When the egg and sperm cell meet, it will be fertilized. Then, the fertilized egg will move through your Fallopian tube to your Uterus to attach to its lining and will stay there for 9 months to grow. That's what happens in a normal pregnancy, but in 1 of every 50 pregnancies, the fertilized egg stays in the fallopian tube to grow. That's what you call Ectopic Pregnancy or Tubal pregnancy. In rare cases, the fertilized egg attaches to an ovary or other abdominal organs.
This happens in the first week of pregnancy but doctors usually discover it by the 8th week of pregnancy. This can really be fatal for the mother, especially to the child. In most cases, the child dies.
Symptoms
- Light vagina bleeding
- Nausea and vomiting
- Lower abdominal pain
- Sharp abdominal cramps
- Pain on one side of the body
- Dizziness or weakness
- Pain in your shoulder, neck or rectum
- If the fallopian tube ruptures, the pain and bleeding could be severe which can cause fainting
If these symptoms are felt, it is very important to go a physician to reduce the risk of internal hemorrhaging due to the ruptured fallopian tube.
Etiology
You may be in a higher risk to have an ectopic pregnancy if you have:
Used an intrauterine device (IUD), a form of birth control, at the time of conception
- History of pelvic inflammatory disease (PID)
- Sexually-transmitted diseases such as chlamydia and gonorrhea
- Congenital abnormality (problem present at birth) of the fallopian tube
- History of pelvic surgery (because scarring may block the fertilized egg from leaving the fallopian tube)
- History of ectopic pregnancy
- Unsuccessful tubal ligation (surgical sterilization) or tubal ligation reversal
- Use of fertility drugs
- Infertility treatments such as in vitro fertilization (IVF)
Having those may warn you that you are in a risk to have an Ectopic Pregnancy.
Occurrence
Ectopic pregnancy is one of the major pregnancy problem accounting for about 10% of all maternal mortility. This pregnancy is not common, happening in one in every 100-150 women. Thirty-eight of 376 US women, and 10 in every 193 British women has suffered this kind of pregnancy. Usually happening with women who had a history of abortion and pelvic surgeries.
Pathophysiology
Second-hand smokers in time of the conception increases the risk of impaired immunity which connects to the impaired functioning of the Fallopian tube or if one has undergone a pelvic surgery or any of the etiology written above. They cause a dysfunction in the cilia in the tube, which normally pushes the fertilized egg to the uterus. Dysfunction of the uterine tube blocks or slows the movement of the fertilized egg to the uterus. Then, the fertilized egg is blocked and is implanted in the fallopian tube where it intends to grow in 9 months. Abnormal bleeding from the vagina, usually appearing scanty spotting, happens and a sudden severe pain in the abdomen.
Diagnosis
This pregnancy is difficult to diagnose at an early stage because it has the same symptoms as a normal pregnancy. But women having this kind of pregnancy often are having severe abdominal pains. This is often diagnosed by the 8th week of pregnancy. A urine test may not be the best way to know this kind of pregnancy but they said that a positive result in a specialized HCG blood test my confirm it. Internal pelvic examination may reveal that the womb is smaller than a normal pregnancy, this way it can be diagnosed. Ultrasound is the safest way when it comes to knowing this kind of pregnancy.
Treatment
Nowadays, this can be treated without any permanent damage, but in some cases that are not early diagnosed, it resulted to the death of the mother and the child. When diagnosed, a surgery is needed to be performed as soon as possible. Laparotomy (open surgery) or laparoscopy (pin hole surgery) can be done, depending on the size of the ectopic pregnancy. Before, the whole fallopian tube is removed, but in the technologies we have nowadays, just a part of the tube can be removed.
Prevention
This cant be prevented. But the decrease use of condoms and IUDs can not lead to this kind of pregnancy. It can only be treated as early as possible but not prevented. Just have a proper lifestyle, avoiding the accumulation of STDs and other things harmful in the conception of the baby. Yearly medical examination are necessary, if one uses n IUD. If you are experiencing the signs above, go immediately to your doctor.
Nursing Intervention
Assess maternal vital signs, bleeding and pain in the abdomen. Explain the condition and the possible outcomes of the pregnancy. Monitor the amount of vaginal bleeding and the increase of abdominal distention and rigidity. Monitor the complete blood count and provide comfort because losing a child is very depressing. Emotional support are really needed on patients with these kind of problems.
