Ectopic Pregnancy

Ectopic pregnancy is pregnant outside the womb or uterus. The condition causes bleeding from the vagina and severe pain in the pelvis or lower abdomen. Ectopic pregnancies should be treated immediately as they can be dangerous, and the fetus will also not develop normally.

Pregnancy begins with an egg that has been fertilized by sperm cells. In the normal process of pregnancy, the fertilized egg will settle in the fallopian tube (ovary) for approximately three days, before being released into the uterus. In the womb, the fertilized egg will continue to develop until the delivery period arrives.

In ectopic pregnancies, fertilized eggs do not attach to the uterus, but to other organs. Fallopian tubes are the organ most commonly affixed to eggs in ectopic pregnancies. In addition to fallopian tubes, ectopic pregnancy can also occur in the ovaries, cervix (cervix) or in the abdominal cavity.

Causes of Ectopic Pregnancy

Although it is not yet known exactly what causes ectopic pregnancy, it is often associated with damage to the fallopian tubes, which are the ducts connecting the ovaries and uterus.

Fallopian tube damage can be caused by:

  • Genetic factors.
  • Congenital born.
  • Hormonal imbalance.
  • Inflammation due to infection or medical procedures.
  • Abnormal development of reproductive organs.

Ectopic Pregnancy Risk Factors

Ectopic pregnancy can be experienced by any woman who has actively had sex. There are several factors that can increase the risk of ectopic pregnancy, namely:

  • 35 years of age or older while pregnant.
  • Has a history of pelvic inflammation and endometriosis.
  • Suffer from sexually transmitted diseases, such as gonorrhea and chlamydia.
  • Having an ectopic pregnancy in a previous pregnancy.
  • Having repeated miscarriages
  • Had surgery on the abdominal and pelvic areas.
  • Have undergone treatment related to fertility problems.
  • Using spiral type contraceptives.
  • Have a smoking habit.

Ectopic Pregnancy Symptoms

Ectopic pregnancies tend not to show symptoms at an early stage. Early signs of ectopic pregnancy are similar to regular pregnancies, such as nausea, hardened breasts, and stalled menstruation.

While in the advanced stages, there are some symptoms that are often felt by people with ectopic pregnancy, namely abdominal pain and bleeding from the vagina. The symptoms will get worse over time.

When to see a Doctor

Check with your doctor immediately if any of the following symptoms appear while pregnant:

  • Pain such as punctures in the abdomen, pelvis, shoulders, and neck.
  • Pain on one side in the lower part of the abdomen, which worsens over time.
  • Pain in the rectum during bowel movements.
  • Light to severe bleeding from the vagina, with a darker blood color than menstrual blood.
  • Dizziness or weakness.
  • Diarrhea.

These symptoms should be immediately examined by a doctor because they can indicate rupture of the fallopian tubes due to ectopic pregnancy.

Ectopic Pregnancy Diagnosis

The doctor will perform an examination with a transvaginal ultrasound to ensure the occurrence of ectopic pregnancy. In addition to helping the obstetrician see the condition of the patient’s reproductive organs, this procedure can accurately ascertain the location of the pregnancy.

Another test that can be done is a blood test, to measure levels of the hormones hCG and progesterone. In ectopic pregnancies, levels of both hormones tend to be lower than normal pregnancies.

Ectopic Pregnancy Treatment

Fertilized eggs will not be able to grow normally if they are outside the uterus. Therefore, ectopic tissue should be removed immediately, so that the patient avoids serious complications. There are several treatment options that can be done to deal with ectopic pregnancy, among others:

Injectable methotrexate

Early stage ectopic pregnancy can be overcome by injecting methotrexate. The drug will stop the growth of ectopic cells, while destroying the already formed cells. After the injection, the doctor will monitor the levels of hCG hormone in the blood every 2-3 days, until the levels decrease. Declining hCG levels indicate pregnancy is no longer developing.

Laparoscopic surgery

Another option to cope with ectopic pregnancy is by keyhole surgery or laparoscopy. Through this procedure, the obstetrician will remove the ectopic tissue and the fallopian tubes where the ectopic tissue is attached. However, if possible, the fallopian tubes are sufficiently repaired without having to be removed.

Laparotomy surgery

To treat patients who have severe bleeding due to ectopic pregnancy, the obstetrician will perform an emergency action in the form of laparotomy. In laparotomy, the doctor will make a large incision in the abdomen as a way to remove the ectopic tissue and ruptured fallopian tubes.

Ectopic Pregnancy Prevention

Ectopic pregnancies cannot be prevented, but the risk of experiencing this condition can be lowered. There are a number of ways that can be done, including:

  • Avoid risky sex behaviors, such as changing sex partners by not using condoms.
  • Avoid smoking, since before pregnancy.

Pregnant women are also recommended to have regular blood tests and ultrasounds. In addition to monitoring the progress of pregnancy, regular examinations can detect ectopic pregnancies early, so that they can be treated immediately.