Ectopic Pregnancy : Causes, Symptoms, Tests & Treatments

What is an ectopic pregnancy?

In a normal pregnancy, the fertilized egg travels through the fallopian tubes toward the uterus, where it establishes itself and begins to grow. In the case of an ectopic pregnancy, the fertilized egg implants outside the uterus, usually in the fallopian tubes (and in some cases in the ovaries, cervix, or other places in the abdomen).

The fetus cannot develop properly in these places, so the pregnancy cannot continue. The chance of an ectopic pregnancy is relatively low, accounting for only 2 percent of pregnancies.

What causes an ectopic pregnancy?

In a few cases, an ectopic pregnancy does not cause any noticeable symptoms, and it is detected only during a routine pregnancy test, but in most cases, some symptoms and signs appear on women, often between the fourth and twelfth week of pregnancy, and among these symptoms :

• Pain on one side of the abdomen, usually constant and severe.
• Shoulder tip pain usually occurs when lying down.
• Bowel pain when passing urine or stool.
• vaginal bleeding, which is different from period bleeding; It is spotty and the color of the blood may be bright red or dark.
• Diarrhea and vomiting. 

Is there a test to diagnose ectopic pregnancy?

Diagnostic tests for ectopic pregnancy include:

• Pelvic examination to check for pain on pressure or a mass in the abdomen.

• Transvaginal ultrasound: This involves inserting a small probe into the vagina so that the doctor can see if the gestational sac is in or outside the uterus. This examination will show if the fertilized egg has engulfed one of the fallopian tubes.

• Blood test to determine levels of human chorionic gonadotropin (HCG) and progesterone: If the levels of these hormones decrease or remain the same over a few days and the gestational sac is not present on the ultrasound, it is likely that the pregnancy is ectopic.

• Laparoscopy: It is a surgery performed under general anesthesia, through making an incision in the abdomen and inserting a viewing tube called a laparoscope to examine the uterus and fallopian tubes.

• Urine pregnancy test.

How an ectopic pregnancy is treated?

Treatment of ectopic pregnancy depends on the size of the fetus, the pregnant woman’s suffering from pain, bleeding, and many other factors. The methods used in treatment include:

• methotrexate medication

This drug is given intramuscularly and works to terminate a pregnancy by stopping the growth of placental cells, and when the drug begins to work, a woman may feel abdominal pain or cramps, nausea, vomiting, and diarrhea. Then, a series of blood tests are done to check hCG levels and make sure the treatment is working. This usually takes a few weeks.

• Removal of the fallopian tubes

The fallopian tube must be partially or completely removed in case it has ruptured and bleeding appears, and the bleeding must be stopped immediately.

• Laparoscopic surgery

A laparoscope is used under general anesthesia to remove an ectopic pregnancy and to repair or remove a damaged fallopian tube. If the ectopic pregnancy cannot be removed laparoscopically, another surgery called abdominal exploration can be performed.