Tubal Pregnancy
A tubal pregnancy happens when the fertilized egg attaches itself in the fallopian tube. A tubal pregnancy is the most common type of ectopic pregnancy. An ectopic pregnancy is a term used to describe the situation when a fertilized egg attaches itself to anywhere except inside the uterus. The American Pregnancy Association reports that one out of 60 pregnancies is ectopic.
Am I At Risk?
If you're trying to get pregnant, you may be wondering if you're at risk for a tubal pregnancy. A tubal pregnancy can happen to any woman, but there are a few risk factors that can increase your chances.
Women between the ages of 35 to 44 tend to have a higher risk for a tubal pregnancy. Abdominal surgery, a previous ectopic pregnancy or a history of abortions can increase the likelihood of a tubal pregnancy. Tubal pregnancy can occur after a tubal ligation or if a woman is using an IUD as a birth control option. The sexually transmitted pelvic inflammatory disease (PID) can cause significant internal scarring which could lead to a tubal pregnancy.
Potential Causes
Sometimes the cause of an ectopic pregnancy is unknown. Other time physicians are able to narrow down the cause.
Any type of damage or inflammation of the fallopian tube that causes it to become partially or entirely blocked makes it difficult for a fertilized egg to travel to the uterus. So the egg gets trapped in the fallopian tube where it implants.
Damage to the tubes can be caused by scar tissue from a previous operation or infection. Sometimes previous surgery in the pelvic area can cause adhesions on the fallopian tubes. A misshapen fallopian tube can increase the likelihood of a fertilized egg becoming trapped.
Symptoms
Women who have a tubal pregnancy tend to still experience the same signs and symptoms of a standard early pregnancy. As the fertilized egg grows problems occur since there's no room for an embryo to properly develop. Sometimes the fallopian tube ruptures and the woman experiences sharp or stabbing pain. Pain can even be felt in the shoulder and neck if blood from the ruptured tube gathers under the diaphragm. Other symptoms include vaginal bleeding and gastrointestinal discomfort. Women tend to feel dizzy, weak or faint from the internal bleeding.
Diagnosis and Treatment
If you suspect you have a tubal pregnancy, you should immediately seek emergency care. A physician will probably perform a pelvic exam and an ultrasound. HCG levels will be measured since a low HCG level could indicate a tubal pregnancy. A procedure called a culdocentesis may be performed. This involves inserting a needle into the space behind your uterus at the top of the vagina in front of the rectum to see if there's blood there. The blood could indicate bleeding from a ruptured fallopian tube.
Treatment involves giving methotrexate which allows the body to absorb the embryo to try to save the fallopian tube. This can only be done to a certain point of the pregnancy. If the tube has been ruptured, emergency surgery is required and part or all of the fallopian tube may have to be removed. Another option is removing the tubal pregnancy with a laparoscopic surgery under general anesthesia.
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