What Can Cause Ectopic Pregnancy

Complications Of Ectopic Pregnancy

An ectopic pregnancy is a serious complication of pregnancy, as it endangers the mother’s health if not detected in time. Therefore, in the event of any abnormal bleeding, severe waist pain, fainting, severe cramping, etc., it is recommended to consult a specialist as soon as possible.

Most commonly, an ectopic pregnancy will result in miscarriage naturally, i.e. without medical or pharmacological intervention. The embryo is not capable of developing in a place other than the uterus.

However, if the ectopic pregnancy does not end naturally, complications arise. Rupture of the fallopian tubes may occur, which should be attended to immediately by a physician. Although it can occur, this complication is not common. Another consequence of an ectopic pregnancy is female fertility problems.

Symptoms Of Ectopic Pregnancy

The symptoms of ectopic pregnancy can mimic miscarriage or the symptoms of other reproductive disorders, such as pelvic inflammatory disease or endometriosis. An ectopic pregnancy can first appear as a normal pregnancy.The symptoms of ectopic pregnancy can include:

• the usual signs of pregnancy, such as amenorrhoea , morning sickness and breast tenderness
• pain in the lower abdomen
• pain in the lower back
• cramps on one side of the pelvis
• vaginal bleeding or spotting
• sudden and severe pain in the lower abdomen .

When To Get Emergency Help

Call 999 for an ambulance or go to your nearest accident and emergency department immediately if you experience a combination of:

• a sharp, sudden and intense pain in your tummy
• feeling very dizzy or fainting
• feeling sick
• looking very pale

These symptoms could mean that your fallopian tube has split open . This is very serious and surgery to repair the fallopian tube needs to be carried out as soon as possible.

A rupture can be life threatening, but fortunately they’re uncommon and treatable, if dealt with quickly. Deaths from ruptures are extremely rare in the UK.

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What Are The Signs And Symptoms Of An Ectopic Pregnancy

Signs of a condition are things someone else can see or know about you, like you have a rash or youre coughing. Symptoms are things you feel yourself that others cant see, like having a sore throat or feeling dizzy.

An ectopic pregnancy may start out with usual signs and symptoms of pregnancy, like missing your period or having nausea and tender breasts. Or you may not have any signs or symptoms and not even know youre pregnant.

• Bleeding from the vagina
• Feeling faint or dizzy. This can be caused by blood loss which can cause low blood pressure. Blood pressure is the force of blood that pushes against the walls of your arteries. Arteries are blood vessels that carry blood away from your heart to other parts of the body.
• Pain in your lower back or even your shoulder
• Pain in your pelvic area . The pain may be mainly on one side. It can come and go, start out mild and then become sharp and stabbing.

Can An Ectopic Pregnancy Be Prevented Or Avoided

You cant prevent an ectopic pregnancy, but you can try to control your risk factors. Dont smoke. If you do smoke, plan on quitting before you get pregnant. Before getting pregnant, use a condom when having sex. This can help prevent sexually transmitted infections, such as chlamydia and gonorrhea, which can cause PID.

If youre at higher risk of having an ectopic pregnancy, talk to your doctor. He or she may take extra steps to detect an ectopic pregnancy early. This could include checking your hormone levels or scheduling an early sonogram.

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Signs And Symptoms Of Ectopic Pregnancy

Initially, an ectopic pregnancy may feel like a normal pregnancy, with some of the usual signs and symptoms, such as a missed period, swollen, tender breasts, nausea or an upset stomach. Other signs may include abnormal vaginal bleeding, low back pain, mild pain in the pelvis or belly, or mild cramping on one side of the pelvis. Because it can be difficult to know if youre experiencing symptoms of a typical pregnancy or an ectopic one, its important to report any abnormal bleeding or pelvic pain to your obstetrician-gynecologist promptly.

As an ectopic pregnancy, sometimes called a tubal pregnancy, grows and progresses, more serious symptoms may develop. These may include sudden, severe pain in the pelvis or belly shoulder pain or weakness, dizziness, or fainting. Any of these more severe symptoms should send you to an emergency room, especially because they could point to a ruptured fallopian tube, which can cause life-threatening internal bleeding.

