EXTRACT FROM “MAKING BABIES”


Ectopic Pregnancy

Right result, wrong place



A foetus normally grows within the womb (uterus). An ectopic pregnancy is one that starts and continues to develop outside the uterus. About one in every 200 pregnancies is ectopic. Conditions such as pelvic inflammatory disease and salpingitis increase the risk of ectopic pregnancies, as they cause damage to the Fallopian tubes. Other infections in the pelvis (eg. severe appendicitis) may also be responsible for tube damage.

Symptoms of an ectopic pregnancy may be minimal until a sudden crisis from rupture of blood vessels occurs, but most women have abnormal vaginal bleeding or pains low in the abdomen in the early part of the pregnancy. Many ectopic pregnancies fail to develop past an early stage, and appear to be a normal miscarriage. Serious problems can occur if the ectopic pregnancy does continue to grow.



The most common site for an ectopic pregnancy is the Fallopian tube, which leads from the ovary to the top corner of the womb. A pregnancy in the tube will slowly dilate the tube until it eventually bursts. This will cause severe bleeding into the abdomen and is an urgent, life-threatening situation for the mother. Other possible sites for an ectopic pregnancy include on or around the ovary, in the abdomen or pelvis, or in the narrow angle where the Fallopian tube enters the uterus.

If an ectopic pregnancy is suspected, an ultrasound scan can be performed to confirm the exact position of any pregnancy. If the pregnancy is found to be ectopic, the woman must be treated in a major hospital. It is rare for a foetus to survive any ectopic pregnancy.


TREATMENT

Surgery to save the mother's life is essential, as a ruptured ectopic pregnancy can cause the woman very rapidly to bleed to death internally. If the ectopic site is the Fallopian tube, the tube on that side is usually removed during the operation. With early diagnosis and improved surgical techniques, the tube may not have to be removed. Even if one Fallopian tube is lost, the woman can fall pregnant again from the tube and ovary on the other side.

If a woman is unfortunate enough to have two ectopic pregnancies, and both Fallopian tubes are surgically removed, she will be unable to fall pregnant naturally, but eggs may still be harvested from her ovaries and she can fall pregnant using artificial insemination techniques.




CURIOSITY

Bruising around the belly button (Cullen's sign) may indicate conditions as varied as a ruptured ectopic pregnancy and cancer of the pancreas.