When the fertilized oocyte implants outside the endometrial cavity, this is known as an ectopic or extrauterine pregnancy. This type of pregnancy cannot go ahead and poses a risk that can be serious for the mother, for which reason termination of the pregnancy is indicated. Treated in time, ectopic pregnancy poses no risk to the fertility of the woman, who can successfully carry a subsequent pregnancy.
Why does an ectopic pregnancy occur and why is it dangerous?
Ectopic pregnancy occurs because the egg, once fertilized, implants and begins to develop outside the uterus. Generally, it usually implants in the fallopian tubes, although it can also nest in an ovary, in the abdominal cavity or in the cervix.
The fallopian tubes are narrow, have more fragile walls than the uterus and are not prepared to accommodate the development of an embryo. If the embryo continues to develop in them, it can even rupture them. It is therefore essential to know its symptoms in order to treat it as soon as possible.
Causes of ectopic pregnancy
About 50% of women who suffer an ectopic pregnancy have had a previous pelvic inflammatory disease (PID), such as salpingitis (inflammation of the fallopian tubes).
Other causes of extrauterine pregnancy are obstructions and/or congenital malformations in the fallopian tubes, adhesions from previous surgery, endometriosis, previous ectopic pregnancy, intrauterine device (IUD) use, or previous tubal surgery.
Symptoms of ectopic pregnancy
The symptoms of ectopic pregnancy that should put you on alert and for which you should go to the doctor are:
- Constant pain on one side of the abdomen, isolated or accompanied by nausea, dizziness and intestinal or urinary disorders.
- Symptoms of internal bleeding (pallor, low blood pressure, etc.).
- Severe abdominal pain. If the rupture of the tube is sudden, the woman will experience sharp pain in the lower abdomen accompanied by intense pressure in the rectum, low blood pressure and pain in the shoulder area.
How to treat ectopic pregnancy
Ectopic pregnancy is dangerous for the mother and therefore needs to be terminated surgically or medically. Surgical treatment by laparoscopy consists in the removal of the tube (salpingectomy) or its opening and cleaning (salpingostomy). Pharmacological treatment consists of injections to reabsorb the embryonic tissue.
The choice of one treatment or another depends on the location of the embryo and the number of weeks of gestation. Surgical treatment is indicated when the pregnancy is at an advanced stage or if the mother is breastfeeding another child. Similarly, if there is a lot of scar tissue in the abdomen, heavy bleeding or the embryo is too large, major abdominal surgery should be performed.
Can ectopic pregnancy be prevented?
Most ectopic pregnancies cannot be prevented, but if you suffer from endometriosis or if you have had an infection or disease that may have affected the fallopian tubes, it is advisable to consult your gynecologist when seeking pregnancy, since early diagnosis is the best way to avoid serious consequences.
Will I be able to get pregnant again?
After the termination of an ectopic pregnancy, a woman is advised to wait for a reasonable period of time before becoming pregnant again. Ectopic pregnancy does not necessarily affect her fertility, although it depends on whether it has caused damage to the fallopian tubes. On the other hand, women who have had an ectopic pregnancy are at higher risk of having another one, especially if the cause is a fallopian tube blockage or a previous malformation or infection.
After an ectopic pregnancy, many women achieve a new pregnancy without any problem. In the event that both tubes have been removed or are not permeable, the only option is to perform in vitro fertilization, a technique whose success rate in patients with tubal damage is very high, since it consists of directly depositing the embryo, already fertilized, in the uterus.