Symptoms Of This Type Of Pregnancy

Common symptoms of an ectopic pregnancy also occur in normal uterine pregnancies and can include a missed period, nausea and breast soreness. A pregnancy test will present a positive result with an ectopic pregnancy.

This type of pregnancy can cause a woman to experience sharp waves of pain, light vaginal bleeding, dizziness or fainting. Some women may also experience urges to have a bowel movement.

More severe symptoms can cause heavy bleeding , severe pain in the abdomen or pelvis, weakness, more severe dizziness or fainting. Contact a doctor immediately if any of these symptoms appear.

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Use Of Oral Contraceptives Or An Intrauterine Device

All contraceptive methods lead to an overall lower risk of pregnancy and therefore to an overall lower risk of ectopic pregnancy. However, among cases of contraceptive failure, women at increased risk of ectopic pregnancy compared with pregnant controls included those using progestin-only oral contraceptives, progestin-only implants, or IUDs and those with a history of tubal ligation.

The presence of an inert, copper-containing or progesterone IUD traditionally has been thought to be a risk factor for ectopic pregnancy. Data from the Contraceptive CHOICE Project demonstrated a relative risk of 3.16 for ectopic pregnancy in women not using any form of contraception as compared with women using the progesterone IUD. Nevertheless, if a woman ultimately conceives with an IUD in place, it is more likely to be an ectopic pregnancy. The incidence of ectopic pregnancy in IUD users is 1 in 1000 over a 5-year period.

Emergency contraception does not appear to lead to a higher-than-expected rate of ectopic pregnancy.

Unusual Sites Of Implantation

Over 98% of ectopic pregnancies implant in the Fallopian tube, in its ampullary region , isthmus or fimbria . Interstitial or cornual ectopics, where the pregnancy implants in the intramyometrial portion of the Fallopian tube, are less common but have a mortality twice that of any other type of Fallopian tube ectopic pregnancy.77 Rarely, an ectopic pregnancy implants at an extratubal location, such as the cervix, ovary, abdomen, liver, spleen or Caesarean section scar.1 This produces a diagnostic challenge and colour Doppler visualisation aids in the identification of the ectopic pregnancy by creating awareness of vasculature supplying the implanted gestation.77 Surgical treatment is difficult and systemic methotrexate is considered first-line treatment, with an early recourse to more than one dose, for the majority of extratubal ectopic pregnancies.78 A more detailed description of the management of these unusual cases is beyond the scope of this review.

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Ectopic Pregnancy: Symptoms Causes And Treatments Healthline

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• Summary: What causes an ectopic pregnancy? · inflammation and scarring of the fallopian tubes from a previous medical condition, infection, or surgery · hormonal factors

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• Summary: What can cause an ectopic pregnancy? · pelvic inflammatory disease · previous ectopic pregnancy · previous surgery on your fallopian tubes · fertility

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History Of Ectopic Pregnancy

If one has already had an ectopic pregnancy, it is possible the causes still exist. This is why the doctor should keep an eye out for complications in future pregnancies. Tests and scans might be done in order to rule out another ectopic pregnancy.4

You cannot control most risk factors of ectopic pregnancy. But you can practice safe sex to prevent STDs, stop smoking, and treat scar tissues after surgery.

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Causes Of An Ectopic Pregnancy And Risk Factors

In many instances the cause of this unhealthy pregnancy isnt ever determined. The reason why an embryo may not make its way inside the uterus is most often caused by a scarred or damaged fallopian tube that blocks the embryos passage.

Damage to the fallopian tubes can be caused by the following:

• Scar tissue caused by endometriosis.
• Pelvic inflammatory disease .
• Infections caused by sexually transmitted diseases such as chlamydia or gonorrhea.
• Partial or complete blockages in the tubes, either at the ends or in the middle.
• Prior pelvic or fallopian tube surgery.

What Is An Ectopic Pregnancy

An ectopic pregnancy is a pregnancy that happens outside of the uterus. This happens when a fertilized egg implants in a structure that cant support its growth. An ectopic pregnancy often happens in the fallopian tube . In rare cases, an ectopic pregnancy can occur on an ovary or in the abdominal cavity.

