An Ectopic pregnancy is a pregnancy situated outside its normal location within
the uterine cavity. The commonest site outside the uterus is in the fallopian
tube. Though it can occur in a perfectly normal tube it usually occurs in a
tube partly blocked due to infection or pelvic surgery.
Though at times there may be a history of a missed period , sometimes slight
bleeding at the time of the missed period may confuse the issue. One constant
feature of an ectopic pregnancy is pain on one or the other side in the lower
abdomen. The danger associated with such a pregnancy is that eventually the
tube can burst leading to haemorrhage of varying degree in the abdominal
cavity. The pregnancy situated outside the uterus can never grow beyond a few
weeks and needs to removed.
An ectopic pregnancy can usually be diagnosed by a combination of Beta HCG
levels(a hormone test which detects pregnancy) and
sonography though at times
laparoscopy maybe required to clinch the diagnosis. Very often an
ectopic pregnancy can be identified and the tube possibly saved before it
bursts. In most other cases, the tube needs to be surgically removed. Today
most cases of ectopic pregnancy which require surgery can be managed through
the laparoscope. Only a few cases require open surgery.
In select cases where the tube has not burst (Unruptured ectopic) it may be
possible to arrest the growth of the pregnancy by an injection of an anti
cancer drug Methotrexate . However there is a risk of the tube bursting with
attendant emergency surgery while waiting for the pregnancy to regress. This
method may also require initial hospitalisation besides repeated blood
tests and sonographies till such a time that the pregnancy stops growing.
The possibility of a future natural pregnancy or the recurrance of an ectopic
pregnancy would depend on the condition of the other tube and whether it was
possible to conserve the affected tube. When both the fallopian tubes are
damaged, pregnancy can still be achieved with
IVF-ET.
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