An ectopic pregnancy is a pregnancy that develops and starts growing in the wrong place in the body. This most commonly is a pregnancy that begins to grow in the fallopian tubes, but it can occur on the cesarean scar, ovarian, and in other places that do not support life. About 95% of ectopic pregnancies occur in the fallopian tubes. Ectopic pregnancies are rare, occurring in less than 2% of all pregnancies, but when this does happen, it must end in termination.
If you have a history of ectopic pregnancy, it is much more likely that you have an ectopic pregnancy again. For some individuals, knowing that an ectopic pregnancy is more likely is enough information to want to get an early ultrasound. For others, they would rather wait and see if any symptoms could be caused by ectopic pregnancy.
Symptoms
It is important to note that symptoms only occur for about 50% of individuals who are diagnosed with ectopic pregnancy. Some of the possible symptoms are lower tummy or abdominal pain, shoulder pain, fainting or lightheadedness, bleeding during pregnancy, UTI, PID, and flu symptoms, and personal intuition.
Treatment Options
If you are diagnosed with ectopic pregnancy and come in stable, they will check your vitals, like blood pressure, bleeding, pain, and dizziness. There are three different treatment options depending on the severity and how far along the ectopic pregnancy is.
The first and least invasive option is expectant management. Expectant management is only an option if you are stable and there is no sign of you being in current danger. In over 50% of ectopic pregnancies, the fetus will terminate on its own without the need for surgery or medications. The option of watching and waiting can feel nerve-wracking, but the risk of surgery is less, and the rate of healing will be faster.
Another treatment option is the medical treatment with methotrexate. This drug stops a pregnancy from developing further and gradually reabsorbs it into the body. Methotrexate is only a viable option in early pregnancy and has a beta hCG level of less than 5000. This treatment is given by an injection, usually into your bottom. Before this treatment is provided, whether you are anemic must be determined. The hope of getting methotrexate would be to avoid surgery, but this method requires close watching and follow-up with your care provider. The way they monitor is by checking your hCG levels as well as your vitals throughout the injection.
The most invasive way of treating ectopic pregnancies is also the method used when there is an emergency like bleeding, lack of consciousness, etc., and that is surgery. When surgery is done, the ectopic pregnancy is removed from the area in the body that it implanted, most commonly the fallopian tubes. In most circumstances, this is done laparoscopically, but in some cases, it must be done with a larger incision using your bikini line. If there is a rupture of a fallopian tube, there is a chance that you will need to have it removed.
Risks
Ectopic pregnancies are severe and are the leading cause of parental death in the first trimester of pregnancy. When looking into treatment options, you must discuss the amount of risk that comes with each option and weigh out which feels best for you and your family. Remember, your OBGYN is the expert in ectopic pregnancy, but you are the expert of your body. Only you can decide on how to move forward.
It is important to note that there is no way to lower one's risk for ectopic pregnancy, and there is nothing you could have done to cause an ectopic pregnancy. These things sometimes happen, and we are so sorry if they happened to you. Knowing that no matter how you treat the ectopic pregnancy, it will lead to you losing your baby is heartbreaking. Oh, how we wish we could take away some of that pain you will inevitably experience.
For some, the experience of an ectopic pregnancy is hugely traumatic. In these situations, we highly recommend therapy, especially EMDR. This is not an easy experience; in some cases, it is one of life and death. Throughout the experience, remember that your intuition is most commonly correct, and if you suspect an ectopic pregnancy, it is always a good idea to seek immediate medical help.