This is a life-threatening condition. An ectopic pregnancy is not a pregnancy that can be carried to term and can be dangerous for the mother if not treated right away.

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Shoulder Tip Or Neck Pain

Shoulder tip pain can be a distinguishing factor in diagnosing ectopic pregnancy or miscarriage, as opposed to appendicitis. However, all three conditions require immediate medical attention.

Pain the neck and/or shoulder tip is often the distinguishing symptom indicating that the ectopic pregnancy has ruptured or miscarried. It is because of internal bleeding that irritates the diaphragm. This type of pain is quite unlike that caused by bad posture. The pain may begin suddenly and may often be accompanied by a general sense of discomfort, abdominal pain, or vaginal bleeding.

Can A Woman Get An Ectopic Pregnancy At Any Age

Ectopic pregnancy can occur in any sexually active woman, regardless of age. As the pregnancy progresses, the fertilized egg grows in size and poses a danger for the tube to burst, resulting in significant internal bleeding or hemorrhage. Women of all ages can experience this problem, but it is more common among younger women because their reproductive organs are still developing.

Women under the age of 20 account for nearly 80% of all ectopic pregnancies. The risk increases with age by age 35 it accounts for about 15% of all pregnancies. After age 35 it becomes less common again although it can still happen. There are also trends in how often they occur after menopause. Because estrogen levels decrease after menopause, there is less protection against an embryo attaching itself to the lining of the uterus instead of the womb. This can lead to increased risks for women older than 40.

Ectopic pregnancy is a serious medical condition that requires immediate treatment in a hospital setting. Left untreated, it could result in heavy blood loss and require a hysterectomy to save the patient’s life. Age is only one factor considered when determining who will receive chemotherapy after surgery. Other factors include cancer stage and health conditions such as heart disease. Women of child-bearing age with ectopic pregnancies should discuss potential side effects of treatments with their doctors before undergoing any procedures.

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What Can You Expect After An Ectopic Pregnancy

Losing a pregnancy is always hard, no matter how early it happened. Take time to grieve your loss, and get the support you need to make it through this time.

You could be at risk for depression after an ectopic pregnancy. If you have symptoms of depression that last for more than a couple of weeks, be sure to tell your doctor so you can get the help you need.

It is common to worry about your fertility after an ectopic pregnancy. Having an ectopic pregnancy does not mean that you can’t have a normal pregnancy in the future. But it does mean that:

• You may have trouble getting pregnant.
• You are more likely to have another ectopic pregnancy.

If you get pregnant again, be sure your doctor knows that you had an ectopic pregnancy before. Regular testing in the first weeks of pregnancy can find a problem early or let you know that the pregnancy is normal.

How To Prevent An Ectopic Pregnancy

There is no way to guarantee you wont have an ectopic pregnancy again, however certain things may help. While half of ectopic pregnancies occur for unknown reasons, avoiding the known risk factors listed earlier will reduce the chance of another ectopic pregnancy. Eating a healthy diet and avoiding inflammation causing foods that impair sexual organ function, like vegetable oils and sugar, may also help. Here are some additional tips:

• Choose healthy fats like olive oil, coconut oil, and grass-fed butter
• Get at least 8 hours of sleep each night
• Reduce your stress levels
• Avoid endocrine disruptors like toxins in plastic, cleaning products, and personal care items
• Limit or avoid caffeine
• Take probiotics for gut health
• Get enough folate

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Can I Prevent An Ectopic Pregnancy

An ectopic pregnancy cannot be prevented. But you can try to reduce your risk factors by following good lifestyle habits. These can include not smoking, maintaining a healthy weight and diet, and preventing any sexually transmitted infections . Talk to your healthcare provider about any risk factors you may have before trying to become pregnant.

Who Is At Risk For An Ectopic Pregnancy

All sexually active women are at some risk for an ectopic pregnancy. Risk factors increase with any of the following:

• maternal age of 35 years or older
• history of pelvic surgery, abdominal surgery, or multiple abortions
• conception occurred despite tubal ligation or intrauterine device
• conception aided by fertility drugs or procedures
• history of sexually transmitted diseases , such as gonorrhea or chlamydia
• having structural abnormalities in the fallopian tubes that make it hard for the egg to travel

If you have any of the above risk factors, talk to your doctor. You can work with your doctor or a fertility specialist to minimize the risks for future ectopic pregnancies.

