Spotting Ectopic Pregnancy: A Special Guide by Dr. Shreya Iyengar Patel, Infertility Specialist at Balaji Horizon Women’s Hospital
Ectopic pregnancy is defined as the condition of a woman who has had the implantation of a fertilized ovum outside of the womb, which could be life threatening in nature. It is critical to detect ectopic pregnancy at its very onset if possible so as to minimize any severe consequences and guarantee appropriate intervention. We at Balaji Horizon Women’s Hospital are fully dedicated to provide you with professional care and advice for early detection and management of ectopic pregnancy in order to protect your health.
What is Ectopic Pregnancy?
Ectopic pregnancy accounts for approximately 1 to 2 percent of all pregnancies, the most frequent location seems to be the fallopian tubes (tubal pregnancies). However, they may also occur in the cervix, ovaries, abdominal cavity, and even in some locations where there are cesarean section scars. Various factors impede the movement of the egg from the womb to the uterus resulting in it being ectopically implanted. When left unattended, an ectopic pregnancy can bring dire consequences such as a ruptured fallopian tube and great amount of internal hemorrhage.
Possible Causes of Ectopic Pregnancy
The fertilized egg can be prevented from reaching the uterus for a number of reasons, all of which are cases of ectopic pregnancy.
Common causes and risk factors include the following:
- Pelvic Inflammatory Disease (PID) – Sexually transmitted diseases like chlamydia and gonorrhea may lead to scarring due to PID, which impedes the egg’s journey to the uterus as it is trapped in the fallopian tubes.
- Past Ectopic Pregnancy – Women who have had ectopic pregnancies are prone to having future ones as well. Thus, they fall into a higher risk group.
- Tubal Surgery or Abnormalities – There is also the case of patients suffering from endometriosis or who had a tubal ligation surgery, as they are also at risk of developing an ectopic pregnancy.
- Age and Smoking – A woman over 35 years of age stands a greater chance of ectopic pregnancy as well as someone suffering from smoking as both factors help mitigate the movement of the fallopian tubes.
- Assisted Reproductive Technologies (ART) – Pregnancy through certain methods of ART has been linked, although in a minor way, to an increased risk of ectopic pregnancy.
We conduct thorough examinations, so we do not overlook such details about women who are older or have had recurrent issues. This is why, at Balaji Horizon Women`s Hospital, we ensure that women prone to risk factors are properly monitored.
Signs of Ectopic Pregnancy
As in normal pregnancies, symptoms often appear within the first few weeks and in some cases, can be severe and therefore need immediate treatment if not addressed correctly. Some of the signs include:
- Initial Signs:
- Only one breast is tender
- Period is missed
- Nausea or vomiting
- Ectopic Pregnancy Symptoms: Warning Signs
- Abdominal or pelvic pain usually is sharp pain located on one side.
- Vaginal bleeding or spotting ranging from light to heavy bleeding.
- Shoulder pain may occur when irritation of the diaphragm from internal bleeding causes referred shoulder pain.
- Dizziness or fainting can indicate blood loss or shock.
All of these warning signs require immediate medical attention for prompt care diagnoses.
Diagnostic Methods for Early Detection
The early identification of an ectopic pregnancy combines clinical history evaluation, laboratory confirmation, and imaging modalities.
- Clinical Evaluation:
- Medical History: We obtain the patient’s medical history and identify other ectopic pregnancy risk factors like prior ectopic pregnancies, infections, or tubal surgery.
- Pelvic Examination: We examine for tenderness and masses or cervical motion tenderness which may suggest the possibility of an ectopic pregnancy.
- Laboratory Tests:
- Human Chorionic Gonadotropin (hCG) Levels: During the earliest stages of an ectopic pregnancy, the hcg level rises more slowly than within a normal pregnancy. Serial hCG levels must be tested continually to monitor abnormal elevations or plateaus.
- Thyroid Tests: A progesterone level <5 ng/mL could indicate either a failing pregnancy or an ectopic pregnancy.
- Imaging Techniques
- Transvaginal Ultrasound (TVUS): This is the most reliable test for diagnosing an ectopic pregnancy.
The absence of an intrauterine pregnancy while hCG levels are high correlates to the increased risk of ectopic pregnancy.
- Doppler Ultrasound: This technique can be used to determine whether blood circulation exists in a potential area of ectopic pregnancy.
- MRI or CT scan: While these are not common, these tests may be required in complex diagnostic situations like abdominal pregnancies.
- Other minimally invasive techniques include these:
- Diagnostic Laparoscopy: This procedure permits direct inspection of an ectopic pregnancy, and it is considered a conclusive technique for diagnosis.
How Ectopic Pregnancies Can Be Resolved
Once an ectopic pregnancy is diagnosed, the treatment will depend on the patient’s condition, including the size and region of the ectopic tissue as well as the concentration of hCG in the serum.
- Non-Surgical:
- Methotrexate Therapy: This medication controls the cellular proliferation of ectopic pregnancy tissues. Stable patients with low hCG levels are prescribed this medication, and the patient will be monitored closely to ensure the pregnancy resolves.
- Surgical Options:
- Laparoscopic Salpingectomy/Salpingostomy: Laparoscopic techniques are appropriate in cases when the surgical management of ectopic pregnancy is warranted in those patients who have hCG levels above the expected range. Additionally, these techniques have been shown to reduce recovery time.
- Open Surgery: As a last resort when bleeding is and will be non-stop and more life threatening than internally operating on the damage.
- Expectant Management:
Some ectopic pregnancies that are smaller in size can in fact resolve without intervention happening. Keeping track of the person’s progress is crucial to ensure that there are no complications happening.
Steps Taken to Prevent Ectopic Pregnancy
While not all ectopic pregnancies are avoidable, several of the following can at least lessen the chances:
- Prompt treatment of infections that may lead to pelvic inflammatory disease.
- Smoking cessation to promote better health of the fallopian tubes.
- Periodic evaluation by gynecologist for early discovery of any deviations from normal.
- Careful application of ART technology with a physician’s supervision.
Need for Follow-Up Care
Following up with your provider to monitor hCG levels and confirm the ectopic pregnancy’s resolution is very important. This follow-up is necessary to investigate worsening complications and enabling future fertility.
Conclusion
To be able to take care of a mother’s health and fertility, it is very important to be able to identify ectopic pregnancy and treat them while ensuring its thoroughness. By patients taking proactive measures with identifying signs, using the right tests and following the prescribed dose of medicines, chances of worrying complications greatly diminishes. If you think there is a chance of having ectopic pregnancy, or have a higher risk of developing one, contact us today at Balaji Horizon Women’s Hospital. It would be our pleasure to assist you with our highly equipped team headed by Dr.
Consider Shreya Iyengar Patel as your trusted companion with the know-how to take care of you every step of the way.
Reach out to us now if you would like to book an appointment or if you need details regarding your consultation. We are here to prioritize your health and well-being.
