When Does a Baby Go From Fallopian Tube to Uterus?
Ectopic Pregnancy: Signs, Symptoms & Treatment
An ectopic pregnancy occurs when a fertilized egg implants outside of the uterus or not within the uterine cavity. The word "ectopic" refers to something medically that is in the incorrect place or position.
In virtually 98 per centum of ectopic pregnancies, the fertilized egg implants within a woman's fallopian tube, the narrow tube that links the ovaries and uterus. This is as well called a tubal pregnancy.
In rare cases, the fertilized egg can implant in a adult female's cervix, or in a scar from a previous Caesarean section, co-ordinate to the Mayo Clinic. Rarely, it can also attach straight to a adult female's ovary, or to her cervix, or to an organ in the abdomen, such as the abdominal wall.
During twin pregnancies, information technology'south possible — but rare — for 1 embryo to implant in the uterus while a 2nd implants at an ectopic location, exterior of the uterus.
An ectopic pregnancy tin can be dangerous because when an embryo implants in a location other than the uterine wall, information technology's unable to develop normally. Locations other than the uterus don't have plenty space or the right tissue for the embryo to grow, according to the March of Dimes.
As the embryo grows, it tin can cause the organ it attaches to, such equally the fallopian tube or an ovary, to rupture. If this occurs, it tin atomic number 82 to astringent internal bleeding. In some cases, a pregnant adult female might die.
"The uterus is a unique organ that can stretch dramatically with a growing pregnancy," said Dr. Jennifer Kickham, an obstetrician and gynecologist, and the medical director of the outpatient gynecology clinic at Massachusetts General Hospital in Boston. "No other tissue in the torso has the ability to grow to accommodate a nine-pound babe or twins," she said.
An ectopic pregnancy can exist life threatening to a woman when the embryo implants onto locations exterior the uterine cavity. That's because the tissue in these areas can't stretch like the uterus and if the embryo implants into the vascular supply, claret vessels can start bleeding, Kickham said.
Although an ectopic pregnancy tin be a life-threatening gynecological emergency, well-nigh women who experience one can be treated and can have normal pregnancies in the future, she explained.
In the United States, an ectopic pregnancy can touch 1 to 3 percent of all pregnancies, so information technology affects a meaning number of women and is more common than people realize, Kickham said.
Symptoms
Ordinarily the virtually common complaints of women with an ectopic pregnancy are vaginal bleeding and/or hurting in the abdomen or pelvis, peculiarly on one side of the body, Kickham said. Some women may accept shoulder hurting or lower back pain. At that place may likewise exist some dizziness or fainting, considering of claret loss. Some women may take no symptoms at all until the fallopian tube ruptures.
It'due south most common for women to experience the symptoms of an ectopic pregnancy 6 to x weeks after a missed menstrual menstruation, Kickham said.
Take a chance factors
Anything that affects the power of the egg to travel downwards the fallopian tube into the uterus — such as prior harm to the fallopian tubes, tubal abnormalities or infections that may block the tube — tin can increase the chance of having an ectopic pregnancy.
The post-obit women may be at college risk of having an ectopic pregnancy:
- Women who have had a prior ectopic pregnancy.
- Women who have a history of infertility.
- Women who have had sexually transmitted diseases, such equally infections caused by gonorrhea or chlamydia.
- Women who have had pelvic inflammatory disease, an infection that can damage the fallopian tubes, uterus and other parts of the pelvis.
- Women who have had endometriosis, a condition in which cells that normally line the uterus implant and grow elsewhere in the body, such every bit the ovaries or bladder.
- Women who have had scars inside the pelvis from a outburst appendix or past surgeries.
- Women who have become meaning while using an intrauterine device (IUD) or after having their "tubes tied," which is known equally a tubal sterilization.
- Women who smoked cigarettes prior to becoming pregnant.
- Women with a history of multiple sexual partners because this may increase the chance of pelvic infections.
Causes
An ectopic pregnancy is likely caused by a combination of prior medical history and lifestyle factors, Kickham said. It is not genetic, she explained.
As described above, anything that affects the operation of a woman's fallopian tubes, such every bit prior tubal surgeries or pelvic infections, can increase the risk of an ectopic pregnancy. In addition, factors that can ho-hum movement in the fallopian tube, such as cigarette smoking, tin also make a woman more than likely to have an ectopic pregnancy.
