Pregnancy is typically the happiest time of a couple’s life. Their minds are filled with visions of a healthy newborn. They make plans for their soon-to-be family. However, as every mother will tell you, each pregnancy can be vastly different. Early and routine prenatal care with your OBGYN can help to make sure you have a healthy pregnancy and can address any potential issues early.
In a normal pregnancy, one sperm fertilizes an egg, usually in the last part of the fallopian tube. An egg is only ready about 2 days before and 1 day after ovulation. Once the sperm penetrates the egg, it can fertilize. Fertilization is when the egg and sperm DNA combine. The fertilized egg travels through the fallopian tube, dividing to form an embryo, which reaches the uterus, grows a bit, and then implants itself into the endometrium (uterine lining). If it does not implant, the endometrium will shed, and menstruation occurs.
Once a woman is pregnant, signs of pregnancy quickly begin to show. Some of these signs include:
- Sore and tender breasts
- Nausea and vomiting
- Frequent urination
- Food cravings
- Mood swings
Approximately 40 weeks later you give birth to a healthy baby. One in 10 babies are born preterm, before 37 weeks’ gestation. Most OBGYN physicians will recommend inducing labor before then. Around 97% of babies born in the United States are perfectly healthy.
One out of every 50 pregnancies results in ectopic pregnancy . This occurs when the fertilized egg attaches itself somewhere other than the uterus. Typically, the egg is fertilized by the sperm in a section of the fallopian tubes, called the ampulla. The fertilized egg travels to the uterus, where it develops until birth. If it does not, and starts to develop somewhere other than the uterus, it is called an ectopic pregnancy. Most ectopic pregnancies occur in the fallopian tubes, and are sometimes known as tubal pregnancies. Tubal pregnancies can be dangerous, as they can rupture the fallopian tube as the egg grows. The fallopian tube tissue is very thin, and can easily rupture. Many times, the woman does not even know she is pregnant, and simply has odd symptoms that she does not recognize.
Ectopic pregnancy typically occurs around six weeks of pregnancy. It can happen as soon as a few weeks, or up to 14 weeks of pregnancy. The farther along you are, the higher the chance of having problems with the fallopian tube.
The causes of ectopic pregnancy are:
- The fallopian tube being infected or inflamed, which can cause it to be blocked partially or entirely.
- Scar tissue from prior infections or surgeries of the fallopian tubes.
- Adhesions on the fallopian tubes from previous surgeries in the pelvic area.
- An abnormal fallopian tube shape, either from an abnormal growth or a birth defect.
Women who are at higher risk of having an ectopic pregnancy are typically between 35 and 44 years old. Women with Pelvic Inflammatory Disease are also liable to undergo ectopic pregnancy, as are women who have suffered endometriosis or previous ectopic pregnancies. Procedures such as abortions, pelvic or abdominal surgeries, and tubal ligation can increase the risk of ectopic pregnancy, though it usually take several abortions to increase this risk. Lastly, having an IUD in place when conceiving, using fertility medications, undergoing fertility treatments, can increase the chances of ectopic pregnancy, as well.
Ectopic pregnancy symptoms include the typical signs and symptoms of pregnancy, but are also accompanied by sharp, shooting pain in the lower abdominal area, which can radiate to the pelvis. Many women experience vaginal bleeding , different from their regular periods . Some may experience weakness, dizziness, or fainting. This usually occurs after the fallopian tube has ruptured, and is due to loss of blood. Ectopic pregnancy is a medical emergency, and must be treated immediately in order to prevent rupture of the fallopian tube and internal bleeding.
Diagnoses & Treatment
In the hospital or at the physician’s office, ectopic pregnancy is diagnosed by pelvic exam, ultrasound and blood test . Physicians will look at hCG levels and progesterone levels. Progesterone levels are usually low in an ectopic pregnancy. Some physicians will do a culdocentesis, which involves inserting a needle into an area at the top of the vagina, between the uterus and the rectum. If there is blood in this area, this may indicate bleeding from a ruptured fallopian tube.
Once the physician gives a diagnosis, treatment for ectopic pregnancy is immediate. Medicine may be given, such as Methotrexate, which allows the body to absorb the pregnancy tissue. This could save the fallopian tube if the pregnancy has not gone too far. Sometimes the tube has to be removed due to rupture or bleeding, which requires surgery.
After treatment, your hCG level must be rechecked routinely until it reaches zero. If it does not reach zero, this could mean that the ectopic tissue was not fully removed, and further treatment will be necessary. If the fallopian tubes remain intact, your chances of having a successful pregnancy in the future are approximately 60%.
If you are pregnant and have questions about ectopic pregnancy, The Woman’s Clinic can help answer your questions. Please contact your Little Rock OBGYN at 877–455–1491 or request an appointment online to see one of our caring physicians. They can answer your questions and provide a thorough examination to ensure your peace of mind.