Ectopic pregnancy: what it is, symptoms, treatment and risks

Ectopic pregnancy is characterized by the implantation and development of the embryo outside the uterus, which can occur in the tubes, ovary, cervix, abdominal cavity or cervix.

The appearance of intense abdominal pain and blood loss from the vagina, especially in the first trimester of pregnancy, may be indicative of an ectopic pregnancy, and it is important to consult a doctor for a diagnosis.

It is important to know exactly where the embryo is, as this means that the most appropriate treatment can be determined, since when it is in the abdominal cavity the pregnancy can continue, despite being a rare and delicate situation.

Ectopic pregnancy with the embryo developing in the tube

Ectopic pregnancy symptoms

Ectopic pregnancy symptoms arise as the embryo develops outside the uterus. The main site for embryo implantation outside the uterus is the uterine tubes, also called fallopian tubes, which can rupture as the embryo grows, resulting in some symptoms, the main ones being:

• Intense abdominal pain, only on one side of the belly;
• Irregular vaginal bleeding, especially between the 5th and 14th week of pregnancy;
• Feeling of heaviness in the vagina;
• Severe pain when palpating the uterus;
• Swollen abdomen;
• Beta HCG exam is usually negative.

In the case of pregnancy outside the uterus, but without signs of rupture of the tubes, the symptoms may be:

• Abdominal pain or discomfort;
• Vaginal bleeding after the last menstrual period;
• Severe pain when palpating the uterus;
• Pain during intimate contact or during a pelvic exam;
• Beta HCG exam is usually positive.

If you suspect it, you should immediately go to the hospital so that the doctor can perform an ultrasound, which can confirm the ectopic pregnancy and indicate the most appropriate treatment to solve the problem. The best way to know if the embryo is developing outside the uterus is through an ultrasound performed by a doctor because the Beta HCG test does not always give a positive result.

How long can it be an ectopic pregnancy?

Pregnancy in the tubes or ovaries can develop up to 14 weeks of gestation, and if this happens it is not possible to save the life of this embryo as there are no medications or procedures that can move the embryo from the tubes to the uterus. When an ectopic pregnancy develops in places other than the tubes, such as the abdominal cavity, it can be discovered later, but always through ultrasound.

Who is most at risk

Ectopic pregnancy is an uncommon situation, but women who have had a previous ectopic pregnancy, have changes in the fallopian tube and/or a history of endometriosis, have had a sexually transmitted infection or have already had pelvic inflammatory disease are at greater risk of having the implant implanted. embryo outside the uterus.

In addition, women who have already had an abortion, have undergone tubal ligation, use an IUD (Intrauterine Device) or have undergone fertilization in vitrohave an increased risk of ectopic pregnancy.

Types of ectopic pregnancy

Ectopic pregnancy is a rare condition in which the embryo can be implanted in various locations in the body, such as the tubes, ovary, abdominal cavity or cervix, which is when the fetus grows in the cervix. The least common types of ectopic pregnancies are:

• Interstitial ectopic pregnancy: It occurs when the embryo develops in the interstitial segment of the tube. In this case, there is an increase in Beta HCG and treatment is normally carried out with medication and potassium chloride, in various doses;
• Cervical pregnancy: This is when the embryo develops in the cervix, which can cause intense bleeding. Treatment can be done with embolization, curettage or local injection of methotrexate, for example;
• Ectopic pregnancy in cesarean section scar: It is very rare, but it can happen, requiring treatment with methotrexate and folinic acid for about 1 week;
• Ovarian pregnancy: Sometimes it is only discovered during curettage and therefore methotrexate is not used;
• Heterotopic pregnancy: This is when the embryo develops between the uterus and the tube, but it is generally only diagnosed after the tube has ruptured and therefore the most commonly used treatment is surgery.

In addition to these types, there is also abdominal ectopic pregnancy, which is when the baby develops in the peritoneum, between the organs. This is a very rare condition and each case must be evaluated individually. This is a complicated pregnancy because as the baby grows, the mother’s organs become compressed and blood vessels can rupture, potentially fatal. However, there are reports of women who managed to get their baby to 38 weeks of gestation, with a cesarean section being performed for the birth.

How the treatment is carried out

Treatment for ectopic pregnancy must be guided by an obstetrician, because it depends on the exact location of the embryo, but can be done with the use of medicines to promote abortion or surgery to remove the embryo and reconstruct the uterine tube, for example.

In some cases, when an ectopic pregnancy is discovered before 8 weeks of gestation, and the embryo is very small, the doctor may recommend taking a medication called Methotrexate to induce an abortion, but when the pregnancy is more advanced, it must be performed surgery to remove it.

Find out more details about treatment in case of ectopic pregnancy.

Risks of ectopic pregnancy

The main risk associated with ectopic pregnancy is hemorrhage, which can put the woman’s life at risk, especially in the first trimester of pregnancy, which is normally related to the rupture of blood vessels due to the development of the embryo. Furthermore, as a consequence of heavy bleeding, a woman may experience profound anemia, decreased blood pressure and increased heart rate. See how to identify the main signs and symptoms of hemorrhage.