An ectopic pregnancy occurs when the fertilized egg attaches itself outside of the uterus.
What is an ectopic pregnancy?
An ectopic pregnancy occurs when the fertilized egg attaches itself outside of the uterus. Nearly all ectopic pregnancies occur in the fallopian tube, and are sometimes referred to as tubal pregnancies. During a tubal pregnancy, the fertilized egg cannot develop properly and must be treated because the fallopian tubes are not designed to hold a growing embryo. If you are experiencing an ectopic or tubal pregnancy, you need an obstetrician who specializes in high-risk pregnancy, like Dr. Heather Stanley-Christian. She can properly diagnose and treat your ectopic pregnancy to give you the safest possible outcome.
What causes ectopic pregnancies?
Ectopic pregnancies are caused by one or more of the following issues:
- An inflammation or infection of the fallopian tube, which can cause it to become partially or fully blocked.
- Congenital disabilities or abnormal growths that result in an abnormality in the tube’s shape.
- Previous surgery on the tubes or in the pelvic area, which can cause adhesions.
- Scar tissue from a surgical procedure or previous infection on the tube, which can also block the egg’s movement.
What are the symptoms?
Signs and symptoms may help you recognize a potential ectopic pregnancy. You may experience the typical signs and symptoms of a standard pregnancy, but you may also experience:
- Sharp, stabbing pain in the abdomen, pelvis, shoulder, or neck. This pain may come and go and vary in intensity and may be due to blood from a ruptured ectopic pregnancy gathering up under the diaphragm.
- Gastrointestinal symptoms.
- Vaginal bleeding that is lighter or heavier than your normal period.
- Fainting, dizziness, or weakness.
If you experience bleeding or sharp pain that lasts more than a few minutes, contact your doctor immediately.
Am I at risk?
Risk factors for ectopic/tubal pregnancy include:
- Expecting mothers between the ages of 35-44
- Previous ectopic pregnancy
- Pelvic Inflammatory Disease (PID)
- Previous abdominal or pelvic surgery
- Several induced abortions
- Conceiving while an IUD is in place or after having a tubal ligation
- Ongoing fertility treatments or medications
If any of these risks apply to you, schedule an appointment with Dr. Stanley-Christian.
How are ectopic pregnancies diagnosed?
Dr. Stanley-Christian diagnoses ectopic pregnancies through a series of steps. First, she will perform a pelvic exam. The pelvic exam will allow her to locate tenderness, pain, or a mass in the abdomen. She will then use an ultrasound to determine whether the uterus contains a developing fetus. It is also essential to measure your hCG levels. hCG, or human chorionic gonadotropin, is a hormone produced during pregnancy. It is made by cells formed in the placenta, which nourishes the egg after it has been fertilized and becomes attached to the uterine wall. An hCG level that is lower than expected is one reason to suspect an ectopic pregnancy.
Your progesterone levels may also be an indicator, as low levels can be a sign of tubal pregnancy. Lastly, Dr. Stanley-Christian may do a culdocentesis. During this procedure, a needle is inserted into space at the very top of the vagina, behind the uterus and in front of the rectum. The presence of blood in this area can indicate bleeding from a ruptured fallopian tube.
How does Dr. Stanley-Christian treat tubal pregnancies?
A tubal pregnancy can be treated in several ways. Methotrexate is a medication that allows the body to absorb the pregnancy tissue and may save the fallopian tube. This treatment option depends on how far your pregnancy has progressed.
If the tube is bleeding, stretched, or ruptured, part or all of it may need to be removed. Emergency surgery is necessary to stop the bleeding promptly. Laparoscopic surgery under general anesthesia may be performed. Your surgeon will use a laparoscope to remove the ectopic pregnancy and repair the affected fallopian tube.
What happens after the treatment?
If you did not have your entire fallopian tube removed, your hCG level would need to be rechecked until it reaches zero. If your hCG level remains high, it might indicate that the ectopic tissue was not entirely removed. As a result, surgery or medical management with methotrexate would be required.
Can I still get pregnant after an ectopic pregnancy?
The chances of having a successful pregnancy after a tubal pregnancy may be reduced. Ultimately, the reason your pregnancy was ectopic and your medical history will determine whether you can successfully become pregnant again. If your fallopian tubes have been left in place, you have roughly a 60% chance of having a successful pregnancy in the future.