Information on Ectopic Pregnancy

In an Ectopic Pregnancy, the fertilized ovum is implanted, which develops outside the normal uterine cavity. The sites of such implantation are

• Extra uterine i.e Tubal pregnancy, ovarian pregnancy and abdominal pregnancy
• Uterine i.e cervical pregnancy, angular pregnancy and corneal pregnancy

The commonest implantation site for Ectopic Pregnancy is the Tubal Pregnancy where the incidence is about 97 percent among pregnant women. Here, the fertilized ovum usually remains in the Fallopian tube due to certain factors. And the migration of the ovum to the uterine cavity is delayed or such factors facilitate nidation of the fertilized ovum in the tubal mucosa.

Factors responsible for an increased incidence of Ectopic Pregnancy are

• An increased prevalence of chronic Pelvic Inflammatory disease (PID) or sexually transmitted infections (STI) like Gonorrhea, Chlamydia, etc. STI or PID, if remains untreated for long, may cause severe damages in your reproductive tract and may increase the risk of having an Ectopic Pregnancy by 6-10 folds
• When you are pregnant despite a surgical sterilization or tubal ligation. Tubal reconstructive surgery to improve the fertility increases the chance of having Ectopic Pregnancy by 15-50 percent
• Previous Ectopic Pregnancy- You have 10-15 percent chance of having a repeat Ectopic Pregnancy
• If you have undergone infertility treatments before your current Pregnancy
• Prior induced abortion may significantly increase the risk
• Use of progestin only pills or hormonal contraceptives probably impairs tubal motility during pregnancy and may increase the chance of tubal pregnancy
• Getting pregnant with Intrauterine devices (IUD) in situ increases the chance by 7 times more

Usual symptoms of a disturbing Ectopic Pregnancy in women are

• A short period of Amenorrhea or a delayed period (in 75 % cases)
• A constant abdominal pain (in all cases)
• Appearance of vaginal bleeding (in 70 % cases)
• Frequent or even retention of urine
• Feeling of nausea, vomiting and fainting attacks
• Persistent high pulse rate even during rest

Ectopic Pregnancy still contributes to the cause of maternal mortality and morbidity. While there has been about four fold increase in incidence over a couple of decades, but the mortality has been slashed down to about 80 percent due to improved diagnostic tests.

Advances in ultrasound particularly Transvaginal Sonography (TVS) and sensitive ß-hCG assay have considerably improved diagnostic capability at the early stage even prior to its termination.

Some doctors also use Dilation and Curettage (D&C) method to determine whether there is an intra-uterine pregnancy. However, Laparotomy and Laparoscopy have been reported as the conclusive diagnosis of the Ectopic Pregnancy. Laparoscopy also helps to remove the ectopic mass using operative procedures at the same time. In cases of recurrent Ectopic Pregnancy , In-vitro Fertilization (IVF) is considered as the best measure for having a successful pregnancy in future.