Smoking raises the likelihood of an ectopic pregnancy; hence smoking cessation would lower the risk.

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