Ectopic pregnancy is a pregnancy where a fertilised egg becomes implanted at sites other than the endometrial cavity of the uterus. Ectopic pregnancies can be dangerous for women during the first trimester of pregnancy.

Causes of ectopic pregnancy

General practitioner, Dr Sadie Habib, says that no single cause is linked to ectopic pregnancy but occurs due to a variety of factors, including a history of pelvic inflammatory disease, smoking, fallopian tube surgery, previous ectopic pregnancies, and infertility.

Symptoms of ectopic pregnancy

Ectopic pregnancy symptoms include abdominal pain, pelvic pain, and bleeding. having abnormally high levels of the hormone beta human chorionic gonadotropin (B.hCG) could also be an indicator of an ectopic pregnancy. Ultrasound is the most effective way to diagnose an ectopic pregnancy.

Treatment for ectopic pregnancy

Dr Habib says that once diagnosed, the ectopic pregnancy should be managed immediately, as any delay in treatment may induce the rupture of the growing embryonic sac outside the uterus and cause severe bleeding which may lead to death. Treatment of ectopic pregnancy depends on the clinical stability of the patient and includes either medical treatment or surgery.

If the mother is in a stable condition with a small embryonic sac, no signs of rupture and no foetal cardiac activity, medical treatment could include an intramuscular injection of methotrexate. This drug stops cells from reproducing. The foetus is absorbed by the body over four to six weeks.

Surgical management of tubal ectopic pregnancy can be done by laparoscopy, a minimally invasive surgery done using a thin instrument called a laparoscope with a light and camera which is introduced into the abdominal cavity through small incisions.

Two surgical procedures are commonly performed for ectopic pregnancy

Salpingostomy is a conservative surgery and it involves opening the fallopian tube, removing the ectopic pregnancy and leaving the tube to heal on its own. It is typically used to remove a small unruptured pregnancy.

Salpingectomy, on the other hand, involves complete removal of the tube. It is recommended in ruptured ectopic pregnancies, with excessive bleeding and in large tubal pregnancies.

Dr Habib states that with professional management, doctors expect that the ectopic pregnancy will resolve naturally without any intervention.

It is crucial to know that once an ectopic pregnancy has developed, there is a higher risk of having another one and to be aware of the signs and symptoms of ectopic pregnancy and seek medical help as early as possible.

A woman can become pregnant again after having an ectopic pregnancy. Future fertility plans should be discussed with an obstetrician.

sarene.kloren@iol.co.za

IOL Lifestyle

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Ectopic pregnancy: What you should know