What Does An Ectopic Pregnancy Involve?

18 November, 2020
It's important to know the early symptoms of ectopic pregnancy so that you can consult with your doctor if necessary. Here we'll tell you what you need to know.

Ectopic pregnancy is a pathology that requires early diagnosis and treatment to avoid putting a woman’s life at risk. If we take into account all the pregnancies that occur in the world, approximately 1-2% of them are ectopic.

This means that out of every 100 pregnant women, 1 or 2 suffer from the extra-uterine form of pregnancy. Among those women who present ectopic pregnancy, 99% occur in the Fallopian Tubes. Therefore, this is the most frequent location.

What is an ectopic pregnancy?

Basically, an ectopic pregnancy is any gestation that develops outside the woman’s uterus. Some also refer to it as an extra-uterine pregnancy. Ectopic is a word that comes from the Greek language and consists of two parts: ektos, meaning outside, and topos, meaning place.

Unfortunately, the frequency of this pathology has been increasing in the world for several decades. It’s not clear what factors are causing this to be the case. However, experts suspect that the increase in sexually transmitted infections is a risk factor, as we’ll see later on.

Read also: Molar Pregnancy Diagnosis

Causes of ectopic pregnancy

A woman with abdominal pain standing in a hospital.
Ectopic pregnancy can have anatomical and functional causes. However, there are other risk factors involved in its development.

Broadly speaking, we can separate the causes of ectopic pregnancy into two groups: Anatomical and functional causes.

1. Anatomical causes

Among these, the biggest problem is the passage through the Fallopian tubes. This female anatomical structure has to be able to allow the fertilized egg formed by the egg and sperm to travel freely.

The Fallopian tubes can become blocked by polyps or by adhesions that form due to previous infections. Sexually transmitted diseases are a common source of adhesions.

2. Functional causes

Instead of an alteration in the anatomy of the Fallopian tubes, there may be an alteration in the mobility of the tubes. The mobility we’re referring to is a function that accompanies the path of the fertilized egg in order to reach the uterus.

The Fallopian tubes may have muscular weakness, or, more commonly, a cilia deficit. Cilia are small structures of the organ that move microscopically to carry the fertilized egg. If there are fewer cilia, then there’s less mobility.

Risk factors

There are groups of women who are more likely to have an ectopic pregnancy than others because they have some risk factor. In other words, some previous condition that makes them more susceptible to reach the situation where the pregnancy develops outside the uterus.

The most important risk factors are:

  • Pelvic inflammatory disease (PID): This is the greatest risk factor according to scientific studies on ectopic pregnancy. Women who have had PID and have a positive pregnancy test should see their doctor as soon as possible for an ultrasound to determine the location of the pregnancy.
  • Previous ectopic pregnancies: A woman who has already had an extra-uterine pregnancy is more likely to have another one.
  • Having had an abortion.
  • Using an IUD as a method of contraception.
  • Having had surgical procedures on the abdomen or pelvis.
  • Have a history of diseases such as endometriosis or tuberculosis.

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How ectopic pregnancy develops

The evolution of ectopic pregnancy.
Because of its complexity, ectopic pregnancy puts a woman’s life at risk. Therefore, it’s important to detect it in a timely manner.

All pregnancies start outside the uterus, when a sperm fertilizes an egg. This fertilization occurs in the Fallopian tubes, specifically in the area of the infundibulum. This is the region furthest from the uterus and closest to the ovary.

The first days of the fertilized egg take place there. Then, it migrates through the tubes in order to implant, which is the process by which the fertilized egg attaches to the uterus. Normally, within 7-8 days after fertilization, the egg must begin its implantation. In other words, a week after fertilization takes place, the egg should enter the uterus and remain there.

In ectopic pregnancy, nesting or implantation occurs outside of the uterus. The most common location is the Fallopian tube, but it can also develop in an ovary or in the woman’s own abdominal cavity.

The vast majority of ectopic pregnancies are not viable, because only the uterus is prepared to receive the egg and protect the embryo by feeding it. The usual outcome of extra-uterine pregnancies is a miscarriage, which may manifest itself without symptoms. Therefore, the woman may never know it. However, it may also become evident with vaginal bleeding and lower abdominal pain.

The importance of early detection

In a low percentage of cases, it doesn’t resolve on its own. Gestation continues to take place outside the uterus, sometimes reaching up to a full trimester. This is the most dangerous variant. Ectopic pregnancies located in the Fallopian tube, when growing, can rupture the tubes causing internal abdominal bleeding that will require immediate surgical intervention.

When detected in time, ectopic pregnancy is dealt with before serious complications appear. That’s why it’s essential to consult a doctor during the first trimester of pregnancy. And, in the same way, you should undergo an obstetric ultrasound scan to determine the location of the embryo within your body. And, finally, in the event of any vaginal bleeding or persistent lower abdominal pain, timely medical consultation also becomes essential.

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