An ectopic pregnancy (pregnancy outside the uterus) is the attachment of a fertilized egg in the fallopian tube or somewhere other than the uterus. An ectopic pregnancy can turn into a medical emergency immediately if left untreated or undetected. That's why, you should know the symptoms of an ectopic pregnancy and how to diagnose and treat this condition with the help of a doctor.
Step
Part 1 of 3: Identifying Ectopic Pregnancy Symptoms
Step 1. Watch your menstrual period
If your period doesn't come, even though you had sex without any form of contraception, take a pregnancy test.
- Even if an ectopic pregnancy does not develop in the uterus, your body will show many of the typical signs of pregnancy.
- If you have an ectopic pregnancy, the pregnancy test is usually positive. But you need to know, this test has the possibility of a false positive result or a false negative result. So if you are in doubt, it is better to visit a doctor to do a blood test and confirm it.
Step 2. Start looking for other signs of pregnancy
If you become pregnant, whether the egg implanted in the uterus (as in a normal pregnancy), or in the fallopian tube or elsewhere (as in an ectopic pregnancy), you may still experience some or most of the following common symptoms:
- breasts soften
- frequent urination
- Nausea, with or without vomiting
- not menstruating (as previously mentioned).
Step 3. Stomach hurts
If you've confirmed that you're pregnant, or if you're still unsure but your stomach hurts, this could be due to an ectopic pregnancy.
- The pain is mainly due to the pressure exerted by the growing fetus on the surrounding tissue, which, in the case of an ectopic pregnancy, does not have sufficient space to accommodate the fetus (in the fallopian tubes for example, the most common site of ectopic pregnancies, which are not designed to accommodate the fetus, for example). developing).
- The abdominal pain can be sharp and severe, or in some cases it may not even be painful.
- The pain often increases when you move and the muscle stretches, and is localized to only one side of the abdomen.
- The shoulder can also be painful because of the blood in the abdomen irritating the nerves leading to the shoulder.
- However, round ligament pain is a common condition in pregnancy. The pain is uniformly on one (or both) sides and occurs at intervals (which usually lasts a few seconds at a time). The difference, round ligament pain tends to occur in the second trimester. The pain in an ectopic pregnancy usually appears sooner than that.
Step 4. Watch for vaginal bleeding
Mild bleeding can occur due to irritation of the fallopian tubes that are getting stretched. And heavy and severe bleeding can occur later, as the fetus develops to the point where the fallopian tube ruptures. If you experience bleeding at any gestational age, consult a doctor immediately, especially if the bleeding is continuous or profuse. In this condition, it is better to act quickly and go to the emergency department immediately. Don't procrastinate.
- Severe bleeding from a ruptured fallopian tube (which can occur due to an ectopic pregnancy) can lead to massive blood loss, fainting, and-in very rare cases-instant death if not treated promptly by medical workers.
- Other serious symptoms (besides bleeding) that require immediate medical attention are abdominal pain, light-headedness, dizziness, sudden pallor, mental confusion, all of which could indicate symptoms of a ruptured ectopic pregnancy.
- Bleeding that occurs during implantation of the egg is normal. This condition will occur a week before your period is supposed to come (or 3 weeks after your last menstrual period), and the color of the discharge will appear pink or brown with a volume that can fill a few pads. Meanwhile, bleeding in an ectopic pregnancy usually occurs later than that time, ie after the embryo is implanted and begins to develop in a space that cannot accommodate its growth optimally.
- However, if, at any stage of pregnancy, the bleeding is bright red, the volume fills with many pads, and your condition does not improve within a few days, seek medical attention immediately.
Part 2 of 3: Diagnosing an Ectopic Pregnancy
Step 1. See if you have any risk factors for an ectopic pregnancy
If you experience any of the symptoms listed above, you should also pay attention to whether you are in a high-risk group for an ectopic pregnancy. Several factors can also increase a woman's chances of having an ectopic pregnancy.
- In general, women who have had an ectopic pregnancy before are more likely to experience this condition again in the future.
- Other risk factors include: pelvic infection (sexually transmitted infection [STI]), having multiple sexual partners (as this increases the risk of an unknown STI), presence of a tumor or abnormality in the fallopian tubes, previous abdominal or pelvic surgery, having an IUD inserted, suffering from endometriosis, or smoking.
- In addition, risk factors also arise if a woman has had sterilization (also known as "tubal ligation" surgery, namely binding the fallopian tubes to prevent future pregnancies). This method is usually successful in preventing pregnancy. However, when a person decides to get pregnant again, the risk of having an ectopic pregnancy becomes much higher.
Step 2. Check the -HCG level in the blood test
This is the first step to diagnosing an ectopic pregnancy.
- -HCG is a hormone secreted by the developing embryo and placenta. So this hormone will increase as the pregnancy progresses, and is a more certain (and reliable) pregnancy test.
- If the -HCG level is above 1500 IU/L (usually between 1500-2000 IU/L is a concern), but there is no visible pregnancy in the uterus when examined by ultrasound, the doctor will advise you of the possibility of having an ectopic pregnancy. That's because -HCG levels are usually higher in ectopic pregnancies than in normal pregnancies in utero. So this is definitely something to watch out for.
- If an ectopic pregnancy is suspected due to the -HCG level, the doctor will perform further tests with a transvaginal ultrasound to see if he or she can detect a pregnancy, as well as its location.
Step 3. Perform a transvaginal ultrasound
This ultrasound can detect 75-85% of ectopic pregnancies (the developing fetus can be seen via ultrasound in the percentage of cases as mentioned above, as well as confirming its location).
- Please note, a negative ultrasound does not necessarily mean that this ectopic pregnancy did not occur. On the other hand, a positive ultrasound (which confirms that there is a pregnancy in the fallopian tube or elsewhere outside the uterus) is sufficient to establish the diagnosis.
- If the ultrasound is negative (or inconclusive), but the -HCG level is high and your symptoms are enough to convince you and your doctor that an ectopic pregnancy is likely, your doctor will usually recommend diagnostic laparoscopy. This is a simple operation with very small incisions to insert a camera into the abdomen for a better view of the condition.
Step 4. Allow the doctor to perform a diagnostic laparoscopy
If the results of blood tests and ultrasound are inconclusive and you still suspect an ectopic pregnancy, your doctor will likely perform a diagnostic laparoscopy to view the pelvic and abdominal organs from the inside and look for places where the egg has attached.
This procedure usually takes about 30 minutes to 1 hour
Part 3 of 3: Dealing with an Ectopic Pregnancy
Step 1. Seek medical help immediately
After the diagnosis of ectopic pregnancy is established, the doctor will take action as soon as possible, because the procedure for ectopic pregnancy will be easier if done as soon as possible. In addition, an ectopic pregnancy in the fallopian tube is unlikely to survive. In other words, the fetus will definitely not be able to survive. So removing the pregnancy as soon as possible will actually prevent complications (which if left too long, can be life-threatening).
Step 2. Take medication to abort the pregnancy
The drug most often given for this case is methotrexate. This drug is given as an intramuscular injection, one or more times, depending on the amount needed to abort an ectopic pregnancy.
After the methotrexate injection is given, you will have several blood tests to check your -HCG level. If the level of this hormone drops to near zero (or is not detected in a blood test), the treatment is considered successful. Otherwise, you will be given another methotrexate injection until the target is reached. And if it still doesn't work, you may have to have surgery
Step 3. Have surgery to remove the ectopic pregnancy
During surgery, the doctor will repair or remove the damaged fallopian tube if necessary. Indications for surgery include:
- Losing a lot of blood and requiring urgent treatment.
- Treatment with methotrexate was unsuccessful.
