Ectopic pregnancy is a pregnancy disorder characterized by a fertilized egg attaching to and growing outside of a woman's uterine wall. According to the American Academy of Family Physicians (AFFP), this condition occurs in every 1 in 50 pregnancies. An ectopic pregnancy that goes unchecked can become a medical emergency, the embryo will not survive, and the growing tissue can cause bleeding that can be life-threatening to the mother.
Diagnosis of ectopic pregnancy
A pregnant woman with this condition may not immediately realize what she has, even though prompt and appropriate treatment is essential to ensure health in the future.
The following are some diagnostic ways that can be done to determine the condition of an ectopic pregnancy:
1. Pregnancy test
The doctor will suggest doing a blood test to check the hormone human chorionic gonadotropin (HCG) levels as a sign of pregnancy. HCG hormone levels will rise when a woman is pregnant. This blood test can be done every few days until an ultrasound can confirm the pregnancy is ectopic, usually up to 5-6 weeks after conception.
2. Ultrasound (USG)
Transvaginal ultrasound allows the doctor to determine the exact location of the pregnancy. In this test, a rod-like instrument is inserted through the vagina. The tool uses sound waves to produce images of the uterus, ovaries, and fallopian tubes that are sent to the nearest monitor. Abdominal ultrasound may also be performed to confirm pregnancy or evaluate internal bleeding if present.
3. Other blood tests
A thorough blood test will be done to check for anemia or other signs of blood loss. Someone diagnosed with an ectopic pregnancy is usually advised to have a blood group test if they need a blood transfusion.
Treatment for ectopic pregnancy
The fertilized egg cannot grow and develop normally outside the uterus. Ectopic tissue must be removed to avoid complications threatening the mother's life. Embryo removal can be done using medications, laparoscopic surgery, or abdominal surgery based on known symptoms and the time of an ectopic pregnancy.
1. Medicine
An ectopic pregnancy detected early and not accompanied by irregular bleeding is usually treated with methotrexate. This drug is given by injection to prevent cells from growing and to dissolve formed cells.
After the injection, the doctor will recommend doing the HCG test again to check the drug's effect. Before taking this medication, it is essential to confirm that the existing pregnancy is an ectopic pregnancy.
2. Laparoscopic surgery
Salpingostomy and salpingectomy are two types of laparoscopic surgery commonly used to treat ectopic pregnancies. In this procedure, a small incision is made in the abdomen, near or near the navel. Next, the doctor will use a thin tube with a camera lens and light (laparoscope) to view the fallopian tube area.
In the salpingostomy procedure, only the ectopic tissue is removed, while the fallopian tubes heal independently. However, the ectopic pregnancy and fallopian tube are removed in a salpingectomy. Which procedure to choose depends on the amount of bleeding and damage to the fallopian tubes.
The embryo will not be able to grow properly outside the uterus, so it must be removed.
3. Emergency operation
Emergency surgery is most likely needed if the ectopic pregnancy causes heavy bleeding. Emergency surgery can be performed laparoscopically or through an abdominal incision (laparotomy). In some cases, the fallopian tubes can still be saved. However, if the fallopian tube ruptures, it must be removed.
Avoid smoking so as not to increase the risk of an ectopic pregnancy.
Avoiding sexually transmitted diseases, such as gonorrhea and chlamydia, is one way to prevent inflammation of the fallopian tubes, which can increase the risk of an ectopic pregnancy. In addition, smoking habit before pregnancy is also often associated with a greater risk of ectopic pregnancy.
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References:
Mayo Clinic Staff. (2022). Ectopic pregnancy. [online]. https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/diagnosis-treatment/drc-20372093
NHS UK. (2022). Ectopic pregnancy. [online]. https://www.nhs.uk/conditions/ectopic-pregnancy/treatment/