An ectopic pregnancy can constitute a medical emergency if it is not treated immediately. The situation is that usually no one realizes that this type of pregnancy has occurred until symptoms have occurred showing that it is not a normal pregnancy and immediate intervention is necessary.
In a normal pregnancy, the sperm fertilizes the egg in the fallopian tube. The embryo which is then formed travels down to the uterus where it then implants into the uterine wall. It is then nourished by the uterus until the placenta is formed. In an ectopic pregnancy, the embryo implants in an area outside of the uterus. This most commonly happens in the fallopian tube. It is for this reason most lay people call this a tubal pregnancy. Technically an ectopic pregnancy is any pregnancy that occurs outside the uterus. On occasion the pregnancy can occur in other areas besides the fallopian tubes. On rare occurrences, the embryo can implant on the ovary, the cervix, or even in the abdomen.
The medical emergency occurs as the embryo grows it can cause the fallopian tube or other structure to burst open and bleed. Internal hemorrhage can follow. This constitutes a medical emergency that needs to be treated with surgical intervention immediately. If not treated promptly a woman can go into shock and even die if not treated properly. Other complications that can occur include infection that can set up in the abdominal cavity.
The symptoms that are associated with an ectopic pregnancy start out with all of the same symptoms that occur with an early uterine pregnancy. These symptoms include a missed menstrual period, nausea, fatigue, increased sleepiness, and sore or tender breasts. Symptoms of an ectopic pregnancy when rupture is imminent include pain in the abdomen that may start on one side then spreads over the whole abdomen and vaginal bleeding. If these symptoms occur, a woman should see her physician immediately for consultation, an exam and testing to rule out this problem.
A physician will usually do the following tests to rule out an ectopic pregnancy. A pelvic exam will be done to check for tenderness, swelling, any unusual growths, or to see if the uterus has increased in size. They can then do a blood test called a beta HcG to test the level of HCG in the bloodstream. Women secrete this hormone in early pregnancy. Level that rise and even double suggest a normal uterine pregnancy while levels that drop can be indicative of an ectopic pregnancy. Finally an ultrasound can be done to see if the pregnancy is in the uterus. These can usually be seen after 6 weeks. If the physician decides that an ectopic pregnancy has occurred they will then decide on the type of treatment that is appropriate.
Medication can be used in rare cases where the fallopian tube has not been damaged already. However most ectopic pregnancies are not found until a rupture has taken place. Once this has happened, surgical intervention is necessary to remove the tube or structure affected and the pregnancy itself. Bleeding is then stopped and the damage is repaired. Surgeons can most often use laparoscopic surgery to take care of these issues which allow the woman to heal quickly and easily from this procedure.
Some women are more at risk for an ectopic pregnancy than others. Women who are at risk of ectopic pregnancies include those women who smoke. Women who have had pelvic inflammatory disease are more at risk of an ectopic pregnancy. This disease is an infection in the pelvic organs that is usually caused by organisms such as Chlamydia and Gonorrhea. Women who have had previous abdominal or pelvic surgery who may have scar tissue are more likely to have an ectopic pregnancy. Women who have had endometriosis or whose mothers were treated with DES before they were born are more likely to have this condition. Those women who have had invitro-fertilization are more likely to have an ectopic pregnancy as well.
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