Ectopic pregnancy miscarriage
An ectopic pregnancy, or tubal pregnancy, is one that occurs outside of the womb. The most common location for an ectopic pregnancy is inside one of the fallopian tubes.
This can occur when an egg is fertilized and does not implant into the uterus. The fertilized egg can attach to the inside of the fallopian tube, the ovary, the outside of the uterus or to the intestine. Fertilised eggs that implant outside of the uterus can not grow to become fetuses due to the lack of nutrients and non-accommodating organs.
Ectopic pregnancies are very dangerous. As the attached fertilised egg grows, it can damage organs and cause severe internal bleeding. For example, your fallopian tube isn’t designed to expand and accommodate a growing fetus. Therefore, if a fertilised egg implants there, it can rupture the tube. Arteries are located nearby and they can rupture as well.
The most common symptoms of an ectopic pregnancy are vaginal bleeding and abdominal or pelvic pain. Symptoms can become much more severe if the ectopic pregnancy ruptures. You may become dizzy or even pass out. You may experience a fast heart rate of over one hundred beats per minute. You may become pale, clammy and sweaty. Pain will become so severe that you are unable to stand or walk. Many women go into shock when an ectopic pregnancy ruptures.
If you suspect that you have an ectopic pregnancy or ectopic rupture, then you should immediately seek medical attention as you could have an immediate life-threatening condition. First, pregnancy will be confirmed. Second, an ultrasound will be performed to confirm that the pregnancy is ectopic. This will also help locate the developing embryo (fertilised egg). If the embryo or the gestational sac is too small to be detected by ultrasound, and you are in stable condition, then your doctor may monitor you closely by performing blood tests every two to three days to follow hormone levels. When the pregnancy (gestational sac, embryo or fertilised egg) has grown large enough, the ultrasound will be repeated to locate it. If it is confirmed that the pregnancy is ectopic, then immediate treatment will be ordered.
Depending on how long the fertilised egg has been growing, your doctor may be able to treat your ectopic pregnancy with a methotrexate injection. Make sure that you discuss with your doctor what you should expect after the injection, the risks involved and how to take care of yourself after the drug has been administered. If the drug is not effective or if the pregnancy (fertilised egg) has grown too large, then surgery will be necessary to remove the growing gestational sac and embryo (fertilised egg). Remember that this is not a viable egg capable of growing into a live born fetus, and it is a definite life-threatening situation.
The surgery depends on the size and location of the implanted egg. Whether or not you want to be able to conceive again is also a consideration. Laparoscopy can sometimes be used to remove the pregnancy. Keep in mind that if it is an emergency situation or if there is extensive internal injury, then a more extensive surgery called a laparotomy often must be performed.
If you believe that you may be experiencing any of the symptoms discussed here, seek immediate medical care. Time is of the essence when dealing with a possible ectopic pregnancy.
The above article was originally written by Dr. Eric Daiter a medical director of The NJ Center for Fertility and Reproductive Medicine, LLC.