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Ectopic Pregnancy

Description

An ectopic pregnancy or tubal pregnancy, occurs when the embryo never makes it to the uterus , where it typically implants , and starts to develop in the fallopian tube . Sometimes the embryo can also occur in the cervical canal, one of the ovaries or the pelvic or abdominal cavity ( abdominal pregnancy ).An ectopic pregnancy is a life-threatening condition which must be dealt with immediately.
Between 1970 and 1987, the incidence of ectopic pregnancies rose from 18,000-88,000, a huge increase, now accounting for 1.5% of all pregnancies in the United States alone.

The risk of an ectopic pregnancy is increased where:

  • Women who wore intrauterine devices (IUDs).
  • Women with a history of PID .
  • Women with a history of pelvic surgery (scarring may block the tube and prevent the egg from leaving).
  • Women with a history of ectopic pregnancy.
  • Women pregnant as a result of assisted conception techniques , where gametes or embryos have been injected into their fallopian tubes.
  • Women with endometriosis .
  • The foetus was exposed to diethylstilbestrol .
  • Sterilisation or a failed tubal ligation (a sterilisation procedure in which the fallopian tubes are cut or blocked)

Symptoms and Signs

Common symptoms of ectopic pregnancy are sharp abdominal cramps or pains on one side. The pains may start out as a dull ache that gets more severe with time. Neck pains and shoulder pains are also common. You may also have a menstrual type of bleeding along with the pain, but the pain is the most obvious sign.

Diagnosis and Treatment

If a woman tests positive for pregnancy ( hCG levels test ), or has missed her period but the uterus does not display the typical signs associated with pregnancy, an ectopic pregnancy is suspected. An ultrasound scan can be useful in identifying that the uterus is indeed empty and that blood has accumulated in the pelvic or abdominal cavity. A culdocentesis may also be then performed to confirm a diagnosis of an ectopic pregnancy. A laparoscope may also be employed to directly view the ectopic pregnancy.
An ectopic pregnancy generally requires surgery to remove it and sometimes a fallopian tube ( salpingectomy ) and/or one ovary ( oophorectomy ) will also need to be removed.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. From The Fertility Sourcebook, 1998 by M. Sara Rosenthal. Online: Web Md Health: http://my.webmd.com/


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  http://www.hon.ch/Dossier/MotherChild/complications/complicate_ectopic.html Last modified: Oct 20 2004