Ectopic Pregnancy: Causes and Treatment

Ectopic pregnancy can have very dangerous consequences for the mother's health. In an ectopic pregnancy, the pregnancy implants outside the uterus (womb), most often in the fallopian tubes.

Causes of Ectopic Pregnancy

Conditions that prevent the fertilized egg from passing through the tubes to reach the uterus increase the risk of ectopic pregnancy.

• Congenital problems of the fallopian tubes
• Appendicitis or previous pelvic infections
• Endometriosis
• A previous ectopic pregnancy
• Pregnancy occurring while using an intrauterine device (IUD)
• Pregnancy occurring after tubal ligation
• Multiple sexual partners
• Some infertility treatments
• Pregnancy over the age of 35
• Sexually transmitted diseases

In some cases, the cause cannot be identified. It can also occur in patients using birth control pills.

Signs and Symptoms of Ectopic Pregnancy

This type of pregnancy can mimic many acute clinical conditions. Depending on its location, it may be confused with problems such as acute appendicitis, a ruptured ovarian cyst or ovarian torsion.

The most common complaints:

• Abnormal vaginal bleeding
• Pressure on the rectum
• A drop in blood pressure
• Pain radiating to the shoulders
• Severe, sharp, sudden pain in the lower abdomen

Diagnosing Ectopic Pregnancy

It is a life-threatening condition. The pregnancy cannot continue to term, and it must be ended to save the mother's life. For this reason, making the correct diagnosis is very important. Various ectopic pregnancy calculation methods may also be used in diagnosis.

Gynecological examination: The doctor checks for tenderness and a palpable mass.

Pregnancy test (hCG): If hCG, a hormone produced by the pregnancy, is above a certain level but no gestational sac is seen inside the uterus on ultrasound, an ectopic pregnancy is suspected. In uncertain cases, the patient is kept under close observation with follow-up hCG tests and ultrasounds until the clinical picture becomes clear.

Treatment of Ectopic Pregnancy

If the ectopic pregnancy has not ruptured, treatment involves ending the pregnancy;

• With surgery, or
• With medication.

If the ectopic pregnancy has ruptured, because of the risk of heavy bleeding and shock, the patient receives;

• Blood transfusion
• Fluids
• Oxygen support
• Leg elevation
• Measures such as keeping the patient warm, and the tube containing the ectopic pregnancy is promptly removed with surgery.

Clinical Course (Prognosis)

One in three women who have had an ectopic pregnancy can later have a healthy birth. A successful pregnancy after an ectopic pregnancy is closely related to the patient's age, whether she has had children before and the cause of the ectopic pregnancy.

Because ectopic pregnancy is more common in women who smoke or have had a sexually transmitted infection, quitting smoking and practicing safe sex are recommended.