Ectopic pregnancy

21:54 - 4 May , 2021

Disease

What is Ectopic pregnancy?

It is an anomaly in which the fertilized egg does not remain implanted in the uterus, but develops outside of it, which makes the pregnancy impossible and if it is not treated it can trigger serious complications such as intense bleeding that can be fatal. The places where ectopic pregnancy usually occurs are the fallopian tubes, cervix, ovaries, and abdomen.  It happens when something obstructs the path of the egg to the uterus and remains in the place where it stopped moving. The obstruction may be due to malformations or inflamed tissues, hormonal changes, or that the egg has morphological alterations.

Symptoms

At first, symptoms do not usually appear, but in some cases the symptoms are the same as those of normal pregnancy (dizziness, nausea, breasts hypersensitivity, and cessation of menstruation), so it is difficult to know that something is wrong until the egg develops in the wrong area. That is when atypical symptoms such as mild vaginal bleeding and pelvic pain begin to be noticed. Later, as it continues to grow, the egg can cause heavy bleeding, and if it is found in a fallopian tube and is not treated, it can rupture the tube as it increases in size, causing loss of consciousness, shock, and potential risk of death. Potential risks:
  • Sexually transmitted diseases: several sexually transmitted diseases inflame the fallopian tubes and surrounding organs. 
  • Hormonal or fertility treatments: an ectopic pregnancy is more likely to develop by causing a hormonal alteration. 
  • Having previously had an ectopic pregnancy.
  • Smoking. 
  • Certain contraceptive methods: mainly the intrauterine device and tubal ligation are two methods that if they fail, the pregnancy is likely to be ectopic. 
Preventive actions: As there are no direct ways to avoid ectopic pregnancy, we recommend certain actions that reduce the risk level of suffering from it:
  • Avoid promiscuous behavior, reducing sexual partners and using a condom when you have intercourse.
  • Quit smoking, either actively or passively. 

Diagnosis and treatment

Once your doctor analyzes your symptoms and your medical history, he or she will perform a physical examination to detect pelvic abnormalities and corroborate areas that cause discomfort. However, to confirm the diagnosis, they will request blood tests to verify that there is a pregnancy and to check for signs of anemia due to bleeding. Also, he or she will ask you for a transvaginal ultrasound to locate where the egg was implanted. Before an ectopic pregnancy, the only treatment is to remove the fertilized egg and the adjacent tissue that may have formed. In the early stages of pregnancy, it is possible to stop the egg’s development and dissolve the tissue on a cellular level with specialized drugs for this purpose; but when the egg is more developed, the only option is to remove it through surgery, which can be laparoscopy or laparotomy in case of an emergency procedure.  The most common laparoscopic surgeries to solve ectopic pregnancies are salpingostomy and salpingectomy. In both cases, a small abdominal cut is made through which a laparoscope is inserted, which is a probe with a small camera with which the place of pregnancy can be observed and the extraction performed. 
  • Salpingostomy: only the fertilized egg is removed. 
  • Salpingectomy: the fertilized egg and the fallopian tube in which it was implanted are removed.
Comprehensive women's health is our priority at the Women's Center, so we offer services focused on women in all their chronological stages with the highest standards of care to improve their quality of life, through a wide range of prevention, diagnosis, timely treatment, and follow-up services.  It has three specialized units:
  • Obstetrics Center.
  • Gynecology Center.
  • Gynecology in adolescence.
Reasons to choose our Women's Center:
  • Multidisciplinary team: we have obstetrician gynecologists and specialized nurses who provide gynecological and prenatal care.
  • Personalized and humane care: our services are designed to meet your individual needs and preferences, ensuring that you receive humane care that allows you to have a healthy life.
  • Better treatment options: reducing hospitalization times, a quicker and less painful recovery, and taking care of the aesthetic appearance of our patients.
  • Robot surgery: we have a great technological development that allows us to perform more precise surgical procedures using robotic instruments and an endoscopic video camera.
  • Comfortable facilities with state-of-the-art technology: in case of requiring special care, we have facilities fully equipped with the latest technological advances.

Fuentes: 

  • cigna.com
  • mayoclinic.org
  • msdmanuals.com 
  • medlineplus.gov
  • cdc.gov
  • medigraphic.com
  • Espinoza GS, Garnier FJC, Pizarro AG. Generalidades sobre embarazo ectópico. Revista Médica Sinergia. 2021;6(05):1-9.
  • Guerra MI. Importancia del método clínico en el diagnóstico del embarazo ectópico. Revista Cubana de Obstetricia y Ginecología. 2019;45(4):1-4.
  • Drullet DL, Hernández CME, Iznaga BOdalis. Embarazo ectópico abdominal. Presentación de un caso y revisión de la literatura. RIC. 2019;98(4):540-552.
  • Zarama-Márquez F, Buitrón-García R, Córdoba-Guacan E, et al. Embarazo ectópico cornual. Tratamiento combinado con metotrexato e histerotomía y evacuación por laparoscopia. Reporte de un caso. Ginecol Obstet Mex. 2019;87(10):676-679.
The dissemination of the content of this material is for informational purposes only and does not replace, under any circumstance or condition, a consultation with a specialist doctor, for which the ABC Medical Center is not responsible for the different use that may be given to it. If you require more information related to the subject, we suggest you contact the specialist doctor you trust directly.