Ectopic pregnancy

Ectopic pregnancy

What is ectopic pregnancy?

A ectopic pregnancy (GÉU) or ectopic pregnancy occurs when the fertilized egg implants outside the uterus. Most often, the egg is lodged in one of the fallopian tubes (tubal pregnancy), more rarely in the ovary (ovarian pregnancy) or in the peritoneal cavity (abdominal pregnancy).

An ectopic pregnancy cannot be carried to term normally and requires emergency intervention. The woman needs to be injected with medicine or have surgery to remove the poorly implanted egg.

If the fertilized egg is not removed, its development may cause the fallopian tube to burst, which may cause severe bleeding which can be fatal for the woman.

Symptoms of ectopic pregnancy

Symptoms of ectopic pregnancy

Some women have no symptoms. Many ectopic pregnancies are diagnosed even before a woman knows she is pregnant.

Other women have the same symptoms as a normal pregnancy: absence of periods, tenderness in the breasts, nausea.

The first signs:

  • Light vaginal bleeding and abdominal cramps after 3 to 6 weeks.

If the fallopian tubes rupture:

  • Severe abdominal pain and heavy vaginal bleeding.
  • A drop in blood pressure causing symptoms of shock, such as pallor, sweating, and fainting.

People at risk 

  • Women who have had an ectopic pregnancy in the past.
  • Women whose fallopian tubes are abnormally shaped or who have been damaged following surgery (eg tubal ligation).

Risk factors

  • Have pelvic inflammatory disease, which is an infection of the fallopian tubes, ovaries, or uterus. This type of infection is often caused by gonorrhea or chlamydia.
  • Have inflammation of the fallopian tubes (salpingite).
  • Have had treatment for infertility, such as using medications such as clomiphene and the gonadotropins.
  • Become pregnant despite wearing an IUD. The latter is very effective in preventing all pregnancies, but if it fails, tubal pregnancy is common.
  • Smoke cigarettes.

Causes

Tubal pregnancy, the most common ectopic pregnancy (about 98% of cases), occurs when the fertilized egg fails to reach the uterus. It gets stuck due to inflammation, damage, or an abnormality in the shape of the fallopian tubes. Sometimes a hormonal imbalance can be involved. Some ectopic pregnancies sometimes have unexplained causes.

Prevalence

In France and North America, ectopic pregnancy represents 2% of live pregnancies. There is 1 ectopic pregnancy for 13 miscarriages.

Diagnostic

A pelvic exam, blood tests and an ultrasound can detect an ectopic pregnancy. When blood tests show low gonadotropin hormone levels chorionique (hCG) or a slower increase than normal, it could be an ectopic pregnancy. An ultrasound can check for the presence of the fertilized egg in the uterus and identify the presence of blood pooled in the abdominal and pelvic cavities. A laparoscopy (a fiber optic tube, attached to a camera) can be performed to examine the inside of the uterus.

Our doctor’s opinion

As part of its quality approach, Passeportsanté.net invites you to discover the opinion of a health professional. Dr Jacques Allard, general practitioner, gives you his opinion on the ectopic pregnancy :

Tubal pregnancy is a very serious event, with sometimes fatal consequences. If you have symptoms of a normal pregnancy (absence of periods, breast tenderness, nausea) and light vaginal bleeding accompanied by abdominal cramps, do not hesitate to consult your doctor very quickly. Early diagnosis allows relatively easy treatment with few sequelae.

However, if you also have severe abdominal pain and heavy vaginal bleeding, tube rupture is imminent (if you haven’t already) and you should go to a hospital emergency room immediately.

Dr Jacques Allard  M.D.   FCMFC

 

 

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