What is ectopic (extrauterine) pregnancy?

The ectopic pregnancy is the condition in which the fertilized ovum has become embedded outside the uterine cavity.

What is ectopic pregnancy?

The ectopic pregnancy is the condition in which the fertilized ovum has become embedded outside the uterine cavity. Over 90% of the ectopic pregnancies take place in the fallopian tubes (the tubular organs that connect the ovaries to the uterus). As the pregnancy grows, life-threatening intraabdominal bleedings may occur due to rupture of the fallopian tube. This condition may require urgent surgical intervention.

What are the risk factors for ectopic pregnancy?

• Ectopic pregnancy history in previous pregnancies
• Previous fallopian tube surgery
• Pelvic or abdominal surgery history
• Sexually transmitted infections 
• Pelvic Inflammatory Disease (PID)
• Endometriosis (Chocolate Cyst)
• Smoking
• Getting pregnant while being protected with intrauterine device (IUD)
• Being over 35 years old
• The use of the assisted reproductive technology like in-vitro fertilization treatment increases the ectopic pregnancy risk. 

However, nearly half of the women who have experienced ectopic pregnancy do not have known risk factors. 

What are the symptoms of ectopic pregnancy?

Initially, the ectopic pregnancy has the similar symptoms with normal pregnancy such as late menstruation, tenderness in breasts, nausea, and positive pregnancy test. When you have complaints such as abnormal vaginal bleeding, lumbar pain, dull ache in abdomen or pelvis, light cramping in some part of your pelvis, it may be difficult to understand whether you have an ectopic pregnancy or a healthy pregnancy. In cases of abnormal bleeding, pelvic pain, and positive pregnancy test, you must make sure to consult with your Gynecologist and Obstetrician against the probability of ectopic pregnancy.
As the ectopic pregnancy grows, if a fallopian tube is ruptured especially, more serious symptoms like a sudden and severe pain in the abdomen or pelvis, dizziness, and fainting may emerge. This condition may indicate a life-threatening internal bleeding. You must apply to the emergency service as soon as possible.

How is ectopic pregnancy diagnosed?

In case of ectopic pregnancy suspicion, the pregnancy hormone (beta-hcg) levels in blood are checked in addition to abdominal examination. Additionally, ultrasonography is used to see if the gestational sac is in or out of the uterus. Sometimes the results of the examinations and tests conducted allow diagnosing the ectopic pregnancy immediately, but most of the times, it may be necessary to repeat these tests every few days.

How is ectopic pregnancy treated?

The ectopic pregnancy can be treated in 2 ways: medication and surgery.
• Medication
• Surgery

Which medicines are used to treat ectopic pregnancy?

Methotrexate is the most common medicine used to treat ectopic pregnancy. This medicine terminates the pregnancy by stopping the growth of cells and embryo. In this treatment, there is no need to remove the fallopian tube (the tubular organ that connects the ovary to the uterus).

When the medicines are used to treat ectopic pregnancy?

Your doctor will decide on using methotrexate by considering various factors such as the pregnancy hormone levels, the size of the gestational sac, existence of heartbeats of the embryo in the gestational sac, and whether the fallopian tube that contains the gestational sac has been ruptured. One of the most important factors is that you can have your blood analyzed regularly after the medication. You cannot use methotrexate while breastfeeding or if you have a serious problem like liver diseases.

How is the methotrexate administered?

The methotrexate is usually injected through the hip in a single dose. Before taking methotrexate, blood tests are conducted to measure the hCG level and the functions of certain organs. If the hCG levels do not drop sufficiently after the first dose, an additional methotrexate dose can be administered.

When is surgery done to treat ectopic pregnancy?

If the ectopic pregnancy has been diagnosed late, and if termination of the pregnancy has been delayed, the tubes may be stretched, ruptured, or burst. Such cases require urgent surgical intervention. Sometimes, even if the fallopian tube is not ruptured, the patients who will not get benefit from the methotrexate treatment may also be taken under operation. In that case, the ectopic pregnancy may be removed from the tube, or the whole tube may be removed together with the pregnancy.

How is the operation performed?

This operation is typically performed through laparoscopy. This procedure uses a thin, lighted camera inserted through small incisions in the abdomen.

Can the ectopic pregnancy be prevented?

Mostly, the ectopic pregnancy cannot be prevented. 

Can the ectopic pregnancy affect the future pregnancies?

When you have experienced an ectopic pregnancy, the risk of ectopic pregnancy in your future pregnancies increases. During your future pregnancies, you must watch out for symptoms of ectopic pregnancy until your doctor verifies that your gestational sac is growing in the right place. You must have yourself checked out regularly before and during your pregnancy.


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