Ectopic Pregnancy Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Ectopic pregnancy is a pregnancy that occurs outside the uterus. In a normal pregnancy, the fertilized egg will pass through the fallopian tube that connects the ovary to the uterus to the uterus. The egg will attach to the uterus and begin to grow into a fetus.
But in an ectopic pregnancy, the fertilized egg will stick and grow where it shouldn’t.
This condition most often occurs in the oviduct area, which is 98 percent.
However, ectopic pregnancies can also occur in the ovaries, abdominal cavity, or cervix.
Ectopic Pregnancy
| Medical specialist | Obstetrics and Gynecology |
| Symptom | Sharp and intense pain in the lower abdomen, the pain will get worse when moving, massive vaginal bleeding, stomach cramps |
| risk factor | Previous ectopic pregnancy, previous fallopian tube surgery, previous pelvic or abdominal surgery, certain sexually transmitted infections, pelvic inflammatory disease, endometriosis, smoking, age over 35 years, history of infertility, history of in vitro fertilization ( IVF ) |
| How to diagnose | Medical interviews, physical examinations, and supporting examinations such as urine, blood and ultrasound examinations |
| Treatment | Termination of pregnancy (surgery) and drugs |
| Drug | Methotrexate |
| Complications | Bleeding in the pelvic and abdominal cavities, pallor, and hypovolemic shock |
| When to see a doctor? | Massive vaginal bleeding and pelvic pain, abdominal pain, vomiting, stomach cramps, extreme weakness, pain in the shoulder, neck and rectum, dizziness, fainting, shoulder pain, and severe abdominal pain especially on one side |
Symptom
In the early weeks, an ectopic pregnancy will have pregnancy-like characteristics, such as late menstruation, nausea and vomiting, fatigue, and hardened breasts.
Therefore, a more intensive independent examination is needed by paying attention to the following symptoms of ectopic pregnancy:
- Severe pain in the lower abdomen. Initially, this pain can be sharp, then slowly spread throughout the abdomen
- The pain will get worse when moving
- vaginal bleeding The conditions can vary, can be in the form of spotting or heavy bleeding like menstruation
If a woman with an ectopic pregnancy has the above symptoms, it means that the woman has an interrupted ectopic pregnancy (CEP).
Reason
The causes of ectopic pregnancy can be varied, such as:
-
History of previous ectopic pregnancy
The recurrence rate can be up to 15 percent after the first ectopic pregnancy. In fact, the rate increases by 30 percent after a second ectopic pregnancy.
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Still using spiral contraception and progesterone pills while pregnant.
Pills containing the hormone progesterone also increase ectopic pregnancy. The reason is, progesterone pills can interfere with cell movement, thus bringing the fertilized egg to attach to the uterus.
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Damage to the oviduct.
The fertilized egg has difficulty passing through the channel, causing the egg to stick and grow in the fallopian tube.
Several risk factors can cause this channel disorder, including smoking, pelvic inflammatory disease, and endometriosis.
Risk Factors
Risk factors for ectopic pregnancy include:
- Previous ectopic pregnancy
- Previous fallopian tube surgery
- Previous pelvic or abdominal surgery
- Certain sexually transmitted infections (STIs).
- Pelvic inflammatory disease
- endometriosis
- Smoke
- Age over 35 years
- History of infertility
- Use of assisted reproductive technology, such as in vitro fertilization (IVF)
Diagnosis
Examination of ectopic pregnancies will be carried out by doctors based on interviews, physical examinations, and supporting examinations.
During the interview, the doctor will ask the following:
- Felt grievances
- Menstrual history
- History of pregnancy and use of birth control
- Past medical and surgical history
- Allergy history
- Family medical history and other important information
During the physical examination, the doctor will carry out a complete examination, including examination of blood pressure, pulse, temperature, breathing, abdomen and pelvis, and vaginal examination.
This pelvic exam is done to confirm the size of the uterus during pregnancy and to feel the condition of the abdominal surface.
Meanwhile, supporting examinations can be carried out by:
- Urine examination. This stage is carried out to determine the condition of pregnancy
- Blood tests every two days. This is done to check the ß-hCG hormone produced during pregnancy. In young pregnancies, the level of this hormone increases twice every 2 days. Low hormone levels indicate a problem, such as an ectopic pregnancy
- Ultrasound examination (USG). This examination can describe the contents of a woman’s uterus. An ultrasound examination can see where a person’s pregnancy is located, whether in the uterus, fallopian tubes, ovaries, or elsewhere
Treatment
Treatment of ectopic pregnancies is carried out by surgery at the discretion of a specialist in obstetrics and gynecology.
Because ectopic pregnancies can be life-threatening, early detection and decisions to terminate pregnancies are adjusted to the procedures recommended by the hospital.
Treatment of ectopic pregnancy can be done in the following ways.
1. Drugs
Can be given if the ectopic pregnancy is detected early. The drugs used are anticancer drugs
2. Operation
For pregnancies that are more than a few weeks old, surgery is a safer procedure and has a higher success rate than medication
If possible, surgery will be carried out into the interior of the abdominal and pelvic cavities
Meanwhile, the drug most commonly used to treat ectopic pregnancies is methotrexate. These drugs stop cell growth, which ends the pregnancy.
Pregnancy is then absorbed by the body for 4-6 weeks. This treatment does not require removal of the fallopian tubes.
Prevention
Prevention of ectopic pregnancy can be done in various ways, such as:
- Quit smoking. Women who smoke are more likely to have an ectopic pregnancy
- Have sex safely, for example by using a condom. This can reduce the risk of ectopic pregnancy and protect a person from sexually transmitted diseases
- Early detection by seeing a doctor. The risk of ectopic pregnancy cannot be avoided 100 percent. However, you can reduce complications with early detection
If you have a history of previous ectopic pregnancies, cooperation with your doctor should be increased to prevent complications
- When you feel that your period is late or get positive test pack results, immediately consult a doctor so that an ultrasound can be done
This is to determine where the location of the attachment of the fetus. If it turns out that the fetus is attached outside the uterus, immediate treatment can be done before the oviduct ruptures
Complications
The most common form of ectopic pregnancy complication is bleeding in the pelvic and abdominal cavities. As a result, pregnant women will experience from lack of blood to pale faces, shock, and even death if not treated immediately.
When to See a Doctor?
If you experience some of the symptoms below, this is an early sign of an ectopic pregnancy. You should immediately see a doctor.
- Mild vaginal bleeding and pelvic pain
- Abdominal pain and vomiting
- Sharp stomach cramps
- Pain on one side of your body
- Dizziness or extreme weakness
- Pain in the shoulder, neck or rectum
An ectopic pregnancy can cause the fallopian tube to rupture. Emergency symptoms include severe pain, with or without heavy bleeding.
Call your doctor right away if you have heavy vaginal bleeding with lightheadedness, fainting, or shoulder pain, or if you have severe stomach pain, especially on one side.