Tubal pregnancy

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Before we speak about tubal pregnancy, let’s clarify what is normal pregnancy.

During normal pregnancy, the fertilized egg from the ovary travels through Fallopian tube to the uterus. In the uterus, the embryo implants (attaches) to the uterine lining (uterine wall) and starts to grow.

As it was mentioned, travel through Fallopian tube to the uterus is very important part of normal pregnancy.
Sometimes fertilized egg (embryo) meet obstacles inside of Fallopian tube (inflammation, narrowing of the tube, scars, damages) and cannot reach the uterus.

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Actually, the fertilized egg experience trouble passing through damaged Fallopian tube to the uterus. In these cases, the implantation happens in Fallopian tube and embryo starts growing.
This type of pregnancy called “tubal pregnancy” (ectopic pregnancy). There is no way to save tubal pregnancy – pregnancy development is not possible in Fallopian tube and at certain moment growing embryo damages or bursts the tube and causes heavy internal (abdominal) bleeding that could be deadly.
It is pretty dangerous situation which requires urgent hospitalization.
Tubal pregnancy is the leading cause of pregnancy-related deaths in the first trimester of pregnancy in many countries.

Tubal pregnancy causes

In general, any damage of Fallopian tubes can cause tubal pregnancy including the following:

Pelvic inflammatory diseases (PID) – trigger inflammation inside of Fallopian tube;
Sexually transmitted infections – trigger inflammation and scars inside of Fallopian tubes;
Endometriosis – develop ectopic endometrial tissue inside of Fallopian tubes;
Abdominal surgical procedures on Fallopian tubes or on surrounding organs – cause narrowing and internal scars in Fallopian tubes;
Smoking – according to scientists, smoking women have higher chances for tubal pregnancy;
In vitro fertilization – when fertilized egg delivered in the Fallopian tube.

Tubal pregnancy symptoms

Missed period;
Pregnancy symptoms (fatigue, morning nausea, sore breasts, etc.);
Abdominal or pelvic pain;
Vaginal bleeding or pinkish discharge;
Dizziness or loss of consciousness;
Fast heartbeat (over 100 beats per minute).

Tubal pregnancy diagnosis

Tubal pregnancy diagnosis is not difficult – it is usually found in the first 5-10 weeks of pregnancy. Following tests can confirm it:
Pregnancy test;
Ultrasound observation;
Pelvic exam.

Tubal pregnancy prevention
Avoid unprotected relations which will prevent sexually transmitted diseases (gonorrhea, trichomoniasis, Chlamydia, etc.);
If you have pelvic inflammatory diseases, treat it in-time and properly;
Remove the contraceptive before you decide to have a baby;
Avoid surgical interventions on reproductive organs.

Ectopic pregnancy treatment

Ectopic pregnancy can be treated medically (with specific medications) or surgically.

Specific medication can be used only if the tubal pregnancy was found early (before the tube is damaged). In most cases, one or more shots of a medicine called methotrexate (Rheumatrex, Trexall) will end the pregnancy – this medication cause the tissue to stop growing and allow the body to expel it.
Methotrexate is a chemotherapeutic drug that interferes with cell division and growth and has been successfully used in the treatment of leukemias, lymphomas and other cancers. Unfortunately, this medication has several side effects and medical monitoring would be needed.
Bigger ectopic pregnancy (beyond first few weeks) usually requires surgical interventions – through laparoscopy or by abdominal incision.

Credit: Nelson Elemi

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