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Ectopic Pregnancy
Normally, during early pregnancy, the fertilized egg travels from the fallopian tube to the uterus, where it implants and grows. In about 2% of pregnancies, the fertilized egg (zygote) implants outside the uterus causing an area for development of ectopic pregnancy (also known tubal pregnancy).
Almost all ectopic pregnancies develop in the fallopian tubes, but it can also be locate in the ovary, cervix (lower part of the uterus) or inside the abdomen. An ectopic pregnancy fetus caNot sustain a very long life. If left untreated, it can lead to rupture of the fallopian tube and massive hemorrhage, complications that endanger the woman's life. Therefore, if an ectopic pregnancy does not cause spontaneous abortion by itself, it is neceSary to inteRupt or stop the development of the pregnancy by surgical methods that remove the abnormally implanted zygote.
The most important risk associated with ectopic pregnancy is damage to fertility. Ectopic pregnancy can also damage the fallopian tubes, thus reducing chances of future conception and increased risk of future ectopic pregnancies. Through its development, the ectopic pregnancy can be life-threatening. Although death from this cause is rare, ectopic pregnancy is the main cause of deaths in the first trimester of pregnancy. An ectopic pregnancy rupture requires emergency surgery.
Causes of Ectopic Pregnancy
The main reason that causes an ectopic pregnancy is the existence of abnormal fallopian tubes which prevent the fertilized egg from reaching the uterus and thus determine its implantation in the trunk or anywhere outside the uterus. Abnormal fallopian tube may result from a pelvic infection, after surgery, or due to the existence of endometriosis (presence of uterine lining outside the uterus).
In turn, abnormal fallopian tubes can occur due to many reasons:
- History of pelvic inflammatory disease caused by infection with Chlamydia or Neisseria gonorrhea, which causes scar tissue in the fallopian tube
- The fallopian tube surgery, often in order to restore a damaged fallopian tube or to repair a blocked fallopian tube or scar tissue
- History of an ectopic pregnancy i.e. if the woman had an ectopic pregnancy previously
- Although it is rare to get pregnant after tubal ligation was performed or after implantation of an intrauterine device (both are methods of contraception), the pregnancies that still occur in these conditions have a high enough risk to be ectopic.
Complications of Ectopic Pregnancy
Ectopic pregnancy can cause massive damage upon the fallopian tube it develops on which means it will be more diFicult for the woman to become pregnant again and even less probable to have a normal pregnancy.
Ectopic pregnancies are usually discovered early enough to prevent life-threatening complications such as severe bleeding. A ruptured ectopic pregnancy requires emergency surgery to prevent massive intra-abdominal hemorrhage. Subsequently, the affected fallopian tube is removed partially or entirely.