QUESTION: It seems I hear more and more often about incidents of ectopic pregnancy especially in women around my age (early 30's).
How is an ectopic pregnancy detected and how is it treated?
ANSWER: Ectopic gestation, which can include any pregnancy where the fertilized egg implants itself outside of the uterus, is, as you've noticed, on the rise.
The number of ectopic pregnancies has tripled in the past 15 years, and presently accounts for a significant number of maternal deaths. For these reasons, diagnostic and care procedures are becoming more sophisticated. Ectopic pregnancies have always been difficult to detect.
A number of symptoms occurring together can generate suspicion of an ectopic condition. Delayed menstruation, irregular spotting or bleeding, pelvic pain, possible shock or shoulder pain are some symptoms that might cause a patient to seek the advice of a hospital or physician.
First is the all important history and physical exam.
The next step is for the physician to administer a battery of diagnostic tests.
A pelvic sonogram is one testing technique that is increasingly used, along with other tests, including the vital pregnancy test. Other clues are provided by the woman's gynecological history.
The history of previous pelvic infection is an important clue.
A significant number of women between 80 and 90 percent with ectopic pregnancies have given birth to more than one child previously, and some may have had previous ectopic conceptions.
One very significant factor is the woman's method of birth control, as a retained intrauterine birth control device (IUD), a tubal ligation or tuboplasty can increase the likelihood of ectopic gestation. In 9 out of 10 extrauterine pregnancies the site is the Fallopian tube, usually on the right side.
Other locations include the abdomen, the cervix or the ovaries.
The danger of the condition varies from location to location, with one of the worst being the cervix, due to the likelihood of life-threatening hemorrhage. Treatment of an ectopic pregnancy is surgical.
The type of operation required depends on the amount of blood already lost, on the patient's desire or need for future fertility.
In about 10 percent of cases, the woman can expect the problem to occur again.
Infertility is a problem for half, and 30 percent can expect permanent sterility.
The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician.
Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.
