Ectopic pregnancy: signs, causes and treatment

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What is an ectopic pregnancy (pregnancy outside the womb)?

Ectopic pregnancy or pregnancy outside the womb is a complication of pregnancy.

This condition occurs when the fertilized egg does not move to the uterus, but attaches and grows in the fallopian tube.

Reporting from the Ectopic page, in some rare conditions, the egg can attach to other places such as the ovaries, cervix, and abdominal cavity. Ectopic pregnancy often occurs in the first few weeks of pregnancy.

This pregnancy is said to be serious and very likely to endanger the life of the mother. The reason is, the egg that grows outside the uterus cannot survive.

After that, the egg will stick to the tissue where it attaches and destroy the tissue. This can lead to internal bleeding and infection.

It is not easy to sustain a baby in an ectopic pregnancy. Most likely, the baby will have to be aborted (abortion).

How common is pregnancy outside the womb?

Ectopic pregnancy is quite common. It is estimated that out of every 100 pregnancies there are at least 2 women who become ectopic.

This condition can be treated by reducing risk factors. Talk to your doctor for more information.

What is the difference between ectopic and wine pregnancy?

Wine pregnancy and pregnancy outside the womb are two different conditions that are common in pregnant women.

Pregnancy molar or hydatidiform mole, occurs when a fertilized egg that should grow into a fetus, grows into abnormal cells.

These cells develop into white, fluid-filled bubbles that resemble grapes.

Signs and symptoms of pregnancy outside the womb

Launching from Planned Parenthood, one of the signs and symptoms of ectopic pregnancy is bleeding from the vagina.

Bleeding is caused by shedding of fallopian tissue or infection, causing blood to bleed.

Generally this condition can cause pain in the stomach and want to defecate continuously.

Here are some other symptoms of ectopic pregnancy to watch out for:

• Nausea and vomiting
• Pain in the lower abdomen
• Pelvic pain
• Stomach cramps
• Pain on one side of the body
• Dizziness or weakness
• Pain in the shoulder, neck, or rectum
• Fainting (rare)

There may be signs and symptoms not listed above. If you have concerns about a particular symptom, consult a doctor immediately.

When should I see a doctor?

Everyone's body is different. If you feel some of the ectopic symptoms as mentioned, get an antenatal care immediately. The doctor will help further check your condition.

Causes of ectopic pregnancy (pregnancy outside the womb)

The exact cause of an ectopic pregnancy is unknown, but it can occur due to damage to the fallopian tubes.

The fallopian tube itself functions as a channel that delivers the fertilized egg. The egg will then move towards and develop in the uterus.

Here are some of the factors that are thought to be the cause of an ectopic pregnancy:

• Have experienced this condition before
• Infection or inflammation (infection of the fallopian tubes, uterus, ovaries, chlamydia)
• Damage to the reproductive organs
• Take fertility drugs
• Inflammation and scarring of the fallopian tubes from a previous medical condition, infection, or surgery
• Hormonal factors
• Genetic (congenital) disorders
• Birth defects, may be caused by growth problems while still being a fetus in the womb
• Have had surgery on the stomach (appendix or caesarean section) which can damage the fallopian tubes
• Have endometriosis (a condition that causes scarring of the fallopian tubes)
• Are currently using contraception

If you experience pregnancy symptoms while using contraception, it is most likely an ectopic pregnancy.

Risk factors for ectopic pregnancy

There are many risk factors for women experiencing ectopic pregnancy, namely:

• Pregnant at age 34-44 years
• Using an intrauterine device (IUD) as contraception
• Have had sexually transmitted diseases, such as chlamydia and gonorrhea
• Have a history of salpingitis, pelvic inflammatory disease
• Congenital fallopian tube disorders
• Wounds from endometriosis
• Have had a previous ectopic pregnancy
• History of failed tubal ligation (tubectomy)
• Using uterine fertility drugs, generally drugs for in vitro fertilization (IVF) procedures
• Smoking before becoming pregnant
• Use of diethylstilbestrol during pregnancy

You need to be vigilant if you have the risk factors above.

How is an ectopic pregnancy diagnosed?

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

Ectopic pregnancy can be diagnosed by the following methods:

1. Pelvic examination

The doctor can diagnose a lump or abnormal growth in the fallopian tube. This is because these abnormal mass growths could be a sign that you have an ectopic pregnancy.

A pelvic exam test is also done to check the size of your uterus. In normal pregnancy, the uterus will increase in size. Meanwhile, during pregnancy outside the womb, the size of the uterus does not increase.

2. Ultrasound

Ultrasound or commonly abbreviated as an ultrasound test can see the condition of the uterus and fallopian tubes. Apart from seeing the condition of the pregnancy, the ultrasound test is also effective in detecting other health problems, including an ectopic pregnancy in its early stages.

3. Blood tests to check hormone levels

In normal pregnancy signs, the mother's blood is generally found in the hormone human chorionic gonadotropin or hCG. This hormone will increase every day.

If it is not found or there is an abnormality in the HCG hormone, it could indicate that you have an ectopic pregnancy or a miscarriage.

