What is Ectopic Pregnancy? Types, Symptoms, Causes, and Treatment -

We have heard of several issues surrounding pregnancy – miscarriages, fibroid, late delivery – and these are just the basic and common issues we know. But ectopic pregnancy is a pretty odd case on a whole different level!

What is Ectopic Pregnancy?

Ectopic pregnancy, also known as extrauterine or tubal pregnancy, describes a situation where a fertilized egg implants outside the uterus – mostly the fallopian tube. Meaning that you are pregnant with a baby, but not in your womb. That’s crazy!

Types of Ectopic Pregnancy

Ectopic pregnancies occur in different kinds and we can classify them according to where precisely the fertilized egg implants.

Tubal Pregnancy

Tubal pregnancy is the most frequent case of ectopic pregnancy. It happens when the fertilized egg embeds in the fallopian tube. The type of tubal pregnancy depends on where precisely implantation occurs in the fallopian tube.

Fimbrial: This covers about 5% of all cases. It describes a situation where the fertilized egg implants in the fimbrial end of the fallopian tube.
Ampullary: Here, implantation occurs in the ampulla of the fallopian tube. It covers about 80% of all cases of ectopic pregnancy.
Isthmic: Just like the aforementioned, implantation occurs in the Isthmus of the fallopian tube. Due to increased vasculature in this area, mortality is most likely to occur. It covers about 12% of all cases .
Interstitial: In this type of pregnancy, the fertilized egg implants in the interstitial and cornual parts of the fallopian tube. Interstitial pregnancy covers about 2% of all cases. Due to increased vasculature in these areas, mortality is also very likely to occur.

Non-tubal Pregnancy

Non-tubal pregnancy constitutes about 2% of all ectopic pregnancies where implantation occurs in other areas, including the cervix, ovary, and intra-stomach regions.

Ovarian pregnancy: As the name implies, implantation happens in the ovary.
Cervical pregnancy: Here, the egg embeds in the cervical canal.
Intra-stomach (Abdominal pregnancy): In these cases, the embryo implants in the abdominal region. It usually represents a greater risk to the mother than other types of ectopic pregnancy.
Cesarean scar pregnancy: Personally, this one scares me – although the rarest of all. In CSP, a fertilized egg implants on a scar from a previous Cesarean Section procedure.

Heterotopic Pregnancy

In irregular cases where more than one egg fertilizes, one may implant in the uterus while the other elsewhere. Due to the painful nature of ectopic pregnancy, doctors usually discover it before the intrauterine pregnancy. The pregnancy in the womb may still be feasible even after removing the ectopic pregnancy, but only if human chorionic gonadotropin (HCG) levels continue to rise.

Symptoms of Ectopic Pregnancy

At first, the signs of ectopic pregnancy are not noticeable. The woman will only experience the usual symptoms of pregnancy – missed period, vomiting/nausea, and slight breast pain. As the ectopic pregnancy develops, these symptoms begin to show:

Sharp pain coursing through the abdominal, pelvic, and shoulder regions.
Intense pain on one side of the abdomen.
Vaginal spotting and bleeding.
Lightheadedness and fainting.
Difficulty in passing out stool.
In a few extreme cases, rupture of the fallopian tube may occur as ectopic pregnancy grows.

If you are experiencing any of these symptoms, do well to contact your doctor or seek quality medical attention.

Causes and Risk Factors

Sometimes, as the fertilized egg travels through the fallopian tube to the uterus, it gets stuck, often because of inflammation or damage to the fallopian tube – leading to an ectopic pregnancy. Every sexually active woman is at risk of having an ectopic pregnancy, but some habits and medical history can increase one’s risk.

Risk factors include;

History of ectopic pregnancy.
Age of 35 years and above.
Conception using fertility aids.
History of tubal surgery, pelvic surgery, or abdominal surgery.
History of multiple abortions.
History of STDs.
History of endometriosis.
Pregnancy after tubal litigation is likely to be ectopic.
Smoking.

Treatment

The uterus is the only suitable place a baby can develop normally. So outside the uterus, it’s a lost cause and a life-threatening situation. If the pregnancy doesn’t terminate spontaneously – as conditions outside the uterus are unsuitable – a surgical procedure is done to remove the pregnancy, or a medication is given. The treatment method depends on the symptoms and when pregnancy is discovered.

Medication

One of the common medications your doctor may prescribe is Methotrexate (Rheumatrex). Methotrexate stops the development of rapidly dividing cells, like that of an ectopic pregnancy. If the drug is effective, one may experience signs of miscarriage like bleeding, cramps, and passing of the tissue. The side effect is that the recipient might not be able to get pregnant for several months. But it doesn’t come with the risks of damage to the fallopian tube as surgery.

Surgery

Removal of ectopic pregnancy is through a surgical procedure called Laparotomy. The surgeon inserts a small camera through an incision to enable a clear view. The surgeon then removes the embryo and repairs the fallopian tube. In cases where the laparotomy is unsuccessful, the patient undergoes the procedure again. If there is damage to the tubes, it is removed.

Prevention is Better Than Cure

There is no hard and fast rule or ‘to-do’ list on how to run away from an ectopic pregnancy and prevent it from coming close to you and your generation. But there are habits you need to break and others you need to make to decrease your risk of having one to the barest minimum.

Stop smoking – shayo, cigar, weed – before you try to get pregnant.
Practice safe sex with limited partners. Use condoms as much as you can to prevent STDs and STIs. These diseases and infections may affect your fallopian tubes, making you more susceptible to ectopic pregnancies.

Bottom Line

Ectopic pregnancy is not something you write on your birthday wish list. It isn’t just an abnormal situation, but it is also a medical emergency that poses a threat to your health. If you are exhibiting any symptoms, do well to see your doctor. If you have these symptoms and the medical histories, run! Run to the clinic as fast as you can and seek medical attention. Finally, if you do not have medical histories or symptoms associated with ectopic pregnancy – prevention is still better than cure. Keep that in mind, and you’re good to go.