Ectopic Pregnancy: Causes and and Treatments

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Ectopic pregnancy occurs when implantation of the egg takes place outside of the womb (or uterus). Typically, most ectopic pregnancies occur in the fallopian tube - but they can also occur in the ovary, the abdomen, the cervix, or at the joint between the fallopian tube and the uterus.

In most cases, ectopic pregnancies occur when the fertilized egg faces obstructions in the fallopian tube that prevent the egg from moving freely into the womb. Instead of implantation in the uterus, obstructions or tubal abnormalities cause the egg to implant outside of the womb. There is no way to prevent or predict an ectopic pregnancy, though there are a number of risk factor that may predispose a woman for ectopic pregnancy - from advance age to previous pelvic inflammatory diseases or prior surgery in the region.

Symptoms of ectopic pregnancy are diverse and include cramps and spotting early in the pregnancy, vaginal bleeding, lower abdominal paint on one side, nausea, and dizziness. In some cases, symptoms may not be present and the first signs of an ectopic pregnancy may appear suddenly, requiring emergency treatment. In serious cases, the fallopian tube can ruptures and cause hemorrhaging, requiring swift medical treatment.

In most cases, however, ectopic pregnancies present themselves with a missed period and a positive result on a pregnancy test - accompanied by the symptoms listed above (vaginal bleeding, abdominal pain, dizziness or even shoulder pain).

Risk Factors for Ectopic Pregnancy

There is no way to prevent an ectopic pregnancy, though are there are several risk factors to consider that may predispose a woman to an ectopic pregnancy. Any kind of pelvic inflammatory disease, abdominal surgery, or regional infection can increase the risk. Risk factors include:

• Advanced Age: Women over age 30 years face increased risk.
• Smoking.
• Previous pelvic inflammatory disease or endometriosis.
• Abdominal surgery or prior fallopian tube surgery.
• History of previous ectopic pregnancy.
• Previous termination of a pregnancy. The risk of ectopic increases with two or more terminations.

Once an ectopic is diagnosed, there are a number of treatment options (though relocation of the fetus from tube to womb is not an option). Some options include managing the ectopic pregnancy without surgery (if the woman's hCG levels are decreasing and she does not exhibit serious symptoms) or by using the drug methotrexate which causes a medically induced regression of the pregnancy.

The options include surgically removing the ectopic pregnancy. Here, surgery can be performed on the fallopian tube before the tube ruptures. This can save the tube if the ectopic pregnancy is diagnosed early enough. If there is a healthy second fallopian tube, surgery may be performed to remove the fallopian tube containing the ectopic pregnancy. Laparoscopic surgery to remove the pregnancy without removing the tube is call salpingotomy - and surgery to remove the tube altogether is referred to as a salpingectomy.

Fertility after an Ectopic Pregnancy

The possibility of successfully conceiving after an ectopic pregnancy is dependent upon the severity of case and the type of treatment. Methotrexate and laparoscopic surgery have similar rates of normal pregnancy following ectopic pregnancy - and there are other surgical procedures that can restore reproductive function. Also, in vitro fertilization is also an option for women with missing or scarred fallopian tubes.

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