Ectopic pregnancy-why does it arise?

Ectopic pregnancy-what is it?

Ectopic pregnancy, or ecotopic pregnancy, is the implantation of an embryo outside the normal place, i.e. the uterine cavity. In most situations, the ectopic pregnancy localizes in the bulb of one of the fallopian tubes. In addition, ectopic pregnancy can also localize in the ovary, cervix, abdominal cavity (abdominal pregnancy) or cesarean section scar.  

Because of the risk of ectopic pregnancy, despite a positive pregnancy test and rising beta- HCG levels, the correct location of the pregnancy should always be confirmed by ultrasound. This way, timely drug treatment can be applied and surgery can be avoided.

Ectopic pregnancy- causes

Risk factors for ectopic pregnancy include:

• A history of inflammation of the organs of the pelvis (inflammation of the appendages – PID),
• Pelvic surgical procedures,
• smoking,
• assisted reproductive methods,
• Fallopian tube pathologies,
• congenital uterine defects,
• A history of ectopic pregnancy.

The risk of ectopic pregnancy is also higher in women who have previously used emergency contraception or had a levonogestrel-releasing IUD inserted.

Ectopic pregnancy- symptoms

The symptoms of ectopic pregnancy at first are similar to a pregnancy located properly in the uterine cavity. These are most often the absence of menstruation and lower abdominal pain. Breast tenderness or mood swings may also appear. In addition, in the course of ecotopic pregnancy there is bleeding, and in some cases there are also peritoneal symptoms and muscle defense, as well as very severe pain in the lower abdomen. If the ectopic pregnancy ruptures, the woman may go into hypovolemic shock caused by the loss of large amounts of blood.

The characteristic symptom of ectopic pregnancy is an abnormal increase in the concentration of beta-HCG in the blood. Characteristically, its concentration doubles too slowly. Moreover, ultrasound may show changes in the adnexa, and the gynecologist, despite the elevated beta- HCG level, is unable to visualize the pregnancy follicle and cardiac activity in the uterine cavity.

Ectopic pregnancy- treatment

Treatment of ectopic pregnancy involves the drug methotrexate, which is a folic acid antagonist. In addition, folinic acid may be included, which will reduce the risk of side effects of treatment. A 4-dose or 1-dose regimen of methotrexate administration is currently available. In some situations, especially if an ecotopic pregnancy has ruptured, there is a need for surgical treatment. It is most often performed using a laparoscopic method.