Diagnosis and tests
To diagnose an ectopic pregnancy, a woman who may be complaining of vaginal bleeding and pelvic pain, may be given a blood exam to decide her levels of human chorionic gonadotropin (hCG), a hormone that's but present when a adult female is pregnant.
Home pregnancy tests measure hCG levels in the urine, only if an ectopic pregnancy is suspected, doctors volition look at the results from a blood test instead to mensurate the amount of hCG present. In a normal pregnancy, hCG levels will roughly double in a catamenia of 48 to 72 hours, but levels may rise more slowly in an ectopic pregnancy, Kickham said.
Besides measuring levels of hCG, women volition also need a test known equally a transvaginal ultrasound, in which a wand-similar device is inserted into a woman'south vagina to examine the reproductive organs, including the uterus, ovaries, neck and fallopian tubes. Ultrasound uses loftier-frequency sound waves to create images that can identify whether a pregnancy is located inside the uterus or somewhere else.
Sometimes transvaginal ultrasound can detect that this is non a normal pregnancy and the embryo is growing outside of the uterus, and sometimes ultrasound may not exist able to pick up an ectopic pregnancy. Just if levels of hCG are betwixt 1,500 and two,000 mIU/mL, an ectopic pregnancy is suspected even if information technology'south non seen on ultrasound.
Once a diagnosis of an ectopic pregnancy is made, it can exist upsetting for a woman to larn that she is non having a normal uterine pregnancy, Kickham said. Some woman may inquire, "Is it possible to motility the pregnancy to the uterus?" she said, but unfortunately, there is no medical technology bachelor to move the pregnancy to the uterine cavity.
Risks to mother
An ectopic pregnancy tin can be a gynecological emergency because it may be life threatening to a woman, Kickham said. She said that ectopic pregnancies are the leading cause of maternal expiry during the start trimester, accounting for four to x per centum of all pregnancy-related deaths.
Although ectopic pregnancies usually happen in the first trimester, they tin occur subsequently but these are typically the rarer kinds of ectopic pregnancies, Kickham explained.
A woman who has had a prior ectopic pregnancy has an increased risk for having some other ectopic pregnancy, Kickham said. But she also added that a lot of women do go on to take a normal intrauterine pregnancy.
Treatment and medication
For a woman who has minimal symptoms, meaning that there is non a business concern that her fallopian tube will rupture, handling for an ectopic pregnancy typically involves medication, Kickham said. She said that women are given an injection of methotrexate, a drug used in cancer handling. This medication stops the growth of the embryo, which and so allows the body to resorb the tissue. A benefit of this treatment is that information technology does non affect the fallopian tubes.
Methotrexate is typically given equally a one-fourth dimension injection. A woman needs to have her blood drawn twice, on the fourth and seventh days after receiving the drug, and so that doctors can see that her levels of hCG take dropped by fifteen pct or more during this time flow, Kickham said.
If a woman's hCG levels accept not been reduced by at to the lowest degree 15 per centum, she will need a second injection of methotrexate to make sure her hCG levels are falling. An ectopic pregnancy ends when hCG levels accept dropped to zip.
But not all women are good candidates for medication and some may need to undergo surgery to remove the ectopic pregnancy, Kickham said.
Surgery may involve removing the entire fallopian tube, for example. This performance can be done laparoscopically, which is a grade of minimally invasive surgery that requires a smaller incision. For that reason, the surgery can typically be done without a woman needing to stay in the hospital overnight, and she will accept a shorter recovery time after the operation.
In some situations, a larger incision in the belly may be performed during surgery to remove the ectopic pregnancy. Sometimes the fallopian tube may exist removed if its damaged and sometimes information technology tin be surgically repaired.
When a woman has a heterotopic pregnancy, where 1 twin is growing in the uterus and the other twin is an ectopic pregnancy usually in the fallopian tube, it is too risky to treat the woman with medication. A female parent will need surgery to remove the ectopic pregnancy in the fallopian tube, but she volition exist able to go into labor and give nascence to the surviving twin developing in the uterus, Kickham said.
Ordinarily, a woman who has had an ectopic pregnancy is encouraged to wait at to the lowest degree three months before attempting to condign pregnant once again, Kickham said. Since an ectopic pregnancy is a blazon of early pregnancy loss, a adult female should have the time to heal from it, both physically and emotionally.
Additional resources
Learn more than nearly ectopic pregnancy at:
- March of Dimes
- Mayo Clinic
- National Library of Medicine
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Source: https://www.livescience.com/51711-ectopic-pregnancy.html
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