Ectopic Pregnancy

Why in News?

Recently, a case in Bulandshahr, Uttar Pradesh, left doctors stunned when an MRI scan conducted after a pregnant woman reported revealed that the fetus was developing in her liver.

• An ectopic pregnancy occurs when the fertilised egg implants outside of the uterus, most often in the fallopian tube (connect the ovaries to the uterus).
• If the fertilized egg implants in the fallopian tube it is called Tubal pregnancy.
• Sometimes, the fertilised egg may also attach to the ovary, abdominal cavity, or cervix in ectopic pregnancy.
• These sorts of pregnancies cannot proceed normally and it cannot support baby growth.

All tubal pregnancies are ectopic, but not all ectopic pregnancies are tubal.

• Occurrence – The Movement of the fertilised egg is blocked.
• This could occur due to inflammation or damage of the fallopian tubes due to prior surgeries or infections, or an irregularly-shaped fallopian tube.
• Symptoms – It may be similar to those in early pregnancy, such as a missed period, nausea and tenderness of the breasts.
• It includes vaginal bleeding, pain in the lower abdomen, as well as pelvic and back pain, dizziness, pain in the shoulder, discomfort during bowel movements, and low blood pressure.
• The study found that amenorrhea (absence of menstruation) was the most common symptom seen in the cases it analysed.
• On ultrasound, the most common finding was tubo-ovarian mass.
• In the majority of patients studied, the ampullary region in the fallopian tube was the site of the ectopic pregnancy.
• Risk factors – Prior ectopic pregnancy, having had certain sexually transmitted infections.
  • Surgery of fallopian tubes
  • A history of smoking,
  • Infertility and fertility treatments,
  • Endometriosis, and having an intrauterine device in place at the time of conception.
  • Advanced age over 35 is also a risk factor.
• Threat – This sort of pregnancy cannot proceed normally. It could cause severe internal bleeding, and life-threatening.
• Prevalence – The incidence of ectopic pregnancies in India has been reported in the range of 0.91 - 2.3%.
• Treatment – It is usually treated with medication or surgery. A common medication used is Methotrexate, which stops the fertilised egg from growing and helps dissolve existing cells.
• Laparoscopic (keyhole) surgery is usually performed to removing the egg from the fallopian tube, or removing both the egg and the tube.

Ectopic Pregnancy Awareness Day is observed on August 1 to raise awareness about the risks, symptoms, and importance of early detection.

Reference

The Hindu| Ectopic Pregnancy Causes