An ectopic pregnancy occurs when a fertilized egg (embryo) implants in another location other than the uterine cavity (Houry & Salhi, 2009). It’s life-threatening complication and at most times not viable. It poses a great risk of internal hemorrhage secondary to rupture and is considered a medical emergency.

Most ectopic pregnancies implant in the fallopian tubes. The other likely areas of ectopic implantation are the ovaries, cervix and abdomen. According to Schenker and Margalioth (2012), implantation in these areas occurs if there’s a blockage that hinders movement of the fertilized egg through the fallopian tubes.

Causes

  • Congenital abnormalities involving the fallopian tubes
  • Scarring from sexually transmitted diseases, for instance Chlamydia or surgical procedure such as unsuccessful tubal ligation
  • Ectopic pregnancy in the past
  • Some fertility treatments for instance, in-vitro fertilization
  • Pelvic inflammatory disease

Symptoms

According to Houry and Salhi (2009), one may experience early pregnancy symptoms such as amenorrhea, nausea/vomiting and breast tenderness. Other symptoms are as follows:

  • Lower abdominal pain
  • Abnormal vaginal bleeding
  • Sharp abdominal cramps
  • Weakness or dizziness
  • One sided pain of the lower abdomen
  • Severe bleeding and pain in case fallopian tubes rupture
  • Low blood pressure

Diagnosis

The woman may present with pelvic tenderness. A pelvic examination should be done and pregnancy (PDT) confirmed. In ectopic pregnancy, human chorionic gonadotrophin in the blood is lower than in normal pregnancy (Schenke & Margalioth,2012). A vaginal ultrasound and sonogram should be done to confirm the location of the embryo.

Treatment

Ectopic pregnancy cannot grow to term and should be terminated to save the life of the mother (Houry & Salhi, 2009). In un-ruptured pregnancy, use of medication like methotrexate and surgery are employed to remove the growing cells. Ruptured ectopic pregnancy is an emergency which may lead to death through hemorrhage. Early treatment of STIs is necessary to avoid such pregnancies.

References

Houry, D. E., & Salhi, B. A. (2009). Acute complications of pregnancy (7th ed.). In J. Marx (Ed.), Rosen’s Emergency Medicine: Concepts and Clinical Practice (chap 176). Philadelphia: Elsevier Mosby.

Schenker, J. G., Margalioth, E. J. (2012). “Intra-uterine adhesions: an updated appraisal”. Fertility and Sterility, 37(5): 593–610. Web.

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