Ectopic pregnancy is the term given to a pregnancy not inside, but outside the uterus, where it is not supposed to be! Does such a pregnancy have any future? Can it grow there and can we then deliver the baby as we normally do? Unfortunately not! No other part of the reproductive system has the thickness and the strength of the uterus to hold the baby for a full 9 months! And after the 9 months are completed when the baby is ready to come into this world, the uterus lets it out by guiding the baby in the right direction to be delivered through the vagina.

1% - 2% of all pregnancies are ectopic and it is a pregnancy which seems to have lost its way and got entangled most often in the maze of a Fallopian tube or the cervix or sometimes even the ovary! And none of these organs are capable of allowing the baby to grow within them; they are not as receptive as the uterus. 90% of ectopic pregnancies occur in the fallopian tube. The stretching of the growing pregnancy within the thin walled tube causes pain which gradually goes on increasing. The pregnancy does not get the support of a muscular organ like the uterus. The pregnancy penetrates the wall of the tube to get its nutrition, bringing in all the blood it can to that region in order to feed the baby. Once the pregnancy is about 6 to 8weeks old, it cannot continue its growth into the narrow confines of the fallopian tube and it continues its growth through the walls of the tube. All this causes pain to the patient which is usually located in a specific portion of the lower abdomen.  As the pregnancy gets bigger, her pain gets more severe which makes her go to her gynecologist. At this stage the ectopic can be easily diagnosed and taken care of, either medically or surgically.

But if the patient neglects her pain, and suppresses it with painkillers hoping it will go away, then the pregnancy bursts through the wall of the tube, causing a large bleed in her abdomen and pelvis. And since there is no outlet for the pregnancy to come of the body, it continues to bleed inside till action is taken.  A sudden loss of blood into her abdomen makes her feel faint, with a low blood pressure and a very fast heartbeat. She now needs emergency surgery to stop the bleeding and to save her life, because by now she would have lost 2 liters or more of blood into her abdomen, from the time she felt severe pain, rushed to the hospital, was seen by a doctor and taken into the operating theatre for her treatment! Her surgery includes removal of the pregnancy and if necessary the very badly damaged tube, all the collected blood either through a laparoscope or through an open surgery.  This works dramatically, the bleeding stops and the blood transfusions administered do their job.

I am sure you would be thinking, “Why do some women get ectopic pregnancies?”

The commonest cause is a narrow Fallopian tube which may have become narrow because of some infection in the past, causing inflammation and narrowing. The commonest cause of such infections in our country are tuberculosis, sexually transmitted infections, reproductive tract infections following unsafe abortions, delivering babies in unhygienic conditions, or undergoing procedures for infertility management without aseptic precautions.

It is possible for women to get pregnant again normally. But such women are at a higher risk of developing another ectopic hence we recommend to such women   to see her gynecologist as soon as she gets pregnant again.  There is no way that we can avoid an ectopic and it can occur even after IVF, even though her embryos are replaced under ultrasound guidance into the uterine cavity. If a woman gets repeated ectopic pregnancies, then we recommend that she block both her tubes before planning her next pregnancy, with blocked tubes which she would have to resort to Assisted Reproduction i.e. IVF. In such patients success of achieving a pregnancy is higher as the embryo cannot go into the tubes because they have been blocked; the embryos have no choice but to implant in the uterus!

A woman, who is planning a pregnancy for a long time with no success, is most disheartened when she gets an ectopic. It is so very unfortunate when we ask her to give up this very precious pregnancy which has no future!

With good counseling she is reminded that the fact she got pregnant, is a good sign i.e. all the mechanisms are working well and she would soon be pregnant again. We give her hope and usually with IVF we are able to offer her a pregnancy where it is supposed to be!

With over 3 decades of experience, we at Gynaecworld completely understand a woman’s world and are here to look after the medical hurdles that come your way. You are the center of all our efforts!!!

Book your appointment today at Gynaecworld, Kemps corner, Mumbai
Call: 02223802584
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