Diagnosing An Ectopic Pregnancy

Ectopic Pregnancy-What It Is And What Causes It

An ectopic pregnancy is any pregnancy that occurs outside the cavity of the womb.

Ectopic pregnancies most frequently occur in the fallopian tube, a situation that happens in 75-96 percent of all ectopic pregnancies. They can occur in the ovary or cervix as well. Rarely, an ectopic pregnancy occurs in the abdomen and sometimes the fetus arrives fully developed and survives. A laparotomy is performed to deliver the baby in this scenario.

The most common cause of ectopic pregnancy is faulty fallopian tubes. They may be misshapen or too narrow, damaged from disease or surgery, or the distortion may be a congenital defect. In the case of an in vitro fertilization, the embryo may have migrated into the tube from the uterus and the tube is not able to expel the embryo. It remains trapped in the fallopian tube where it will likely remain. Many cases of ectopic pregnancy go unnoticed until between the sixth and tenth weeks of gestation, when the fetus has grown to be too big for the space. The condition is often diagnosed in the emergency room when a woman is admitted with severe pain on one-side of the pelvis.

IVF Treatments Help With Early Diagnosis

There is no sure way to diagnose an ectopic pregnancy with 100 percent accuracy. However, women who have undergone IVF to conceive are often diagnosed early. Since women who have IVF treatments are considered at risk, they are monitored very closely. Measurements of the pregnancy hormone blood beta hCG, progesterone and the use of high-resolution ultrasound scanning has increased the effectiveness of early diagnosis of ectopic pregnancy. A negative beta hCG is a good indication there is not an ectopic pregnancy. Several measurements over a 48-hour period give the physician a good idea of what is going on. With early diagnosis, conservative treatment can be given as opposed to emergency treatment when things have progressed much further.

Additional Ways To Diagnose Ectopic Pregnancy

An ectopic pregnancy produces lower levels of blood beta hCG and progesterone than a normal pregnancy does and, in addition, the levels are less inclined to rise rapidly. The ultrasound scan may not always uncover an ectopic pregnancy. However, when an empty uterus is seen and a positive pregnancy test is in hand, it is a good indication there is a problem. Sometimes a heterotrophic pregnancy is occurring, which will produce near-normal hormone readings. In this case, a vaginal ultrasound is used to make a diagnosis. Vaginal ultrasound scans provide an image of the uterus, tubes and ovaries, giving a much clearer picture than an abdominal ultrasound scan.

If there are no facilities for performing blood tests and ultrasound screening, then a laparoscopy is used to make the diagnosis. The scope will allow inspection of the fallopian tubes and ovaries. In emergencies, a laparotomy is necessary to remove the fetus and blood transfusions may be needed to replace lost blood.

When an ectopic pregnancy is discovered early, treatment is more conservative and a less invasive procedure such as keyhole surgery or drug treatment can be offered.


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