Ectopic pregnancies

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An ectopic pregnancy refers to a pregnancy which starts outside the womb. This is usually in the uterine tubes, but may include the gastric area, the ovaries or the cervix. Ectopic pregnancies are usually caused by factors which prevent or slow the oocyte from arriving at the womb. This includes physical blockages, and hormonal factors. Scarring of the uterine tubes from previous pelvic infections may increase the risk of ectopic pregnancies.

Ectopic pregnancies may result in the rupture of the uterine tubes and severe haemorrhage during the first 8 weeks of gestation which may be fatal to both mother and child. Symptoms of ectopic pregnancies include abnormal vaginal bleeds, amennhorea (lack of menstruation), breast tenderness, Lower back pain, pain on one side of the pelvis, nausea or pain in lower abdomen or pelvic area. If left untreated symptoms may extend to fainting, sharp pain in the abdomen and shoulders, and pressure on the rectum. Internal bleeding may also lead to shock.


Risk factors
l          Women between 35 and 44
l          Previous ectopic pregnancy
l          Pelvic or abdominal surgery
l          Pelvic inflammatory disease
l          Becoming pregnant after previous tubal lignitation.

Diagnosis

Ectopic pregnancies may be indicated by lower levels of HCG than expected. And confirmed by ultrasound and cludocentesis where a needle is inserted at the top of the vagina to test for bleeding. Other tests which may contribute to the diagnosis include pregnancy tests, serum progesterone levels, a hematocrit (red blood cell ratio) and a white blood cell count. A laparoscopy (viewing pelvic area with camera) or laparotomy (taking tissue sample and viewing area with insertion) may also be needed.

Treatment

A surgery may be needed to remove part of the fallopian tubes or the embryo if the fallopian tubes are stretched or ruptured. If ruptured, an emergency surgery may be needed. If diagnosed early, methotrexane may be given to stimulate the resorption of the embryo. A laproscopic surgery is done.

HCG levels are monitored after treatment to confirm the complete removal of any tissues.

Outlook

One third of women who have had an ectopic pregnancy are able to have children successfully thereafter. The risks of a second ectopic pregnancy is also likely to occur in one third of patients.

References 
http://www.americanpregnancy.org/pregnancycomplications/ectopicpregnancy.html
http://www.nlm.nih.gov/medlineplus/ency/article/000895.htm

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