An ectopic pregnancy is an ovum that is fertilized and develops outside the uterus.
Most ectopic pregnancies develop in the fallopian tubesAlso called the oviduct, it is one of a pair of ducts that lead from the peritoneal cavity over the ovary to the uterus. The tubes serve to lead the ovum to the uterus and the spermatozoa to the ovaries. The fallopian tubes are located in the lower abdomen by a broad ligament called the mesosalpinx.
Visit our comprehensive glossary for more pregnancy terms and definitions., and the condition is sometimes called a tubal pregnancy, although the embryo can also grow on the ovary or in the abdomen in which case it is called an abdominal pregnancy.
If the ectopic pregnancy is left undetected the embryo may grow large enough that the fallopian tubeAlso called the oviduct, it is one of a pair of ducts that lead from the peritoneal cavity over the ovary to the uterus. The tubes serve to lead the ovum to the uterus and the spermatozoa to the ovaries. The fallopian tubes are located in the lower abdomen by a broad ligament called the mesosalpinx.
Visit our comprehensive glossary for more pregnancy terms and definitions., which is not designed to expand like the uterus, will burst causing severe pain and shock. Emergency surgery to remove the pregnancy must take place immediately or else falling blood pressure and the hemorrhage may result in death.
This acute form of ectopic pregnancy is now fortunately rare because medical technology now makes it possible to diagnose and treat ectopic development earlier in the pregnancy.
If you are trying to conceive or not using birth control and you are experiencing abdominal pain on only one side of your body about six weeks after your last menstrual period contact your doctor as soon as you can!
Recognizing the symptoms of tubal pregnancy can be difficult since many women do not know they are already pregnant. Some symptoms of tubal pregnancy such as a missed menstural period and vaginal bleeding or spotting two weeks later are similar to the early signs of pregnancy.
About fifty percent (1 in 2) women who are experiencing a tubal pregnancy complain of abdominal pain on one side of their bodies. One third (1 in 3) become light-headed and twenty percent (1 in 5) have shoulder pain on the same side as the stomach pain.
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Between 1970 and 1987 the number of ectopic pregnancies rose almost five times from 18,000 to 88,000. But at the same time the number of fatalities from ectopic pregnancy has fallen due to better diagnosis. While the cause is still unknown, most experts feel that a rise in the number of infections of the fallopian tubesAlso called the oviduct, it is one of a pair of ducts that lead from the peritoneal cavity over the ovary to the uterus. The tubes serve to lead the ovum to the uterus and the spermatozoa to the ovaries. The fallopian tubes are located in the lower abdomen by a broad ligament called the mesosalpinx.
Visit our comprehensive glossary for more pregnancy terms and definitions., salpingitis, as well as improved methods of diagnosis are responsible for the increase.
Because doctors can now detect more ectopic developments earlier in the pregnancy the fatality rate from ectopic pregnancy has fallen. While the condition is still dangerous modern technology and methods have made it far safer than it used to be.
Today about 1.5% (1 in 67) conceptions result in an ectopic pregnancy. About ninety percent (9 in 10) ectopic pregnancies develop in the fallopian tubes and are sometimes called tubal pregnancies.
Anyone who has been subjected to an infection, disease or surgery that may partially block the fallopian tube is at risk of an ectopic pregnancy. Risk factors include:
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Nicotine reduces estrogen levels which control the contractions of the fallopian tubesAlso called the oviduct, it is one of a pair of ducts that lead from the peritoneal cavity over the ovary to the uterus. The tubes serve to lead the ovum to the uterus and the spermatozoa to the ovaries. The fallopian tubes are located in the lower abdomen by a broad ligament called the mesosalpinx.
Visit our comprehensive glossary for more pregnancy terms and definitions. and thus may delay implantation of the embryo. Smokers are also less able to fight infections and are more at risk for sexually transmitted diseases such as chlamydia which can lead to pelvic inflamatory disease or PID: some researchers have demonstrated a direct link between the incidence of chlamydia and ectopic pregnancies. Women who smoke more than thirty cigarettes each day are five times more likely to have an ectopic pregnancy.
