Modern medicine is full of many success stories but here's one you may not have heard about.
Our ability to detect and treat ectopic pregnancy. For most of human history ectopic pregnancies
were fatal. Now the risk of death from ectopic pregnancies is less than one in one thousand.
Although that risk of death is now extremely low, catching ectopic pregnancies early remains key to
being able to treat them in such a way that saves lives and maintains fertility. This is why it's
important to understand what ectopic pregnancies are, their risk factors and what symptoms to look
out for. This video will cover these topics, as well as the treatment options that have made
this such a medical success.
So what are ectopic pregnancies?
Ectopic pregnancies are what happens when a fertilized egg implants in an area outside of the uterus.
In order to understand what this means it may be helpful to first understand what a normal pregnancy would look like.
Normally we'd expect an egg to be released by the ovaries
be fertilized in the fallopian tubes
and then travel to the uterus where it implants in the lining, known as the endometrium.
The uterus on this lining is specialized to be able to support healthy development of an embryo.
About one or two out of 100 pregnancies an egg implants somewhere else instead, like in the
fallopian tubes and we get an ectopic pregnancy.
A fertilized egg cannot fully develop outside of the uterus
and therefore an ectopic pregnancy cannot be continued.
Furthermore, other parts of the body are not equipped to support a growing pregnancy.
Which means that ectopic pregnancies can become life-threatening to the pregnant person if left untreated.
Now that you know what an ectopic pregnancy is you may be wondering who's at risk for one?
Ectopic pregnancies can happen to anyone but there are a few risk factors that may increase your chances of having one.
The most significant risk factor is having had a prior ectopic pregnancy if you've had an ectopic pregnancy in the past your chance of it happening again is about 10 times higher.
Other things that increase your chances are smoking, your age, use of fertility treatments,
a history of a pelvic infection or PID, and a history of surgery on your fallopian tubes.
Finally, although the risk of getting pregnant while using an iud as contraception is very low -
less than one out of a hundred - if a pregnancy does happen while you have an iud there's a
greater chance of it being an ectopic pregnancy.
So what are the symptoms of an ectopic pregnancy?
There are three classic symptoms that are often seen together in ectopic pregnancy
abdominal pain, vaginal bleeding, and a missed period.
However there are times where pain is the only symptom or when these symptoms may be present but there isn't an ectopic pregnancy.
Ectopic pregnancies are therefore diagnosed through certain tests instead of by symptoms alone.
These tests include urine and blood tests for the pregnancy hormone beta-hcg
and an ultrasound of the uterus and ovaries.
Now that we understand a little bit more about ectopic pregnancies we can discuss how they are treated.
There are a few different types of treatment of ectopic pregnancy
and which ones are used can depend on many factors including someone's fertility goals
and the level of immediate danger. Ectopic pregnancies may be treated through surgery,
medication, or a combination of both.
Let's start with talking about some surgical procedures that may be used to treat an ectopic pregnancy.
The surgical options differ in the size of the incision and whether or not the fallopian tube
is left in place. If the ectopic pregnancy has significantly damaged the fallopian tube, the tube may have to be removed.
This can also often be done through a small incision using a camera called a laparoscope.
Although surgery for an ectopic pregnancy often removes a fallopian tube
as long as the other tube is present and healthy it is still possible to become pregnant in the future.
In some cases if the fallopian tube has not been significantly harmed by the ectopic pregnancy,
your surgeon may be able to remove the ectopic pregnancy through an incision in the tube while leaving the tube in place.
The most significant risk with this treatment option is that the ectopic pregnancy might not be
cleared completely, and that the tube is left at a higher risk for having a future ectopic pregnancy.
To account for this risk your levels of beta hcg might need to be monitored over a period of time
after the surgery to ensure the pregnancy is gone and no longer a risk to your health.
If the ectopic pregnancy is small enough and you are able to come back for multiple blood tests,
and your provider thinks it's safe for you, treatment through medication may be an option.
The medication that is used is called Methotrexate.
This medication may also be used after surgery if the pregnancy is not completely removed.
With the surgery this treatment may not be an option if you are breastfeeding, or have certain other medical conditions.
There are also times when your health care provider may not be certain that you have an ectopic pregnancy.
This typically occurs in the first six weeks of pregnancy when it's not clear whether you
have a normal pregnancy, an ectopic pregnancy, or a miscarriage. This is called a pregnancy of
unknown location and requires following your pregnancy hormone closely.
Ectopic pregnancies have the potential to be dangerous, but with modern medicine are very treatable.
If you have questions regarding ectopic pregnancy or you are pregnant and having bleeding be sure to see your doctor.