An ectopic pregnancy is a pregnancy outside the womb or uterus. This condition causes bleeding from the vagina and severe pain in the pelvis or lower abdomen. An ectopic pregnancy must be treated immediately because it can be dangerous, and the fetus will also not develop normally.
Pregnancy begins when an egg is fertilized by a sperm cell. In a normal pregnancy, the fertilized egg will remain in the fallopian tube (egg tube) for approximately three days, before being released into the uterus. In the womb, the fertilized egg will continue to develop until the time of delivery arrives.
In an ectopic pregnancy, the fertilized egg does not attach to the uterus, but to another organ. The fallopian tube is the organ where the egg is most often implanted in an ectopic pregnancy. In addition to the fallopian tubes, ectopic pregnancy can also occur in the ovaries, cervix (cervix) or in the abdominal cavity.
Causes of Ectopic Pregnancy
Although it is not known exactly what causes an ectopic pregnancy, this condition is often associated with damage to the fallopian tubes, the tubes that connect the ovaries and uterus.
Fallopian tube damage can be caused by:
- Genetic factors.
- Congenital birth.
- Hormone imbalance.
- Inflammation due to infection or medical procedures.
- Abnormal development of reproductive organs.
Ectopic Pregnancy Risk Factors
Ectopic pregnancy can be experienced by every woman who has been actively having sex. There are several factors that can increase the risk of an ectopic pregnancy, namely:
- 35 years of age or older at the time of pregnancy.
- Has a history of pelvic inflammatory disease and endometriosis.
- Suffering from sexually transmitted diseases, such as gonorrhea and chlamydia.
- Had an ectopic pregnancy in a previous pregnancy.
- Experiencing repeated miscarriages
- Have had surgery on the abdomen and pelvis.
- Have had treatment for fertility problems.
- Use a spiral type of contraception.
- Have a smoking habit.
Ectopic Pregnancy Symptoms
Ectopic pregnancies tend to be asymptomatic in the early stages. Early signs of an ectopic pregnancy are similar to those of a regular pregnancy, such as nausea, breast tenderness, and stopped menstruation.
While at an advanced stage, there are several symptoms that are often felt by patients with ectopic pregnancy, namely abdominal pain and bleeding from the vagina. These symptoms will get worse over time. Sometimes, the symptoms of abdominal pain due to an ectopic pregnancy can also be similar to the symptoms of appendicitis.
When to go to the doctor
Immediately consult a doctor if the following symptoms appear while pregnant:
- Pain like stabbing in the abdomen, pelvis, shoulders, and neck.
- Pain on one side in the lower abdomen, which gets worse over time.
- Pain in the rectum during bowel movements.
- Light to heavy bleeding from the vagina, with blood that is darker in color than menstrual blood.
- Dizziness or weakness.
- Diarrhea.
These symptoms should immediately be checked by a doctor because it could indicate a ruptured fallopian tube due to an ectopic pregnancy.
Ectopic Pregnancy Diagnosis
The doctor will perform an examination with a transvaginal ultrasound to confirm the occurrence of an ectopic pregnancy. In addition to helping obstetricians see the condition of the patient's reproductive organs, this procedure can determine the location of the pregnancy accurately.
Another test that can be done is a blood test, to check for pregnancy hormones, such as the hormone hCG and progesterone. In an ectopic pregnancy, the levels of both hormones tend to be lower than in a normal pregnancy.
Treatment Ectopic Pregnancy
The fertilized egg will not be able to grow normally if it is outside the uterus. Therefore, the ectopic tissue must be removed immediately, so that the patient avoids serious complications. There are several treatment options that can be used to treat an ectopic pregnancy, including:
Inject methotrexate
Early stage ectopic pregnancy can be treated with injections methotrexate. This drug will stop the growth of ectopic cells, as well as destroy cells that have already formed. After giving the injection, the doctor will monitor the level of the hormone hCG in the blood every 2-3 days, until the level decreases. Decreased levels of hCG indicate pregnancy is no longer progressing.
Laparoscopic surgery
Other options for treating an ectopic pregnancy are keyhole or laparoscopic surgery. Through this procedure, the obstetrician will remove the ectopic tissue and the part of the fallopian tube where the ectopic tissue attaches.
However, if possible, the part of the fallopian tube is simply repaired without having to be removed. This can be done to increase the chances of getting pregnant in the future
Laparotomy surgery
To treat patients who experience heavy bleeding due to an ectopic pregnancy, the obstetrician will perform an emergency procedure in the form of a laparotomy. In a laparotomy, the doctor will make a large incision in the abdomen as a way to remove ectopic tissue and a ruptured fallopian tube.
Prevention Ectopic Pregnancy
Ectopic pregnancy cannot be prevented, but the risk of developing this condition can be lowered. There are a number of ways this can be done, including:
- Avoid risky sexual behavior, such as having multiple sex partners by not using condoms.
- Avoid smoking, since before pregnancy.
Pregnant women are also advised to have regular blood tests and ultrasounds. In addition to monitoring the progress of pregnancy, routine examinations can detect an ectopic pregnancy early, so that it can be treated immediately.