- Signs and symptoms of ectopic pregnancy
- Causes of ectopic pregnancy
- Treatments for ectopic pregnancy
- When remedies are indicated
- When surgery is indicated
- Is it possible to get pregnant after surgery?
- Types of ectopic pregnancy
Ectopic pregnancy, or tubal pregnancy, is a pregnancy that takes place outside the uterus, inside the fallopian tubes, which is condemned to not develop because it is not possible to move the embryo into the uterus, and the tubes are unable to distend, as the uterus can, and therefore it breaks, putting the woman's life at risk.
The main causes of ectopic pregnancy, which is when the embryo is developing outside the uterus, are using the IUD, having endometriosis, chlamydia or having already had a tubal ligation.
Typically, ectopic pregnancy is identified up to 10 weeks of gestation on an ultrasound scan but it can also be discovered later. However, if the problem is not detected, the tube may rupture and is called a ruptured ectopic pregnancy, which can cause internal bleeding, which can be fatal.
Signs and symptoms of ectopic pregnancy
Some signs and symptoms that may indicate pregnancy outside the womb include pain on only one side of the belly, which gets worse every day, always localized, and vaginal bleeding, which may start with a few drops of blood, but which in a short time it becomes stronger.
The pharmacy pregnancy test can detect that the woman is pregnant, but it is not possible to know if it is an ectopic pregnancy, being necessary to perform an ultrasound exam to check exactly where the baby is located. As the ectopic pregnancy becomes broken before the 12th week of gestation, there is not enough time for the belly to start to grow, enough to be noticed by other people. Learn more details of the symptoms and diagnosis of tubal pregnancy.
In a normal pregnancy, with Beta HCG between 1000 and 2000 mUI / ml, the gestational sac must be seen inside the uterus by transvaginal ultrasound.
Causes of ectopic pregnancy
Possible causes of ectopic pregnancy include:
- Use IUDs; Scar from pelvic surgery; Pelvic inflammation; Endometriosis, which is the growth of endometrial tissue outside the uterus; Previous ectopic pregnancy; Salpingitis: Inflammation or deformation of the fallopian tubes; Chlamydia complications; Surgery in the fallopian tubes; Malformation of the fallopian tubes; In case of infertility; Having performed tubal ligation.
There are also factors that increase a woman's risk of having an ectopic pregnancy, such as being over 35, in vitro fertilization and having multiple sexual partners. See more about how Inflammation in the tubes can make pregnancy difficult.
Treatments for ectopic pregnancy
Treatment for ectopic pregnancy, which develops in the tube or ovary, can be done through the use of the drug methotrexate, which induces abortion or surgery to remove the embryo and reconstruct the tube.
When remedies are indicated
The doctor may decide to use drugs such as methotrexate 50 mg, in the form of an injection when an ectopic pregnancy is discovered before 8 weeks of gestation, the woman does not present rupture of the tube, the gestational sac is less than 5 cm, the Beta exam HCG is less than 2, 000 mUI / ml and the embryo's heart is not beating.
In this case, the woman takes 1 dose of this medication and after 7 days she must undergo a new Beta HCG, until it is undetectable. If the doctor thinks it is safer, he can indicate 1 more dose of this same medicine to make sure the problem is solved. Beta HCG should be repeated in 24 hours and then every 48 hours to see if it is gradually decreasing.
During this treatment, which can last up to 3 weeks, it is recommended:
- Do not do the vaginal touch exam because it can cause tissue rupture; Do not have intimate contact; Avoid exposure to the sun because the medicine can stain the skin; Do not take anti-inflammatories due to the risk of anemia and gastrointestinal problems related to the medicine.
Ultrasound can be performed once a week to check if the mass has disappeared because even though the beta HCG values are decreasing, there is still the possibility of rupture of the tube.
When surgery is indicated
Surgery for embryo removal can be done by laparostomy or open surgery, and is indicated when the embryo is more than 4 cm in diameter, the Beta HCG exam has more than 5000 mUI / ml or when there is evidence of rupture of the tube, which puts the woman's life at risk.
In either case, the baby cannot survive and the embryo must be completely removed and cannot be implanted inside the uterus.
Is it possible to get pregnant after surgery?
If the tubes were not damaged by ectopic pregnancy, the woman has new chances of getting pregnant again, but if one of the tubes broke or was injured, the chances of getting pregnant again are much lower, and if both tubes have broken or are affected, the most viable solution will be in vitro fertilization.
Find out how long it takes to get pregnant and tips to speed up this process at: How to get pregnant after a Tubal Pregnancy
Types of ectopic pregnancy
Ectopic pregnancy is a rare condition, the most common being that it develops in one of the tubes, but it can also develop elsewhere in the body, so there may be ectopic pregnancy in the ovary, ectopic abdominal pregnancy or an ectopic cervical pregnancy., which is when the fetus grows in the cervix. The less common types of ectopic pregnancies are:
- Ecstatic interstitial pregnancy: It occurs when the embryo develops in the interstitial segment of the tube. In this case, there is an increase in Beta HCG and the treatment is usually done with the drugs and potassium chloride, in several doses; Cervical pregnancy: It is when the embryo develops in the cervix, which can generate intense bleeding. Treatment can be done with embolization, curettage or local injection of methotrexate, for example; Ectopic pregnancy on cesarean scar: It is very rare, but it can happen, requiring treatment with methotrexate and folinic acid remedies, for about 1 week; Ovarian pregnancy: Sometimes it is only discovered during curettage and therefore methotrexate is not used; Heterotopic pregnancy: It is when the embryo develops between the uterus and the tube, but it is usually only diagnosed after the rupture of the tube and therefore the most used treatment is surgery.
In addition to these types, there is also ectopic abdominal pregnancy, which is when the baby develops in the peritoneum, between the organs. This is a very rare condition and each case must be assessed individually. This is a complicated pregnancy because as the baby grows, the mother's organs are compressed and blood vessels can be ruptured, potentially fatal. However, there are reports of women who managed to get the baby to reach 38 weeks of gestation, having a cesarean section for the birth.
