Ectopic pregnancy (tubal pregnancy)

Abdomen | Gynecology | Ectopic pregnancy (tubal pregnancy) (Disease)


Description

During ovulation, an egg (ovum) is released from one of the ovaries. Conception happens when the egg meets a sperm in the fallopian tube. Normally, the fertilised egg travels down the fallopian tube and into the uterus (womb) to implant in the uterine lining (endometrium).

Ectopic pregnancy means a pregnancy that develops outside the uterus, usually in one of the fallopian tubes. In almost all cases, the embryo dies. The developing placenta can’t access a rich blood supply and the fallopian tube is not large enough to support the growing embryo.

Detection of ectopic pregnancy in early gestation has been achieved mainly due to enhanced diagnostic capability. Despite all these notable successes in diagnosis and detection techniques ectopic pregnancy remains a source of serious maternal morbidity and mortality worldwide, especially in countries with poor prenatal care.

Women with an ectopic pregnancy may have irregular bleeding and often have pelvic or abdominal pain, especially one-sided pain.

Causes and Risk factors

An ectopic pregnancy is often caused by damage to the fallopian tubes. A fertilized egg may have trouble passing through a damaged tube, causing the egg to implant and grow in the tube.

Rarely, an ectopic pregnancy will be located in an ovary or in the cervix, or even in the abdomen. Ectopic pregnancy is more common in women with the following conditions:

(1) infertility (difficulty conceiving)

(2) endometriosis - a condition in which the tissue normally inside the uterus grows in other areas of the pelvis.

(3) sexually transmitted diseases (these can cause infection and scarring in the pelvis)

(4) tubal surgery

Diagnosis and Treatment

Tests to detect ectopic pregnancy include the level of a hormone in the blood called human chorionic gonadotrophin (hCG), which may not increase as it normally would.

Treatment for ectopic pregnancy includes medications to terminate a pregnancy and surgery. Small ectopic pregnancies may be treated using laparoscopy. ...