Pregnancy occurs when the fertilised egg, resulting from the union of
an egg and sperm, successfully implants itself into the uterus.
However, various complications could occur when it comes to pregnancy,
one of them being an ectopic pregnancy.
What is an ectopic pregnancy?
The term “ectopic pregnancy” derives from the Greek word “ektopas,”
which translates to “out of place.”
In a normal pregnancy, the fertilised egg migrates from the fallopian
tube to the uterus, where it implants and continues growing. However,
in some cases, this process is disrupted, and the fertilised egg
implants and begins developing outside the uterus, resulting in an
ectopic pregnancy.
Most ectopic pregnancies develop in the fallopian tubes, which is
referred to as a tubal pregnancy. Ectopic pregnancy is typically
caused by damaged fallopian tubes, which ultimately prevent the
fertilised egg from traveling to the uterus.
What are the risk factors of an ectopic pregnancy?
About half of the women who have had an ectopic pregnancy did not have
known risk factors.
Some of the common risk factors for ectopic pregnancy include:
- Previous ectopic pregnancy
- Previous fallopian tube or tubal surgery
- Previous pelvic or abdominal surgery
-
Structural abnormalities such as scarring of the fallopian tubes
from a previous medical condition, infection, or surgery
- Abnormalities present since birth in the fallopian tubes
- Certain sexually transmitted infections (STIs)
- Pelvic inflammatory disease (PID)
Other factors that may increase a woman’s risk of ectopic pregnancy
include:
- Older than 35 years old
- History of infertility
-
Undergoing fertility treatments such as assisted reproductive
technology or in-vitro fertilisation (IVF)
- Smoking
What are the symptoms of an ectopic pregnancy?
Women who are sexually active should be aware of changes in their
bodies, especially if they experience symptoms of an ectopic
pregnancy.
Some women do not experience symptoms, some may experience a few
symptoms, while others may experience many symptoms.
The symptoms of an ectopic pregnancy may include:
-
Pain in your lower abdomen that develops suddenly
for no apparent reason or may come on gradually over several days.
It may be on one side only.
-
Spotting or vaginal bleeding that is different from
your normal period. The bleeding may be lighter or heavier or darker
than normal.
-
Pain at the tip of your shoulder caused by blood
leaking into the abdomen is a sign that the condition is getting
worse. This pain is there all the time and may be worse when you are
lying down. It is not helped by movement and may not be relieved by
painkillers. You should seek urgent medical advice if you experience
this type of pain.
-
Upset tummy such as having diarrhoea or pain during
bowel movement.
-
Severe abdominal pain may develop if the affected
fallopian tube bursts or ruptures and causes internal bleeding. In
rare instances, collapsing may be the very first sign of an ectopic
pregnancy. This is a medical emergency, and you should seek urgent
medical attention.
When do ectopic pregnancy symptoms start?
Most women experience physical symptoms in the sixth week of pregnancy
(about 2 weeks after a missed period). You may or may not be aware
that you are pregnant if your periods are irregular, or if the
contraception you are using has failed.
Due to the wide variation of symptoms, diagnosing an ectopic pregnancy
may not be straightforward.
How is an ectopic pregnancy diagnosed?
Diagnosis of an ectopic pregnancy will be made based on the following:
-
Consultation and physical examination: Your doctor
will ask about your medical history and symptoms and will examine
your abdomen.
-
Urine pregnancy test: This test will be done to
find out whether you are pregnant.
-
Transvaginal ultrasound: This scan will be done to
check your uterus, ovaries, and fallopian tubes to evaluate your
condition.
-
Blood tests: A test for the level of the pregnancy
hormone βhCG (beta human chorionic gonadotrophin) or a test
every few days to look for changes in the level of this hormone may
help to give a diagnosis. This is usually checked every 48 hours
because, with a pregnancy in the uterus, the hormone level rises by
63% every 48 hours (known as the ‘doubling time’)
whereas, with ectopic pregnancies, the levels are usually lower and
rise more slowly or stay the same.
Book an appointment at Pantai Hospitals
Each pregnancy is unique. Regular prenatal appointments and open
communication with your doctor are crucial for monitoring your health
and addressing any concerns throughout pregnancy.
A dedicated and expert team of
obstetricians and gynaecologists at
Pantai Hospital is available for consultation to provide patients with
the best care and assistance. Get in touch with us to
book an appointment today if you
have any concerns or questions about an ectopic pregnancy.
Pantai Hospital has been accredited by the Malaysian Society for
Quality in Health (MSQH) for its commitment to patient safety and
service quality.