ectopic pregnancy.

 

Ectopic pregnancy

 

What is it?

Eggs make their way from the ovaries to the womb through the fallopian tubes, where they may be fertilised by a sperm.

The fertilised egg continues on to the womb, where it implants itself to the wall and continues to grow.

However, sometimes the embryo implants itself outside the womb, most often in the fallopian tubes themselves, and this is known as an ectopic pregnancy.

 

The embryo can also implant in the ovary, the abdomen, and in the cervix.

 

 

A right tubal ectopic pregnancy as seen at laparoscopy
The swollen right tube containing the ectopic pregnancy is on the right at E
The stump of the left tube is seen at L - this woman had a previous tubal ligation

Close view of the same ectopic

After laparoscopic resection of the tube, the tubal stump is seen at S

Ovarian ectopic pregnancy
Ovary is the white structure in the middle
Pregnancy implanted on the far right side of the ovary at the "X"
Bleeding and clotted blood are seen here around the ovary
Ovarian pregnancies are quite rare

 

 

What causes it?

 

Anything that obstructs or slows the movement of eggs can increase the risk.

Infections in the fallopian tubes can leave them scarred, which will hinder movement, or there may be a physical blockage caused by previous surgery or injury.

 

Hormones - particularly those used in contraceptive pills and devices - can also affect the rate of movement of the egg.

 

Who gets it?

 

Women who have been affected by pelvic inflammatory disease or endometriosis are at higher risk.

 

So too are women who have had abdominal surgery, used a coil for contraception, or taken the progestogen-only mini pill, but become pregnant anyway.

 

There may also be an increased among women who take the morning after contraceptive pill to no avail - although this is still unclear.

 

Women who become pregnant despite having been surgically sterilised have a 60% chance of an ectopic pregnancy.

 

And women who have had previous ectopic pregnancy, are at greater risk of repeating the experience.

 

Ectopic pregnancies are on the rise with the rate nearly tripling from 1970 to 1980.

About half are estimated to be due to the increase in sexually transmitted infections such as chlamydia.

 

What are the risks?

 

With an ectopic pregnancy, the embryo can rupture the fallopian tube, leading to massive internal bleeding - and possibly death - for the mother, and loss of the baby.

If the woman survives this, her fertility is likely to be greatly reduced and her chances of going through the same experience are increased.

 

What is the treatment?

 

Because of the life threatening nature of the condition, early diagnosis is essential and doctors recommend terminating the pregnancy.

If the pregnancy is allowed to continue and the tube ruptures, doctors have to remove it, reducing the woman's fertility.