Pregnancy is one of the most transformative processes a person can go through. Whether it is the person giving birth, the partner, or the baby itself.
But creating a person from scratch is hard work and far from easy. There are often complications with conception. These complications range from frustrating to annoying, painful to heartbreaking and potentially life threatening.
One possible complication is an ectopic pregnancy. You have probably heard this term before and you may have a general idea of what it is. Now we’re going to break it down even further.
What is an ectopic pregnancy?
Ectopic pregnancy is that Leading cause of first trimester deaths in pregnant womenbut it is usually completely treatable if caught early and can even resolve on its own.
About one in fifty pregnancies in the United States is considered “ectopic”.
Typically, a fertilized egg is implanted in the endometrium, also known as the inner lining of the uterus. In the case of an ectopic pregnancy, the embryo actually implants outside the uterine wall.
Sometimes also called tube pregnancies (as typically found in the Fallopian tubes) the implantation can also be carried out in the abdomen, in the cervix or in an ovary.
Signs of ectopic pregnancy
With your body going through so many changes, figuring out what is normal and what is not can be difficult. Knowing what warning signs to look out for can help prevent further complications.
In some cases, a pregnant person may not know until they have symptoms of an ectopic pregnancy.
Please note the following:
- Typical signs of pregnancy: Like missing a period (amenorrhea), nausea, breast tenderness and nausea.
- Abdominal and pelvic pain: Especially if it is severe or gradually worsens.
- Excessive bleeding or bleeding: This could indicate a broken tube.
- Vaginal bleeding or spots: Some spots may be normal during pregnancy, but could be a sign of tube pregnancy.
- Dizziness: Low blood pressure due to bleeding may make you faint or dizzy.
- Nausea and vomiting: Of course, this can be a normal part of pregnancy, but it’s something to watch out for, especially if it comes out of the blue.
- Intense shoulder pain: May occur with internal bleeding.
- Shock: Symptoms of blood loss or internal bleeding such as confusion, pale skin, changes in heart rate or dizziness.
- Intuition: The intuition of a pregnant person is not to be underestimated. If something doesn’t feel good, listen to your gut and have it checked out.
If a pregnant person is undiagnosed, she’ll almost always show signs of an ectopic pregnancy after about eight weeks.
How is it diagnosed?
- Pregnancy test: One can be given, especially if you’re showing symptoms without first confirming pregnancy.
- Ultrasonic: An ultrasound can show ectopic pregnancies occurring in the fallopian tubes, but they may not occur at all. Pregnancy with no visible fetus indicates a fallopian tube. A transvaginal ultrasound (inside the vagina) can also be used.
- Gynecological check: This will allow you to show your doctor any areas of pain, tenderness, or mass outside of the uterus.
- Beta hCG blood test: Your body produces the hormone human chorionic gonadotropin (hCG) during pregnancy. Low or slowly increasing values can be used as a diagnostic test.
These tests are usually done together and may need to be repeated before a correct diagnosis can be made.
It is not always immediately clear whether or not a pregnancy is ectopic, and it can be difficult to diagnose. If something doesn’t feel right, keep going for more testing.
What are the risk factors?
While an ectopic pregnancy can potentially happen to any pregnant person, there are certain ones Risk factors that can increase someone’s chances.
- Cigarettes: We all know the risks associated with lighting up. An ectopic pregnancy is one of them.
- Pelvic Inflammatory Disease / Endometriosis: Although the risk is small, PID and endometriosis have been shown to increase the likelihood of tube pregnancy.
- the IUD; Pregnancy that occurs in someone who has an intrauterine device can increase the XP chance by 4-5 times.
- Fertility Treatments: People who have had fertility treatment have a slightly higher risk of EP.
- Previous ectopic pregnancy: There is about one 10% increased risk for the subsequent tube pregnancy after the first.
How do you handle it?
Treatment for EP depends on when it is discovered, other complications, and of course, the pregnant person’s preferences.
- Expectant management: about 40% of EP do not require treatmentand in the end dissolve yourself. Your provider can monitor your hCG levels, or some people may choose to closely monitor their symptoms from the comfort of their own home.
- Methotrexate: Is the most common medicine used to treat EP. It helps stunt the growth of the fetus and prevent possible rupture.
- Surgery: A surgical procedure called a salpingostomy is done by cutting the fallopian tube to remove the embryo. Although this is no longer as common, it can also involve removing the fallopian tube.
- Birth: In extreme rare casesEspecially in the case of a belly pregnancy, an ectopic pregnancy with a live birth can be brought at full time. These are only a few, but it is possible!
Trust your intuition again. Ectopic pregnancies can come with very serious risks knowing the signs and listening to your body. If you have symptoms of an ectopic pregnancy it is time to see a doctor.
Natasha’s passion for reproductive health began at the age of fourteen when she was present at the birth of her youngest sister. Her incredible experiences as a birthing doula gave her insights into the magical realm of childbirth, pregnancy and everything in between. Your role as an obstetrician is her way of serving as an activist. She uses writing as a key educational tool to change the way we view reproductive health as a whole.