ECTOPIC PREGNANCY

Signs and Symptoms, Causes, Risk Factors, and Prevention of Ectopic Pregnancy

A pregnancy occurring outside the uterus is called an ectopic pregnancy. If left untreated, they may rupture and result in life-threatening bleeding. It is rare and occurs in one out of every 100 pregnancies.

In an ectopic pregnancy, the fertilized egg most commonly attached to the fallopian tube when it is also called a tubal pregnancy. It can also be in the cervix, ovary, or anywhere in the abdominal cavity. An ectopic pregnancy can’t proceed like normal pregnancy because the fertilized egg may not survive outside the uterus, and the growing tissue may cause damage to the surrounding structures.

Signs and Symptoms Of An Ectopic Pregnancy

Symptoms develop in the early stages of pregnancy and vary from woman to woman. Some women will develop no symptoms until pregnancy ruptures.

During early pregnancy, some women will begin to experience symptoms similar to that of a healthy pregnancy. They may include:

1.    Missed menstrual period

2.    Sore breasts

3.    Upset stomach

4.    Low back pain or pelvic pain

5.    Vaginal spotting or bleeding

6.    Abdominal pain or tenderness

7.    Mild cramping at one side of the pelvic region

Around this phase, it is not easy to understand if it is a normal or ectopic pregnancy. But as the ectopic pregnancy develops, you could experience certain severe symptoms

1.    Sudden and severe pain in the abdomen, shoulder, neck or pelvis

2.    Vaginal spotting or bleeding that is light to heavy

3.    Dizziness, weakness or fainting

4.    Rectal pressure

You should see your doctor if you know about the pregnancy and are experiencing these symptoms.

Causes of an Ectopic Pregnancy

The exact reason for an ectopic pregnancy is unknown. However, the condition is likely to be associated with one or more of the following conditions (4):

1.    Scarring or inflammation of the fallopian tubes from a previous infection, medical condition or surgery

2.    Hormonal reasons

3.    Birth defects

4.    Genetic abnormalities

5.    Medical conditions that influence the shape and condition of the reproductive organs, such as the fallopian tubes 

Note that only your doctor can make the correct diagnosis and give you specific treatment options based on the probable cause and risk factors.

Risk Factors for Ectopic Pregnancy

Factors that increase the chances of an ectopic pregnancy include

1.    Maternal age of 35 years and more

2.    Previous ectopic pregnancy

3.    History of fallopian tube, abdominal or pelvic surgeries or multiple abortions

4.    History of pelvic inflammatory disease (PID)

5.    History of endometriosis

6.    Sexually transmitted infections (STIs) such as chlamydia or gonorrhea

7.    Conception despite intrauterine device (IUD) or tubal ligation

8.    Conception through fertility drugs and procedures

9.    Cigarette smoking

10. Structural abnormalities in the fallopian tubes. 

If you think you are at risk, discuss with your doctor or a fertility specialist to minimize the chances of ectopic pregnancies in the future.

Can You Prevent Ectopic Pregnancy?

No, ectopic pregnancy cannot be prevented entirely, but there are certain ways to reduce the chances of developing it

1.    Use condoms during intercourse to avoid the risk of sexually transmitted infections and pelvic inflammatory diseases.

2.    Avoid sex with multiple partners.

3.    Quit smoking before you try for pregnancy.  

References:

1. Dr. V Kumar et al.; Tubal ectopic pregnancy; BMJ Clin Evid (2015)

2. Tian Zhu; Ectopic Pregnancy; The Embryo Project Encyclopedia (2010)

3. Ectopic Pregnancy; UCSB SexInfo (2018)