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Ectopic Pregnancy

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  3. Ectopic Pregnancy

Overview of Ectopic Pregnancy

Ectopic Pregnancy Meaning in Urdu

عام طور پر بچہ دانی میں بچے کی افزائش شروع ہوتی ہے۔ تاہم کچھ کیسز میں خاتون کے انڈے اور مرد کے سپرم کے ملاپ کے بعد بچہ دانی کے باہر بچے کی افزائش شروع ہو جاتی ہے۔ جن خواتین میں بچے دانی کے باہر بچے کی افزائش شروع ہوتی ہے ان میں کوئی بھی علامت ظاہر نہیں ہوتی۔ لیکن کچھ خواتین میں اس کی وجہ سے حمل کے آثار پہلے ظاہر ہونا شروع ہو جاتے ہیں۔ اس کے علاوہ کچھ خواتین کی چھاتی نرم ہو سکتی ہے اور انہیں متلی کا بھی سامنا کرنا پڑ سکتا ہے۔

An ectopic pregnancy occurs when the fertilized egg attaches itself outside the uterus cavity. Usually, this kind of fertilization happens in the fallopian tube. As the baby grows, the chances of tube rupture increase, pushing the mother’s and baby's health to high risk. 

Prevalence

Ectopic pregnancy has been reported to have a low morbidity rate and accounts for a 0.5%-1.5% incidence rate of all pregnancies. However, in Pakistan, ectopic pregnancy occurs in at least 1 woman out of 130 pregnant women. Some significant risk factors associated with ectopic pregnancies in Pakistan are often related to past miscarriage history. overall health, quality of eggs, infertility factors, and age of a woman. 

Does the baby survive ectopic pregnancy?

It is crucial to understand that ectopic pregnancies are not ‘viable’ and will not survive inside or outside the body. This is why almost all ectopic pregnancies are reported to end early in the first-trimester stage. There is a lack of blood supply for the egg to grow and nourish itself. 

Signs and Symptoms of Ectopic Pregnancy

Identifying ectopic pregnancy through symptoms can be challenging. At first, the pregnancy will feel like any normal pregnancy, with similar pregnancy symptoms of breast tenderness, nausea, and missed period. However, as the pregnancy progresses, patients will notice some distinct symptoms from the rest.

Earliest Symptoms of Ectopic Pregnancy

The first warning signs of an abnormal pregnancy are pelvic discomfort and vaginal bleeding. Due to the fragility of the fallopian tube, the blood starts leaking or collecting around the tube region triggering other unusual symptoms like intense shoulder pain or a strong urge for bowel movement. The symptoms become more specific as the baby grows and blood starts collecting in a specific region. 

Emergency Symptoms of Ectopic Pregnancy 

Having a successful ectopic pregnancy is usually more complicated and unlikely to happen. In almost all cases reported, ectopic pregnancy has ended in a miscarriage. In case, the fetus remains intact and starts growing inside the tube, the tube ruptures and heavy bleeding becomes more likely causing extreme symptoms like fainting or severe lightheadedness. Some other notable symptoms will be; 

  • Severe stomach cramps and vomiting 
  • Consistent pain on one side of your body 
  • Pain in your shoulder, neck, or your lower abdomen early on in the pregnancy 
  • Dizzy spells and weakness 

Types of Ectopic Pregnancy

Causes of Ectopic Pregnancy

The primary cause of ectopic pregnancy has not been proven as yet. A patient may be perfectly healthy and may still experience ectopic pregnancy. One of the more prominent reasons for ectopic pregnancy may be due to an already damaged or weak fallopian tube. A weak fallopian tube may be a reason for a fertilized egg to attach itself to the uterus. Some important factors for an ectopic pregnancy can be; 

  • Unhealthy diet and lifestyle 
  • Smoking cigarettes 
  • Conceive after the age of 35 
  • Have sexual infection 
  • Have experience ectopic pregnancy before 
  • Have undergone fertility treatments 
  • Have tried tubal ligation 
  • Got pregnant while having an intrauterine device 
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Risk Factors of Ectopic Pregnancy

The most dangerous complication of an ectopic pregnancy is the bursting of the fallopian tube and internal bleeding. Failure to provide emergency treatment in such a scenario can result in life-threatening situations.

Happniness

Prevention

There is no definite way of preventing an ectopic pregnancy. No preventive measure can fully undo ectopic pregnancy. However, some measures can be taken to reduce a woman’s chances of decreasing ectopic pregnancy; 

  • Limit your sexual partners and use safe sex options to avoid any pelvic inflammatory disease 
  • Adopt a healthy lifestyle and be regular in your gynae checkups 
  • Avoid smoking at all costs if you are trying to get pregnant 
  • As soon as you get pregnant, ensure a detailed checkup is done by your doctor so that in case of ectopic pregnancy, your doctor takes timely precautions for your health 

 

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Diagnosis

Ectopic pregnancy is not exactly detectable at the time of pregnancy test. A doctor will examine your pelvic health on your first checkup. They might perform an ultrasound to examine the health of your uterus and fallopian tubes. 

During the ultrasound, the doctor looks for the baby's heartbeat and the formation of a gestational sac. A gestational sac is a fluid-filled cavity that develops around the embryo. The ultrasound is a noninvasive painless test procedure that usually takes 20-30 minutes to determine the internal health of the mother.

Treatment of Ectopic Pregnancy | When to Consult a Doctor

A fertilised egg cannot survive outside of the uterus cavity. Once diagnosed, ectopic pregnancy has to be removed by the doctor immediately before any serious health repercussions develop. A doctor will opt for medication or surgery based on your health condition, age, and how long you are into the pregnancy. 

In the medication process - this is a safer option than surgery and usually intervenes in the primary stages of ectopic pregnancy diagnosis. This is the stage when the fallopian tube is not on the verge of bursting and there are slimmer chances of internal bleeding. Your doctor will give you a shot of methotrexate (Trexall), which will stop the fertilized egg from growing. The egg will be absorbed by your body in 4 to 6 weeks without having to remove the fallopian tube. 

Before the medication process, your doctor will run some tests to determine the hormone levels of hCG (pregnancy hormone). If you are a breastfeeding mother or have certain health conditions, your doctor will not use methotrexate for your treatment. 

In this method, it is important to get your hCG level regulated timely and to follow up with full checkups. In case the ectopic pregnancy does not end, your doctor will give another dosage. This process may continue to happen until your hCG drops. 

Please note that medications used for abortion are different from ectopic pregnancy as abortion requires the removal of the fetus after it attaches itself to the uterus. Ectopic pregnancy is when the fertilized egg attaches itself outside of the uterus, in the fallopian tube. 

Surgery process- in the case where ectopic pregnancy has progressed, immediate surgery would be required. Laparoscopy is the most common type of surgery performed in such conditions. Your doctor will create a small cut and insert a thin flexible tube to remove the fertilized egg. In the case where the fallopian tube is damaged, it may well be removed as well. In case of internal bleeding, emergency surgery with a bigger cut may be required before the health of the mother deteriorates. 

Common side effects of surgery include; 

  • Pain or swelling 
  • Sudden bleeding 
  • Infection post-surgery 

Post Surgery Care 

Regardless of the treatment you undergo, taking care of your health and body is important for the next 3-6 weeks. You may feel tired and may experience some discomfort in your belly region. The pregnancy-like symptoms may continue for a brief period of time, however after a few period cycles you will feel normal again. 

It is important to note that an ectopic surgery raises the risk of another one. You may also want to get a fertility specialist onboard especially if you have had a fallopian tube removed. It is also recommended to try again after a 3 month healing time. 

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