An is one in which the
Fertilize d
Ovum is implanted in any tissue other than the
Uterine wall. Most ectopic pregnancies occur in the
Fallopian Tube (so-called '''tubal pregnancies'''), but implantation can also occur in the
Cervix ,
Ovaries , and
Abdomen .
]]
In a normal
Pregnancy , the fertilized egg enters the
Uterus and settles into the
Uterine Lining where it has plenty of room to divide and grow. In a typical ectopic pregnancy, the
Embryo does not reach the uterus, but instead adheres to the lining of the Fallopian tube. As the embryo implants and grows, the tube becomes stretched and inflamed, causing increasing pain in the pregnant woman. If left untreated, the affected Fallopian tube will likely burst, causing
Gynecologic Hemorrhage and endangering the life of the woman. Only 2% of ectopic pregnancies occur outside of the fallopian tubes. About 1% of pregnancies are in an ectopic location.
Hair-like
Cilia located on the internal surface of the Fallopian tubes carry the fertilized egg to the uterus. Damage to the cilia, or blockage of the Fallopian tubes is likely to lead to an ectopic pregnancy.
Women with
Pelvic Inflammatory Disease (PID) have a high occurrence of ectopic pregnancy. This results from the build-up of
Scar Tissue in the Fallopian tubes, causing damage to cilia and possibly tube occlusion.
Tubal surgery, such as
Tubal Ligation (or the reversal thereof), is also likely to cause cilia damage. And because ectopic pregnancy is treated with tubal surgery, a history of ectopic pregnancy increases the risk of future occurrences.
High levels of
Estrogen and
Progesterone increase the risk of ectopic pregnancy because these
Hormone s slow the movement of the fertilized egg through the Fallopian tube. The use of
Progesterone -secreting
Intrauterine Device s (IUDs), the
Morning-after Pill , and other hormonal methods of
Contraception often result in high estrogen and progesterone concentration and may increase the risk of ectopic pregnancy. Ectopic pregnancies are seen more commonly in patients undergoing
Infertility treatments.
Patients are at higher risk for ectopic pregnancy with advancing age. Also, it has been noted that
Smoking is associated with ectopic risk. Vaginal douching has been shown to increase ectopic pregnancies.
Patients with an ectopic pregnancy typically have:
Ectopic pregnancy is noted that it can mimic symptoms of other diseases such as
Appendicitis , other gastrointestinal disorder, problems of the urinary system, as well as
Pelvic Inflammatory Disease and other gynecologic problems.
An ectopic pregnancy has to be suspected in any woman with lower abdominal pain and/or unusual bleeding who is sexually active and whose examination may reveal the abnormal location of the pregnancy, show evidence of intraabdominal bleeding, or reveal an empty uterine cavity when normally the pregnancy should have been detectable within the uterus.
A
Laparoscopy or
Laparotomy can also be performed to visually confirm ( and then remove) an ectopic pregnancy within the abdominal or pelvic cavity.
2% of ectopic pregnancies occur in the ovary, cervix, or intraabdominally. Transvaginal
Ultrasound examination is usually able to detect a . An '''ovarian pregnancy''' is differentiated from a tubal pregnancy by the criteria set by Spiegelberg. While a fetus of ectopic pregnancy cannot be salvaged, the case of an occasional '''abdominal pregnancy''' has been the very rare exception to this rule. In such a situation the placenta sits on the intraabdominal organs and the peritoneum and has found sufficient access to support a fetus to viability. Such a fetus will have to be delivered by
Laparotomy . However, the vast majority of abdominal pregnancies require intervention well before fetal
Viability because the risk of hemorrhage.
Early treatment of an ectopic pregnancy with the drug
Methotrexate has proven to be a viable alternative to surgical treatment since
1993 . If administered early in the pregnancy, methotrexate can disrupt the growth of the developing embryo causing the cessation of pregnancy.
If hemorrhaging has already occurred, surgical intervention is necessary to halt blood loss and reduce the risk of
Shock . Surgeon use laparoscopy or laparotomy to gain access to the pelvis and can either incise the affected Fallopian and remove only the pregnancy (salpingostomy) or remove the affected tube with the pregnancy (
Salpingectomy ). The first successful surgery for an ectopic pregnancy was performed by
Robert Lawson Tait in
1883 . The chance of future pregnancy depends on the status of the tube(s) that are left behind, but is decreased. Often, patients may have to resort to
IVF to achieve a successful pregnancy.
A case in England in August 2005 in which a fetus in an ectopic pregnancy was successfully carried to term and delivered by
Caesarean Section is an example of a very rare medical event, possible only when the site of implantation is outside the Fallopian tube - in this instance, the abdomen. There are only a dozen or so known cases of this in the world.
The fetus and placenta have to find an attachment to a major artery, in all cases either the renal (kidney) or hepatic (liver) artery. The woman and the medical staff were unaware of her condition until she delivered
{Link without Title} . The successful ectopic pregnancy leads to theoretic possibility of deliberate human
Male Pregnancy .
