Ectopic Pregnancy: Signs, Causes & How Long It Can Last

Not all pregnancies end in success. Some mothers face the problem of ectopic pregnancy, leading to the necessity of terminating the pregnancy due to the high risk it poses to life.

In general, ectopic pregnancy involves a deviation from the normal development of the fetus, with the fertilized egg implanting outside the uterus. If you are experiencing an ectopic pregnancy, it can cause various symptoms, from abdominal and pelvic pain to irregular vaginal bleeding.

If this occurs, it is a sign that you need immediate medical examination and treatment to prevent serious complications.

Ectopic Pregnancy

When a woman is pregnant, the normal process of sperm and egg fertilization typically results in a cluster of cells known as an embryo. It easily attaches to the tissue surface and normally moves through the Fallopian tube into the uterus.

There, the embryo will attach to the uterine wall (endometrium) for the subsequent fetal growth process.

To better understand ectopic pregnancy, first, understand what ectopic pregnancy is as your guide.

What Is Ectopic Pregnancy

The term ectopic pregnancy refers to a condition in which the fertilized egg implants and begins development outside the uterus, usually in the fallopian tube. The term "ectopic" itself means "out of place" or "in a location not normal." In this case, the fertilized egg is implanted in a location that cannot support its growth and development.

In a normal pregnancy, the fertilized egg moves through the fallopian tube and implants in the uterus, where it can receive nutrients and support for proper development. However, in ectopic pregnancy, the fertilized egg implants in the fallopian tube, ovary, cervix, or abdominal cavity.

It is not suitable for the embryo to develop, and when the embryo grows, it can cause complications and life-threatening conditions for the mother.

According to the American Academy of Family Physicians (AAFP), ectopic pregnancy occurs in 1 out of every 50 pregnancies.

Ectopic pregnancies are highly dangerous. When the fertilized egg attaches and grows, it can damage organs and cause severe internal bleeding. For example, your fallopian tube cannot function as a site for the fetus to grow and expand.

Signs of Ectopic Pregnancy

Usually, ectopic pregnancies cause extraordinary pain compared to women with normal pregnancies. Signs of an ectopic pregnancy can vary for each person, but there are some common symptoms that should be given attention. Here are some signs of ectopic pregnancy:

• Pain in the Lower Abdomen: Sharp and localized pain in both lower abdomen or pelvic regions is a common symptom of ectopic pregnancy. This pain can be continuous or sudden.
• Abnormal Vaginal Bleeding: Unusual vaginal bleeding, such as lighter or heavier bleeding than usual menstruation, can be a sign of ectopic pregnancy. This bleeding may also be brighter or darker than usual.
• Shoulder Pain: Sometimes, when ectopic pregnancy is severe enough to cause radiating pain to the shoulder. This occurs due to internal bleeding that irritates nerves around the diaphragm area.
• Diarrhea and Vomiting: Both of these symptoms should not be ignored,
  especially if they are frequent and severe. This is because pregnant women can experience dehydration, which can lead to "shock" and headaches.
• Other Symptoms: Women experiencing ectopic pregnancy may also have some more common pregnancy symptoms, such as nausea, vomiting, breast tenderness, missed periods, or changes in urine pattern.
• Dizziness or Fainting: Significant internal bleeding due to ectopic pregnancy can cause dizziness and fainting.

It is important to remember that if you experience any of these signs of ectopic pregnancy or have any suspicions, contact a doctor immediately for further
examination.

Causes of Ectopic Pregnancy

The actual cause of ectopic pregnancy is still not fully understood. However, several conditions have been associated with ectopic pregnancy:

1. Inflammation of the fallopian tubes and scarring due to previous disease treatment, infections, or surgery.
2. Hormonal influences.
3. Medical issues affecting the structure and condition of the fallopian tubes and reproductive organs.
4. Ineffective use of contraceptive methods.
5. Previous surgery on the fallopian tubes.
6. Smoking.

Risk Groups for Ectopic Pregnancy

Every sexually active woman is at risk of ectopic pregnancy. The risk increases when any of the following occur:

1. Women aged 35 or older.
2. History of pelvic or abdominal surgery or a history of multiple miscarriages.
3. Family history.
4. Pelvic inflammatory disease (PID).
5. History of endometriosis.
6. Pregnancy occurs despite tubal ligation and the use of Intrauterine Device (IUD).
7. Smoking.
8. Previous ectopic pregnancy.
9. History of STDs such as gonorrhea or chlamydia.
10. Structural issues in the fallopian tubes hindering the travel of the egg.

Refer to your gynecologist if you have any risk factors for ectopic pregnancy as listed above. You can discuss with a doctor or fertility specialist to reduce the risk of ectopic pregnancy in the future.

Detecting Ectopic Pregnancy

• Transvaginal Ultrasound: This diagnostic tool is commonly used for ectopic pregnancy. It allows healthcare providers to visualize the reproductive organs and identify the location of the pregnancy sac.
• Beta-hCG Blood Test: Beta-human chorionic gonadotropin (beta-hCG) is a hormone produced during pregnancy. Monitoring beta-hCG levels in the blood can help diagnose ectopic pregnancy, as abnormal patterns may indicate a
  problem.
• Pelvic Examination: A pelvic exam can provide valuable information about the size and tenderness of reproductive organs. However, it may not be conclusive in diagnosing ectopic pregnancy and is often used in conjunction with other detection methods.

