Ectopic Pregnancy (Fetus Developing Outside the Womb)

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ectopic pregnancy 1 * What is an ectopic pregnancy?

It is a common complication of pregnancy,where the embryo implants outside the uterine cavity( womb). This occurs up to 1 in every 50 pregnancies. Being aware of these conditions and passing the message to others will help you to maintain a healthy pregnancy throughout.

Every healthy and non pregnant female, after puberty, releases an egg from the ovary into the fallopian tube and it can ultimately meet a sperm from the male( conception). The fertilized egg formed as a result of the mating of the egg (ovum) and sperm , slowly travels to your (womb) and attaches to its lining,develop into fetus and stay there for the rest of the 9 months until delivery. But generally up to 1 in every 50 pregnancies, the path from the fallopian tube to uterus can get blocked due to some reason and the fertilized egg can lodge somewhere out of the uterus which is what we call ‘ectopic’ meaning outside. Since the fetus doesn’t have its proper place to attach and develop, it will end up in death ( in few very rare cases it can survive) and mother will need emergency treatment as it is a life threatening condition. Generally ectopic pregnancies happen within the first few weeks of pregnancy and initially you might not even have an idea that you are pregnant. 

* Where else can a fertilized egg lodge?

Majority occur half way through fallopian tube but can also be seen in, Ovaries it self, Cervix,Abdomen, and rarely in C-section scars.

ectopic pregnancy 2

* What can cause ectopic pregnancy?

  • Congenital abnormalities of the fallopian tube
  • Damaged fallopian tube which fails in propelling the fertilized egg in to the womb
  • Sexually transmitted diseases like gonorrhea
  • History of endometriosis (a gynecological condition where scarring of endometrium occurs)
  • History of repeated episodes of Pelvis inflammatory diseases or pelvic surgeries
  • History of ectopic pregnancies
  • Using of fertility drugs or infertility treatments like in vitro fertilization
  • Use of IUDs ( intrauterine device which you use at the time of conception as a form of birth control- very rare)
  • Increase maternal age (females who are above 35 have a risk but it depends on how healthy your fallopian tubes are)
  • Smoking and excessive alcohol which can lead to malfunctioning of fallopian tubes

Scientists suggest that becoming pregnant while using oral contraceptive pills can also increase the risk of ectopic pregnancies but not clinically proven yet. Sometimes you might even know what causes ectopic pregnancies but people mentioned above have a high risk than the normal.

* How can you know whether a fetus is growing ‘outside’ of your womb?

There can be cases where no symptoms are experienced at all and during the first few days of the pregnancy, a miscarriage can occur with a slight vaginal bleeding episode. In other cases, You may miss your period and start experiencing normal symptoms of pregnancy like nausea,dizziness and sore breasts. Meanwhile you do a pregnancy test at home it will be positive. But now you will start abdominal pain, light vaginal bleeding from time to time and it’s high time for you to go to a physician immediately because you have a chance of having an ectopic pregnancy. Vaginal spotting ( bleeding) can be misunderstood as a beginning of light period where Blood is seen dark brown or red.Bleeding severity would be light or heavy either with continuous or intermittent episodes.Some women may experience flu like symptoms including fever,lethargy and vomiting. And also When you go for first prenatal examinations you may feel severe pains when the doctor examines you. Such pains should be accurately described so that no compilations would occur.Similarly Ultra sound scans done for various other reasons can sometimes show ectopic pregnancies. Recurrent Shoulder pains and cramps can be a red flag for ruptures of the tubes.generally the pain is felt in the shoulder region when you lie down flat.

* Why should you be alert of ectopic pregnancies?

Fetus, growing outside the womb will rarely get the chance to see the light of the world.Generally miscarriages in the first stages itself.In addition, not all ectopic pregnancies are life threatening but in severe cases,there is a high risk of mother’s life if immediate diagnosis isn’t made and treat accordingly.The worst complication would be, If the fallopian tube ruptures, severe internal bleeding can take place which will lead to hypovolemic shock ( your blood pressure drastically dropping to a low level) which can rarely cause death.

* How can a diagnosis made?

If you notice at least one of the above mentioned symptoms contact your doctor immediately and do accordingly;

  • Normally a blood test would be done to check your,pregnancy hormone- hCG ( human chorionic gonadotrophin ) and it is usually enough to suggest whether you are pregnant or not but this test should be repeated about 3 times to come to a definite conclusion in case if you have risky symptoms.
  • Ultra sound- sonographer will have a close look up at your fallopian tubes and uterus.
  • Generally by above two investigations, a clinician can come to an accurate idea whether it is an ectopic pregnancy or not, but in some cases
  • Laparoscopic procedures are done where a tiny camera is inserted in to your abdomen to find whether the embryo is lodging there.

* How is it treated?

Treatment depends on the severity, threat to mother’s life, how big the embryo is and the available methods. However, If an ectopic pregnancy is confirmed, immediate pharmacological treatments are started. In case of a very small embryo, A drug named’ methotraxate’ is injected into your muscles where it reaches the embryo through your blood stream. This drug will stop the growing of the cells of placenta by which the embryo and mother are physiologically attached. Eventually the TINY embryo get absorbed into your body. If the mother is in an unstable condition, and the embryo is small enough to be removed surgically by a laparoscopic surgery/.

* Can I get pregnant again after an ectopic pregnancy?

Yes of course you can. It is good if it takes 3-6 months. But you can talk to your family doctor and he will advise you how you should proceed and how long you have to wait. Try to heal your mind and body because its no one’s fault. Sometimes counseling may be needed and after all you still have an opportunity to give a little one a chance to see the light of the world.


Sinhala Article:


Article verified by: Dr (Mrs) Kaushalya Mendis


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