Treatment for ectopic pregnancy

Ectopic pregnancy can be treated and managed appropriately. However, this depends on how quickly the ectopic pregnancy is detected and what the health condition of the woman is.

If an ectopic pregnancy can be diagnosed early, you can avoid the risk of the fallopian tube rupturing. In this case, there are several treatment options:

1. Use drugs

If the doctor diagnoses any signs of pregnancy outside the womb, the doctor will test the levels of pregnancy hormones.

After that, check for the presence or absence of the fetal heartbeat in the uterus and check for other pregnancy symptoms.

If no successful fertilization is found in the uterus, the doctor will inject the drug methotrexate.

This medicine can stop and inhibit pregnancy at that time. Methotrexate has a high success rate and low risk of side effects.

2. Laparoscopic surgery

Laparoscopic surgery is a method used to remove the embryo and repair damage caused by bleeding in an ectopic pregnancy.

This surgery is performed by making a small incision in the abdomen. The incision is located near the navel.

Next, the obstetrician will use a thin tube equipped with a camera lens and light to see the condition of the fallopian tubes.

To treat an ectopic pregnancy, the damaged part of the fallopian tube will be removed (salpingectomy) and repaired (salpingostomy).

After performing this operation, you are required to rest completely for 1 to 2 days.

3. Emergency operation

If the ectopic pregnancy causes heavy bleeding, you may need emergency surgery, which involves an incision in the abdomen (laparotomy).

In some cases, damage to the fallopian tubes can be repaired. If the tubes and ovaries are badly damaged, you may need surgical removal (salpingectomy).

Home remedies for ectopic pregnancy

You cannot prevent an ectopic pregnancy completely. However, you can reduce certain risk factors by following a lifestyle:

• Have safe sex by limiting the number of sexual partners.
• Using a condom during sex to prevent sexually transmitted infections and reduce the risk of pelvic inflammation.
• Quit smoking before pregnancy.
• Consult a doctor before using drugs during pregnancy.
• Visiting the obstetrician on schedule.

In addition, several things that are important to do are:

Make peace with yourself first

Pregnancy is something that many couples crave. Knowing that your pregnancy has not been successful is sure to cause deep disappointment.

After going through the process of diagnosis and treatment, now is the time to make peace with yourself.

Give yourself time to grieve and also share your sadness with your partner, family, or friends.

Ask them to listen to your sad expressions without needing to offer suggestions or other options to get pregnant again.

You can also look for support groups, psychologists, or doctors and others who can be reassuring.

Consider IVF or IVF

A woman's body normally has two fallopian tubes. If one is damaged or removed, you can still get pregnant normally even with only one fallopian tube.

If the ectopic pregnancy continues, causing both fallopian tubes to be injured or removed, in vitro fertilization (IVF) can be an option for those of you who want the presence of your baby.

IVF is a procedure done by combining a woman's egg and healthy sperm cells in a laboratory.

After the egg and sperm are successfully fertilized, they are implanted back into the uterus.

Can I get pregnant again after an ectopic pregnancy?

Most of the women who have an ectopic pregnancy are generally able to get pregnant normally and are healthy again in the future.

Generally, if an ectopic pregnancy is caused by a damaged or problematic fallopian tube, the doctor will remove the tube.

Then, if one fallopian tube is removed, another fallopian tube that is still healthy can still help the pregnancy process.

If the ectopic pregnancy is due to an infection or sexually transmitted disease, medication or other treatment measures can help.

However, if an ectopic pregnancy occurs due to exposure to diethylstylboestrol (DES), the occurrence of a normal pregnancy is unlikely.

Check with yourself and consult a doctor before planning your next pregnancy.

The earlier you prevent an ectopic pregnancy, the less damage to the tubes and the more likely it is to have a normal, healthy pregnancy.

When is it okay to try to get pregnant again?

There is actually not enough evidence to determine how long to wait to try again after an ectopic pregnancy.

Quoted from The Ectopic Pregnancy Trust, obstetricians suggest trying to get pregnant again after 3 months or about 2 to 3 times your menstrual period has passed.

It is not without purpose. The reason is, waiting for 3 months serves to restore a normal menstrual cycle before starting to try to get pregnant again.

Still quoted from the website The Ectopic Pregnancy Trust, several reports that show someone can successfully get pregnant again after 18 months post-ectopic pregnancy with a success rate of 65 percent.

Other studies have also reported that 85 percent of women can get pregnant again if they allow 2 years of time after an ectopic pregnancy.

In addition, what needs to be considered is the effect of methotrexate injections when treating ectopic pregnancy. This makes you have to wait a while for your next pregnancy.

After an injection of methotrexate, you must wait for the hCG level in your body to drop below 5 mlU per milliliter during a blood test.

This is because, the drug methotrexate can reduce folate levels in the body. Folic acid is an important substance that the mother and fetus need from the beginning of pregnancy.

Therefore, the doctor will also recommend that you eat and take supplements that contain folic acid for 12 weeks before trying to get pregnant again after a miscarriage or an ectopic pregnancy.