Ectopic pregnancy is a condition when fertilization of the egg occurs outside the uterus (usually occurs in one of the fallopian tubes).
Pregnancy begins with an egg cell that has been fertilized by sperm cells. In the normal process, the fertilized egg will remain in the fallopian tube for approximately three days, before being released into the uterus. In the uterus, this egg will continue to grow until the time of delivery arrives. But there is a possibility that fertilized eggs attach to organs other than the uterus and this is called an ectopic pregnancy.
The fallopian tube is the organ that is most often attached to the egg. While other organs that may be the site of developing ectopic pregnancy include the abdominal cavity, ovaries, and cervix or cervix.
One of the most common causes of ectopic pregnancy is fallopian tube damage, for example due to inflammation or inflammation. This damage will prevent fertilized egg cells from entering the uterus so that they end up in the fallopian tube itself or other organs.
In addition, unbalanced hormone levels or abnormal development of fertilized eggs can sometimes act as a trigger.
Ectopic Pregnancy Risk Factors
There are a number of factors that are thought to trigger an ectopic pregnancy. These risk factors include:
- Choice of contraception. The use of spiral type contraceptives or intrauterine devices (IUDs) aims to prevent pregnancy. But if the pregnancy persists, chances are that this pregnancy is ectopic.
- Have had an ectopic pregnancy before. Women who have experienced this condition have a higher risk of experiencing it again.
- Have an infection or inflammation. Women who have experienced fallopian inflammation or pelvic inflammatory disease due to sexually transmitted diseases, such as gonorrhea or chlamydia (chlamydia), have a higher risk of having an ectopic pregnancy.
- Fertility problems and their treatment can sometimes trigger an ectopic pregnancy.
- Sterilization process and vice versa. Tubal binding procedures or opening of imperfect tubal bonds also risk triggering an ectopic pregnancy.
Initially, an ectopic pregnancy tends to be asymptomatic or have signs that are similar to ordinary pregnancies before other symptoms appear that indicate an ectopic pregnancy. Among others are:
- Lower abdominal pain that usually occurs on one side.
- Pain in the pelvic bone.
- Mild bleeding from the vagina.
- Dizziness or weakness.
- Pain and nausea and vomiting.
- Shoulder pain.
- Pain or pressure on the rectum during bowel movements.
- If the fallopian tube is torn, severe bleeding will occur which might trigger loss of consciousness.
Ectopic pregnancy includes a medical condition that requires emergency treatment. Therefore, you should immediately go to the hospital if you experience these symptoms.
In addition to asking about general health conditions, the doctor will conduct a physical examination of the pelvic cavity. But ectopic pregnancy cannot be ascertained only through physical examination. Doctors also need ultrasound or blood tests.
The most accurate ultrasound method for detecting ectopic pregnancy is transvaginal ultrasound. This procedure will confirm the location of an ectopic pregnancy as well as the fetal heart rate.
In the early days of pregnancy, especially 5 to 6 weeks after conception, pregnancy may not be detected by ultrasound. In this condition the doctor may recommend a blood test to identify an ectopic pregnancy. This test is used to detect the presence of the hormone hCG (Human chorionic gonadotropin), this hormone produced by the placenta during early pregnancy. In ectopic pregnancy, hCG hormone levels tend to be lower than normal pregnancy.
Steps for Ectopic Pregnancy Management
The fertilized egg will not grow normally if it is not in the uterus. Therefore, ectopic tissue must be removed to avoid complications that can be fatal.
Women suspected of having an ectopic pregnancy must be immediately taken to the hospital to undergo treatment as soon as possible. Ectopic pregnancy detected early without a fetus developing normally in the uterus is generally treated with methotrexate injections. This drug will stop growth while destroying the cells that have been formed.
The doctor will monitor the patient’s hCG level after receiving the injection. If the hCG level in the patient’s blood remains high, this usually indicates that the patient needs another methotrexate injection. Potential side effects of this drug include nausea and vomiting. Abdominal pain can also appear 3 days or 1 week afterwards.
Ectopic pregnancy can also be treated with surgery. This procedure is usually performed through keyhole or laparoscopic surgery. Fallopian tubes that are overgrown with ectopic tissue will be repaired if possible.
Complications and Prevention
Incorrect diagnosis and handling of a late ectopic pregnancy can lead to severe bleeding and even death from a fallopian or uterine tube. If you experience this complication, the patient must undergo emergency surgery through open surgery. A fallopian tube may be repaired, but generally it must be removed.
Handling with surgery also has its own risks. Some complications that may occur include bleeding, infection, and damage to organs around the part of the surgery.
Ectopic pregnancy cannot be completely prevented. To avoid this condition, you must avoid or reduce the risk factors. Examples are by undergoing blood tests and ultrasound as early detection or monitoring the development of pregnancy. Especially for women who have had an ectopic pregnancy.