Ectopic pregnancy is the number one cause of death of women in the first trimester of pregnancy. With the numbers of ectopic pregnancies on the rise, it is important to understand more about ectopic pregnancies.
When we think of the term ectopic pregnancy we frequently imagine a pregnancy that has occurred in the fallopian tube. This is an accurate representation about 95% of the time. The other forms of ectopic pregnancy are: abdominal, ovarian, cornual, and cervical.
While we don't always know the cause of an ectopic pregnancy there are certain risk factors that we can notice:
- Pelvic Inflammatory Disease (PID) or Salpingitis
- Previous Ectopic Pregnancies
- Previous pelvic or abdominal surgery
- Previous Tubal Ligation
- Intrauterine device (IUD) in place
How do you know?
There are several symptoms of an ectopic, some of which are "normal" pregnancy occurrences. If you suspect that you are pregnant and have any of these symptoms, call your practitioner:
- Vaginal Bleeding
- Shoulder Pain
- Abdominal Pain
- Weakness or Dizziness
You may not have an ectopic pregnancy, but it could be caused by something else which may need treatment. Please, seek treatment.
Diagnosing an Ectopic
Testing for ectopic pregnancy is actually difficult, because the answers are not always clear cut, nor are the always available right away. Your hCG levels may be tested to check the rate of rise, they normally double about every two days in a normal pregnancy, this alone is not an indicator of an ectopic pregnancy.
Ultrasound is frequently used, along with vaginal ultrasound to try to visualize the pregnancy. If a uterine pregnancy is confirmed then the chance of ectopic pregnancy is rare. Sometimes it is too early to diagnose an ectopic via ultrasound, and the exam will have to be repeated. If an ectopic pregnancy is visualized then you will proceed to treatment options available depending upon your situation.
Sometimes in urgent situations a laparoscopy procedure will be done to provide diagnosis and treatment. This is done in an operating room as surgery. If you do have an ectopic pregnancy, most likely you will have the surgical treatment done at this time.
There are two main types of treatment: chemical and surgical.
Chemical treatment is done with a drug called methotrexate. It is used in non-urgent cases to dissolve the pregnancy without harming the tubes and other organs. Repeat hCG levels will be taken to ensure that the pregnancy is dissolving and that further treatment is not needed.
Surgery is usually done in cases that are further along in their pregnancy or have another medical reason to not use the chemical process. It may be necessary, especially when the tube ruptures or there is other damage. Sometimes the woman will lose her tube and possibly her uterus if the bleeding can't be stopped.
Facing pregnancy again
Once your recovery is physically underway you may question your ability to have a successful pregnancy. If your fallopian tubes were not damaged you have excellent chances of getting pregnant again, although a higher than average risk of having another ectopic pregnancy. If your tubes were damaged or removed, you still have pregnancy options.
Beyond physical healing there is emotional healing. I personally have experienced two ectopic pregnancies. Both were treated with a wait and see approach and methotrexate, one of which I had exploratory surgery which found a bleeding liver. Even with our other pregnancy losses these were especially hard on Kevin and I because of the added danger of losing my life and/or fertility. I highly recommend talking to someone about your experiences.