Ectopic Pregnancy – A Leading Cause of Pregnancy Related Death
Ectopic pregnancies are a big problem for women of childbearing age. They occur in 2% of pregnancies and can be life threatening to the mother if unrecognized and untreated. In normal pregnancies, the sperm and egg connect to form an embryo which is then implanted in the uterus. In ectopic pregnancies, however, the embryo never reaches the uterus and is implanted somewhere else. The most common place it is implanted is the fallopian tube (the tube that connects the ovary to the uterus). The fallopian tube is not a large space.
As the embryo begins to grow it is constricted by the small size of the fallopian tube and this ultimately leads to death of the fetus and/or rupture of the fallopian tube. (The only organ capable of expanding big enough to accomodate an entire pregnancy is the uterus.) If not caught and treated early, ruptured ectopic pregnancies can cause death of the mother due to massive internal bleeding.
Ectopic pregnancy is such an important issue to be aware of because in certain countries like the USA, it is the leading cause of pregnancy related deaths in the first trimester. Even though ectopic pregnancies only occur in 2% of pregnancies, its still a very real problem that many women worldwide face and should know the signs and symptoms of. Women at higher risk for ectopic pregnancies if they get pregnant are those between 35-44 yrs, smokers, ones with history of Pelvic Inflammatory Disease caused by the STDs chlamydia and gonorrhea, IUDs, got their tubes tied, or had previous pelvic surgeries. The top three signs of an ectopic pregnancy are history of a missed period, severe abdominal pain, and vaginal bleeding.
Other symptoms may include nausea, heavy cramping, shoulder pain, and pain during sex. 50% of women will however, have no signs of ectopic pregnancy. If you experience any of these things you should go straight to an emergency room. There, the doctors will first ask you to take a pregnancy test and then do an ultrasound to look for a fetus in the uterus. If the pregnancy test is positive but there is no fetus in the uterus, then it is highly likely there is an ectopic pregnancy and the fetus is in the fallopian tube instead.
The doctors may also do something called a “bimanual” pelvic exam to feel for unusual masses nearby the uterus. If you are diagnosed with ectopic pregnancy, unfortunately, the fetus will be unable to survive and will need to be removed before the fallopian tube ruptures and your life becomes in danger as well. There are medical and surgical ways that this can be managed. A drug called Methotrexate is often used to stop the pregnancy from growing. Surgeons may also go in laparoscopically and remove the ectopic pregnancy in the operating room.
These methods are very effective. In conclusion, ectopic pregnancies occur when the fertilized egg never reaches the uterus and instead starts to grow in the tube that connects the ovary to the uterus. This happens in ~2% of all pregnancies and can be life threatening. For that reason, it is important for women to know the risk factors and symptoms.