Ectopic Pregnancy: Diagnosis, Treatment and Surgery

All About Ectopic Pregnancy

Ectopic pregnancy, a pregnancy implanted outside the uterus instead of in the fallopian tube, accounts for about 1 to 2 percent of conceptions. While the majority of women who experience an ectopic pregnancy will have a healthy baby, it does affect your chance of becoming pregnant again or your chance of having another ectopic pregnancy.

If you are experiencing this form of pregnancy or have questions or concerns regarding ectopic pregnancy, read on for more information:

Causes

If the fallopian tube is blocked or damaged and unable to transport the embryo to the uterus, the embryo may implant in the lining of the tube, which is an ectopic pregnancy. The fallopian tube cannot support the growing embryo, and the tube may then rupture and bleed. 

While 95 percent of ectopic pregnancies occur within the fallopian tube, they also, very rarely, occur within the cervix, ovary, or in the abdomen.

If you have a history of tubal disease (which commonly results from prior pelvic infection) or history of ectopic pregnancy, you are more at risk.

Symptoms

Is there a way to determine if you are suffering from an ectopic pregnancy? Some signs and symptoms to look out for include, but are not limited to:

  • Pelvic pain
  • Abnormal bleeding
  • Abnormal levels of human Chorionic Gonadotropin (hCG)
    • In a normal pregnancy, the blood level of hCG should double almost every 48 hours. If this doubling does not occur, it may mean an ectopic pregnancy.

Diagnosis

In the past, ectopic pregnancies were often diagnosed after they have ruptured. Now there are a number of sensitive pregnancy tests we can perform and by the time you are due for your menstrual period, we can determine the location of your pregnancy within one to two weeks.

Here a few of the tests we may perform to determine if your pregnancy is ectopic:

  • Measuring hCG and/ or progesterone levels
  • Dilation and curettage (D&C)
  • Laparoscopy
  • Ultrasound
    • We can perform an ultrasound within the first three to five weeks after conception to determine whether the pregnancy is inside the uterine cavity. 

Treatment

Depending on the patient, the treatment for ectopic pregnancy will vary. 

Observation Alone

Some ectopic pregnancies resolve without treatment and can be managed by observation alone. This is typically limited to women with early ectopic pregnancies with no symptoms and low serum hCG levels that can decrease without treatment.

Medical Treatment

With early diagnosis of an ectopic pregnancy, medical treatment often is possible with drugs.

Surgical Treatment

Laparoscopy is a common surgical treatment for this form of pregnancy.

Operative Laparoscopy Versus Laparotomy for Ectopic Pregnancy

Many of these operations can be performed by “laparoscopy,” using a small telescope with a camera and two to four smaller skin incisions approximately one-quarter to one-half inch long. Women generally are able to go home the day of surgery and recover more quickly, returning to activities in three to seven days.

 

If you think you may be suffering from an ectopic pregnancy or you want to undergo testing, call us to schedule an appointment or ask questions.

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