Doctor's Notes on Ectopic Pregnancy
An ectopic pregnancy (also termed tubal pregnancy) is a pregnancy that develops outside of the uterus. This occurs when the fertilized egg from the ovary does not reach or implant itself in the uterus. The products of this conception in most instances do not survive. The most common signs and symptoms of an ectopic pregnancy are abdominal and/or pelvic pain and vaginal bleeding. They usually occur in the first 5-10 weeks of pregnancy. A ruptured ectopic pregnancy is a medical emergency. Signs and symptoms of a ruptured ectopic pregnancy include lightheadedness, pale complexion, sweaty or clammy-feeling skin, fast heartbeats, and severe abdominal pain and/or pelvic pain so intense that the pregnant woman can't stand up to walk.
The cause of ectopic pregnancy is when the fertilized egg lodges in the fallopian tube or some other location instead of reaching the uterus where it is supposed implant. A ruptured ectopic pregnancy may cause the woman to bleed into the abdomen. The blood loss that enters the abdomen causes the more intense signs and symptoms. The amount of blood loss can be life-threatening. A ruptured ectopic pregnancy is a medical emergency. If you suspect that you have an ectopic pregnancy, call 911.
What Is the Treatment for an Ectopic Pregnancy?
A fertilized human egg does not develop normally outside the uterus. After diagnosis of an ectopic pregnancy, the ectopic tissue needs removal. You and your doctor should discuss your options. There are three major types of treatments:
- Methotrexate injection: It stops cell growth and dissolves existing ectopic cells.
- Laparoscopic surgery: Your doctor removes ectopic tissues with a camera and tools inserted through small cuts in the skin of the abdomen.
- Emergency surgery: Excessive bleeding that can be life-threatening may occur with an ectopic pregnancy. Thus, an emergency laparoscopy or laparotomy (abdominal incision) must be done. If the ectopic tissue ruptures a fallopian tube, the tube must also be removed.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.