What if you have an ectopic pregnancy

Over the last few years the numbers of ectopic pregnancies registered in Spain have increased dramatically, but there are still many men and women who do not know exactly what an ectopic pregnancy is , why it occurs and what the symptoms are. An early detection of this type of pregnancy thanks to the knowledge of its symptoms can reduce the risk it causes for the health of the pregnant woman .

In this article we are going to teach you in depth everything you need to know about this type of pregnancy: cause, treatments, symptoms and views of future pregnancies . Keep reading!

WHAT IS AN ECTOPIC PREGNANCY?

This type of pregnancy, commonly known as ectopic or ectopic pregnancy, occurs when the embryo implants outside the uterine cavity, growing outside the uterus . The embryo can implant and develop in various parts of the female reproductive system, such as the tubes, ovary, or abdominal cavity.

To understand why this type of pregnancy occurs, you have to start at the beginning: fertilization . This process, in which an egg and a sperm come together, occurs in the fallopian tubes and once fertilized, the egg begins cell division and undertakes a short journey to the uterus, which usually lasts between two and five days. Once in the uterine cavity, the fertilized egg will cling to the lining of the uterus and begin to grow into a baby. However, an obstacle can block the path of the egg to the uterus and retain it in the tube or other parts of the female reproductive system.

Implantation of the fertilized egg in the fallopian tubes is the most common case of ectopic pregnancy. The tissues that make up the tubes are much more fragile and weaker than those that make up the uterine cavity, which prevents fertilized eggs from nesting in their walls until the end of pregnancy. But why does abortion occur?

During pregnancy, the fertilized egg seeks to feed on the walls of the fallopian tubes , so it searches for blood vessels in them. For this reason, blood accumulates in the tube and it begins to dilate as the small egg grows. Little by little, the egg, malnourished, due to the lack of nutrients that only the uterus can provide, and subjected to the continuous contractions of the tubes, ends up detaching from the walls and quickly dies . It is at this time that the fallopian tube ruptures and causes abdominal bleeding .

CAUSES OF ECTOPIC PREGNANCY

There are several reasons that can occur in the woman’s body and that imply that the fertilized egg does not reach the walls of the uterus. Sometimes it is due to abnormalities in the shape of the female reproductive system , while in others it is a matter of problems in the fertilized egg.

• • The ovum may have dimensions disproportionate to the diameter of the tube, not being able to travel to the uterus.

• • The movement of the ovum can be slow , preventing it from reaching the uterus in time

• • The tube may have an abnormal shape , not allowing the passage of the fertilized egg.

• Some factors can favor the blockage, such as the consequences of possible infections in the tubes , surgical interventions in the area, previous ectopic pregnancies or congenital malformations .

SIGNS AND SYMPTOMS

The symptoms of ectopic pregnancy are varied and can manifest in different ways , depending on each woman. If the pregnancy is unknown, the main symptom will be the absence of the menstrual period , followed by tenderness and discomfort in the breasts, nausea, fatigue and vomiting . These symptoms can clearly be confused with those in a normal pregnancy, but they are the first sign that something is changing in the woman’s body.

Behind this are much more specific symptoms that are a clear warning sign of an ectopic pregnancy. In the first place, the pain stands out, which can be focused on the pelvis, abdomen, shoulders or neck ; In addition, the pain can be mild or acute, depending on each pregnant woman and her pain threshold. The normal thing is to feel a strong pain in the pelvis. On the other hand, along with pain, it can appear from slight bleeding to hemorrhage , in the event that the fallopian tube has burst.

In addition, there are other types of symptoms that can be accompanied by the previous ones and are an unequivocal sign of an ectopic pregnancy:

• • Pain in the lower back

• • Hypotension, dizziness, and fainting associated with blood loss

• Vaginal spotting or vaginal leakage

AVAILABLE TREATMENTS

When a woman comes to the hospital complaining of abdominal pain, the first thing that is done is a pregnancy test using a urine sample . In the case that the woman already knows that she is pregnant and if the urine test is positive, the next medical check that is carried out is a quantitative hGC, a blood test that measures a hormone called human chorionic gonadotropin manufactured by the placenta . This test helps to determine the exact age of the fetus and to diagnose abnormal pregnancies, such as ectopic.

After these two tests, it is normal to do an ultrasound, either a standard ultrasound or a transvaginal ultrasound , depending on the weeks of gestation of the fetus. With this, it will be possible to know the exact position of the fertilized ovum and its size. In addition, the doctor will complete the examination with a vaginal examination , the main function of which is to locate the painful areas, detect the dilation of the uterus due to pregnancy and any abnormalities outside of it.

There may be cases in which the gestation has not exceeded five weeks , so even with the most advanced medical equipment it is very difficult to confirm the pregnancy. In these circumstances, and as long as the woman is not in danger, the patient is sent home and asked to return in a couple of days for repeat blood and urine tests and transvaginal ultrasound.

Finally, once the ectopic pregnancy has been detected and confirmed, it will be decided what type of treatment to carry out , depending on the clarity of the diagnosis, the size of the embryo and the available techniques. There are two types of treatment: pharmacological and surgical.

DRUG TREATMENT

In the event that the ectopic pregnancy is detected in time and the mother is not in danger, the interruption of the pregnancy with drugs can be used . This process ends the pregnancy and allows the tissue that causes erosion in the walls of the tube to be reabsorbed. This is done using a muscle injection of methotrexate .

This type of treatment works within hours of its application and is completely painless . The woman will have a little bleeding due to the expulsion of the remains of the pregnancy and usually no side effects of any kind are experienced.

Drugs can be used as long as the ectopic pregnancy is not too advanced and there are no internal bleeding or severe pain. If any of these cases occurs, a surgical intervention will be carried out.

SURGICAL TREATMENT

There is a procedure called salpingotomy , which is used when the patient has a stable clinical picture and the embryo is small enough to be surgically removed without damaging the tube . It is a small intervention in which an incision is made in the tube to be able to extract the egg from its interior by laparoscopy . This type of practice has been perfected until it is possible to access the damaged areas by means of three cuts in the abdomen, which reduces the convalescence time to twenty-four hours .

In this type of intervention, the tube is preserved intact and the only sequelae are the small scars that will remain both on the abdomen and on the walls of the tube. However, if the tube has suffered great damage or has even burst, these types of interventions are ruled out. In this case , a much more complicated major abdominal surgery will have to be resorted to , in which the tube will be removed and the damaged area will be rebuilt in order to repair as much damage as possible. If this surgical procedure is not performed in time, the mother may bleed out due to internal bleeding .

Although there have been cases in which the surgical intervention has occurred when the embryo was still alive inside the fallopian tube, the purpose of this treatment is to interrupt the pregnancy, since it has not yet been possible to implant the fertilized egg with success in utero.

CAN I GET PREGNANT AGAIN AFTER AN ECTOPIC PREGNANCY ?

In the vast majority of cases, after having an ectopic pregnancy you can have healthy pregnancies in the future . This will depend on the type of treatment that has been carried out to terminate the ectopic pregnancy and the condition of the fallopian tubes. In the event that one of the tubes had been tied or some of them had scars, the fertilization process may be more complicated than on other occasions , but this does not prevent the woman from becoming pregnant again.