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Pressure In The Rectum And Change In Bowel

Intense pressure in the rectum or the abdominal area that feels like gas pain should not be ignored. Often internal bleeding from the ruptured site of pregnancy puts pressure on these areas. Pain while passing urine or stool as well as a change in bowel movement can also be symptoms of an ectopic pregnancy.

Risk Of Multiple Ectopic Pregnancies

The risk of having another ectopic pregnancy is between 5 and 25%, and is not affected by prior treatment.

Since there are two fallopian tubes, a fertilized egg can travel through the unaffected tube to the uterus. In vitro fertilization is also an option if you have trouble getting pregnant after an ectopic pregnancy.

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How Serious Is An Ectopic Pregnancy

An ectopic pregnancy is a medical emergency. The uterus is uniquely suited to hold a growing fetus. Its an organ that can stretch and expand as the fetus grows. Your fallopian tubes arent as flexible. They can burst as the fertilized egg develops. When this happens, you can experience large amounts of internal bleeding. This is life threatening. An ectopic pregnancy needs to be treated right away to avoid injury to the fallopian tube, other organs in the abdominal cavity, internal bleeding and death.

Is Egg Donation Related To Ectopic Pregnancies

While there is no long term studies on this topic, the process of extracting eggs involves an ultrasound probe being placed in the vagina, the aspirating needle is guided to the ovaries to retrieve the mature eggs. It is known that a history of pelvic surgeries is linked to a greater risk of ectopic pregnancy, even where the fallopian tubes are never directly impacted.

Most physicians advise egg donors to wait until their next menstrual before having intercourse again. This allows the ovaries to return to their normal size and allows your body to rest and heal. When your period returns, it is your bodys signal that everything is back to normal. While it would be incredibly rare for an egg retrieval to damage the fallopian tube in any way, it is advised to wait until at least your next period until trying to conceive.

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How An Ectopic Pregnancy Is Treated

There are 3 main treatments for an ectopic pregnancy:

• expectant management you’re carefully monitored and 1 of the treatments below is used if the fertilised egg doesn’t dissolve by itself
• medication an injection of a powerful medicine called methotrexate is used to stop the pregnancy growing
• surgery keyhole surgery is performed under general anaesthetic to remove the fertilised egg, usually along with the affected fallopian tube

You’ll be told about the benefits and risks of each option. In many cases, a particular treatment will be recommended based on your symptoms and the results of the tests you have.

Some treatments may reduce your chances of being able to conceive naturally in the future, although most women will still be able to get pregnant. Talk to your doctor about this.

Read more about treating an ectopic pregnancy.

Medical Treatment With Methotrexate

Medical treatment is useful for patients with an unruptured tubal ectopic pregnancy who are haemodynamically stable and have minimal symptoms and a low volume of free intraperitoneal fluid on ultrasound scan.70 Intramuscular methotrexate is the most widely used and successful medical therapy for ectopic pregnancy and is generally administered in a single-dose protocol.34,69 Methotrexate is a folic acid antagonist that targets rapidly dividing cells and arrests mitosis.9,71 In ectopic pregnancy, the drug prevents the proliferation of cytotrophoblast cells, reducing cell viability and -hCG secretion and thus progesterone support for the pregnancy. This facilitates the resolution of the ectopic pregnancy and tissue remodelling.

After assessing patient suitability for medical management , body surface area is calculated using height and weight measurements. In addition, a baseline full blood count and renal and liver function tests are obtained. In general, apart from some abdominal discomfort 1-3 days after treatment and abdominal bloating, side effects are not common and return to normal activities is quicker than after surgery. Potential serious side effects such as significant hepatotoxicity, bone marrow toxicity or alopecia are extremely rare with ectopic pregnancy treatment regimens. Patients require careful monitoring to ensure complete resolution of the ectopic gestation using serial assessment of -hCG levels every 4-7 days until the -hCG level is < 5 IU/l.72

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