If you or your doctor suspect an ectopic pregnancy, your doctor will perform a blood test to confirm your pregnancy using a quantitative hCG test. Like a regular pregnancy test, the quantitative or beta hCG tests for the presence of human chorionic gonadotropinHuman chorionic gonadotropin is a hormone released into the maternal bloodstream by the developing placenta from about six days after the last period was due (about 22 days after the last menstrual period). Its presence can be detected in the urine by a home pregancy test and a positive result indicates pregnancy. Gonadotropins are used to treat infertility, hypogonadism and nonobstructive cryptorchidism. Often abbreviated to HCG.
Visit our comprehensive glossary for more pregnancy terms and definitions. (hCG) in the blood. But a quantitative hCG test assigns a number value to the level present in the blood. This serial hCG level is an index number that can vary from person to person, since the doctor is more interested in ensuring that the value is doubling every two or three days to confirm your pregnancy. This test is also used to detect a miscarriage.
Once the ectopic pregnancy has been diagnosed it is impossible to move it and save the pregnancy. It is not possible for a tubal pregnancy to continue growing to term and it cannot be transferred to the uterus. Instead your doctor will now concentrate on saving your fallopian tube and ovary.
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If you have a history of ectopic pregnancy or are a patient with a high risk for the condition your doctor may be sufficiently satisfied with the quantitative hCG test to make an early diagnosis. If the detected early enough a medical rather than surgical treatment, using the drug methotrexate may be permitted. The drug is injected into the developing embryo and after it has died it will be reabsorbed, saving the fallopian tube.
If you are not at risk for ectopic pregnancy and have no history of the disease, then the quantitative hCG test, abdominal pain and other symptoms will encourage your doctor to confirm the diagnosis using a vaginal probe ultrasound.
Most treatment for ectopic pregnancy involves surgical removal of the developing embryo from the fallopian tube. If the fallopian tube has not ruptured a delicate operating called a laparoscopyA term used to describe the examination of the abdominal cavity through a small incision in the abdominal wall. A laparoscope is used to view the ovaries and fallopian tubes, and can also serve as a gynecologic sterilization technique for oviduct fertilization. It is also called an abdominoscopy.
Visit our comprehensive glossary for more pregnancy terms and definitions. will be performed.
Laparoscopy is an outpatient procedure performed under a general anesthetic. A needle is placed through the belly button and carbon dioxide is used to distend the abdomen. A laparoscope, a surgical device with a small camera attached to it is used to view and navigate the pelvic organs. Other surgical instruments are inserted through small incisions in the abdomen and the pregnancy is removed.
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If the fallopian tube has ruptured it too will need to be removed using a surgical procedure called a salpingectomy. Depending on the extent of the damage and the amount of blood loss a transfusion may be required. A pregnancy that has progressed sufficiently far may also require the removal of the corresponding ovary in a procedure called an oophorectomy.
A recovery time of one week is recommended after which a further blood test will measure the hCG values and confirm that there are no remaining embryonic tissues. Regular ovulation is possible with one ovary or fallopian tube: the other ovary ovulating twice as frequently.
If you had little or no trouble conceiving prior to your ectopic pregnancy you will have no problem becoming pregnant again after. A history of infertility may reduce your chances of conceiving again by as much as fifty percent (1 in 2).
About sixty percent (3 in 5) of women do conceive successfully after an ectopic pregnancy and about thirty percent (1 in 3) choose to avoid pregnancy voluntarily. If the diagnosis was late the risk of infertility rises to nearly fifty percent (1 in 2), so it is important to contact your doctor right away if you suspect something is wrong.
If you do become pregnant after an ectopic pregnancy be sure to tell your doctor since you will need special care and attention during your subsequent pregnancy.
If you have already experienced an ectopic pregnancy your chance of a repeat episode is ten to fifteen percent (about 1 in 8).
Tubal ligation is 98% effective as a method of contraception. If you choose to reverse the procedure or become pregnant after a tubal ligation you are a high risk candidate for ectopic pregnancy.
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