How Long Ectopic Pregnancy Can Last

According to the National Health Service, symptoms of ectopic pregnancy typically arise between weeks 4 and 12 of pregnancy. Some women may have no symptoms initially and may not be aware of the ectopic pregnancy until early scans reveal issues with the pregnancy or the mother experiences serious signs of ectopic pregnancy later on.

Treatment for Ectopic Pregnancy

Ectopic pregnancy poses a danger to the mother, and furthermore, the embryo will not be able to mature properly. The embryo needs to be removed as soon as possible to ensure the mother's health and long-term fertility.

Treatment methods vary depending on the location and development of the ectopic pregnancy.

1. Medication

Depending on how long the fertilized egg has been developing, your doctor may treat your ectopic pregnancy with methotrexate injections. Methotrexate is a drug that rapidly inhibits cell division, such as that found in the ectopic mass.

If you take this medication, it will be administered to you in the form of injections by your doctor. You will also need frequent blood tests to confirm that the medication is working effectively. When the drug takes effect, it will cause symptoms similar to a miscarriage, such as cramping, bleeding, and tissue expulsion.

2. Surgery

If the condition worsens, the fallopian tube may rupture, leading to serious internal bleeding. To provide immediate treatment, your doctor may perform emergency surgery. Many surgeons advocate removing the ectopic pregnacy and avoiding any internal damage. It can be done via laparotomy or laparoscopic surgery.

The doctor will insert a small camera through a tiny incision to ensure they can see the situation during the surgery. The ectopic pregnancy is then removed by the surgeon, and any damage to the fallopian tube is repaired/removed. The type of surgery depends on the size and location of the ectopic.

Whether you want to conceive again or not is also a consideration. Laparoscopy can sometimes be used to remove the ectopic pregnancy, but it's important to note that if it is an emergency situation or if there is serious internal injury, a larger surgery called laparotomy may be necessary.

Effects After Ectopic Pregnancy Surgery

• Pain and Discomfort: You may experience some pain and discomfort at the surgical site. Your doctor can prescribe pain relievers to help with this.
• Physical Recovery: Recovery time varies, but you may need a few weeks to fully recover.
• Emotional Trauma: Losing a pregnancy, especially through surgery, can cause emotional trauma.
• Grief: You may experience sadness or disappointment. Support from your partner, family, or friends can be crucial during this time.

3. At-Home Care

After surgery, your doctor will provide guidance on caring for your surgical wound. The main objective is to ensure that your wound is clean and dry during the recovery process. You need to check the wound every day for signs of infection, which may include:

• Uncontrolled bleeding.
• Severe bruising.
• Foul-smelling odor.
• Heat when touched.
• Redness.
• Swelling.

After surgery, there may be some light bleeding from the vagina, and there may be a small blood clot. This can occur for up to six weeks after your surgery. You can also practice self-care by doing the following:

• Avoid lifting heavy objects weighing more than 10 kg.
• To prevent constipation, drink plenty of water.
• Rest your pelvis, where you need to refrain from sexual activity, tampon use, and douching.
• Rest as much as possible in the first week after surgery, then gradually increase activity in the following weeks according to your body's acceptance.

Preventing Ectopic Pregnancy

Preventing ectopic pregnancy involves addressing risk factors and taking steps to optimize reproductive health. Although not all cases of ectopic pregnancy can be prevented, there are measures you can take to minimize the risk.

Here are some preventive steps:

• Practice Safe Sex: Using barrier contraceptive methods, such as condoms, can help reduce the risk of sexually transmitted infections (STIs). Infections such as chlamydia and gonorrhea can cause pelvic inflammatory disease, increasing the risk of tube damage and ectopic pregnancy.
• Early Detection and Treatment of STIs: If you suspect you have an STI or are at risk, seek medical treatment promptly. Early detection and treatment of STIs can help prevent complications that can lead to tube damage.
• Regular Check-ups: Schedule regular check-ups with a doctor, especially if you are planning a pregnancy or experiencing fertility issues. Routine check-ups can help identify and address potential reproductive health issues.
• Contraceptive Use: Consistent and correct contraceptive use can help prevent unintended pregnancies. Discuss contraceptive options with your doctor to determine the most suitable method for you.
• Maintain a Healthy Lifestyle: Adopting a healthy lifestyle, including regular exercise and a balanced diet, can contribute to overall reproductive health. Being healthy before pregnancy can reduce the risk of complications.

Effects If Untreated

Untreated ectopic pregnancy can be life-threatening. Immediate treatment is necessary to reduce the risk of complications from your ectopic pregnancy, improve your chances of having a healthy pregnancy in the future, and reduce future health complications.

Getting Pregnant Again After an Ectopic Pregnancy

It may be challenging for you to experience a normal pregnancy afterward. Consider consulting with a fertility doctor, especially if you have had your fallopian tube
removed. Also, seek advice from your doctor on how long you should wait before trying to conceive.

Some doctors recommend giving yourself at least three months for your body to fully recover. If you become pregnant again, due to the history of ectopic pregnancy, it will increase your chances of having another ectopic pregnancy. Monitor changes in your body until the doctor confirms normal growth.

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