Out of every 1,000 pregnancies, five to seven are ectopic pregnancies. It is more common in women who have had an ectopic pregnancy before, as well as in women who have a history of pelvic infection.
Signs & symptoms As in a normal pregnancy, the woman may have a missed period, spotting and pregnancy symptoms such as breast tenderness and nausea. She may also feel lower abdominal pain on one or both sides that gets progressively worse over time.
Should the ectopic pregnancy rupture, she may feel severe pain in her lower abdomen, feel dizzy, and even pass out. The danger from this is the internal bleeding which, if it is severe, can be life-threatening.
Making a diagnosis An ectopic pregnancy is suspected if the woman has all the signs of being pregnancy and yet the ultrasound scan fails to show up a pregnancy in the uterus. Blood tests may be needed to check for pregnancy hormones and further ultrasound scans are required to help make a diagnosis. Ultimately, the diagnosis of an ectopic pregnancy can only be confirmed by an operation.
Treatment options Treatment of an ectopic pregnancy varies, depending on its size and location and whether you want the ability to conceive again.
An early ectopic pregnancy can sometimes be treated with an injection of methotrexate, which dissolves the fertilized egg and allows your body to reabsorb it. This nonsurgical approach minimizes scarring of your pelvic organs.
If the pregnancy is further along, you'll likely need surgery to remove the abnormal pregnancy. In the past, this was a major operation, requiring general anesthesia and a large incision across the pelvic area. This may still be necessary in cases of emergency or extensive internal injury.
However, the pregnancy may sometimes be removed using laparoscopy, a less invasive surgical procedure. The surgeon makes a small incision in the lower abdomen and then inserts a laparoscope. This long, hollow tube with a lighted end allows the doctor to view internal organs and insert other instruments as needed. Sometimes, a second small abdominal incision is made for the instruments. The ectopic pregnancy is then surgically removed and any damaged organs are repaired or removed. General or regional anesthesia may be used.
Getting pregnant again If the fallopian tubes are left intact, a woman still has a reasonable chance for future successful pregnancies. Removal of a tube may not affect her chances of getting pregnant if the condition of the other unaffected tube is good.
A woman who had an ectopic pregnancy is at a slightly increased risk for another ectopic pregnancy. Hence, she should speak with her gynaecologist about her risk and the measures for early evaluation of her next pregnancy.