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Tubal Troubles: Signs And Symptoms Of An Ectopic Pregnancy

December 3, 2020

On Sunday, 5th November 2017, Preeti Mahadevan discovered a scanty maroon discharge in lieu of her period. Perplexed by her newfound visitor, she scheduled a visit with Dr Praveena Shenoi at Cloudnine Hospital, Old Airport Road. One consultation and a handful of tests later, her diagnosis was clear. She was pregnant, albeit with a very low HCG, the hormone indicative of pregnancy.

At a meagre level of 60, Dr Shenoi was concerned and asked Preeti to schedule another HCG test 48 hours later, to see if the value would double as it should. By Tuesday, the level was 200, and for now, Preeti’s prospect of a successful pregnancy looked much brighter. That is until she found her underwear splashed with a pink, watery discharge four days later. And then again, two days after that.

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Dr Shenoy asked Preeti to report any pain following the spotting episodes, and when she experienced a sharp, throbbing ache that spread like a fan in her lower abdomen, Preeti was immediately referred for an early pregnancy scan. There, her pregnancy was found to be ectopic. And at 5 weeks and 6 days, it was medically terminated.Preeti Mahadevan held no risk factors for an ectopic pregnancy.

She was a teetotaller, a non-smoker and at 32, age was on her side. Her case was considered a fluke, but for many women, an ectopic pregnancy is the product of a biological predisposition.

Understanding an Ectopic Pregnancy

An ectopic pregnancy is a fairly rare condition, occurring in about 1-2% of all pregnancies. The condition refers to the implantation of a fertilised egg outside the uterus. Nearly all ectopic pregnancies occur in the fallopian tube, and the condition is interchangeably referred to as a tubal pregnancy.

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Since the fallopian tubes are not equipped to harbour the growth of an embryo, ectopic pregnancies must be treated either medically or surgically, in order to terminate development.

Causes of an Ectopic Pregnancy An ectopic pregnancy may be influenced by one or more of the following factors:

  • Infection: An inflammation or infection of the fallopian tube can lead to a blockage that prevents the fertilised egg from reaching the uterus

  • Previous ectopic pregnancy: A previous case can influence the odds of a recurrent episode

  • Advanced maternal age: A maternal age north of 35 increases the chances of a compromised reproductive mechanism

  • Scar tissue: Previous infections and surgeries can leave scar tissue that hampers the movement of the egg

  • Adhesions: Like scar tissue, adhesions are a common byproduct of surgeries, and can cause tubal damage

  • Congenital anomaly: An abnormally shaped fallopian tube may be a result of a birth defect

Symptoms of an Ectopic Pregnancy

  • Sharp pain: A stabbing pain in the pelvis, abdomen, shoulder or neck, which appears intermittently and at varying degrees of severity

  • Vaginal bleeding: Spotting or bleeding that is lighter or heavier than a regular menstrual cycle

  • Digestive problems: Acid reflux, constipation or diarrhoea, in addition to other symptoms

  • Dizziness: Regular weakness, fainting and dizziness

Treatment Options for an Ectopic Pregnancy

An ectopic pregnancy may be treated in one of three ways, depending on the severity and stage of the case:

Medical Treatment

If the pregnancy is still in its early stages, your doctor might suggest administering methotrexate, a drug that encourages the body to reabsorb pregnancy tissue. Depending on the efficacy of the drug on the body, recurrent injections may be required.

Typically, methotrexate treatment requires an overnight hospital stay, which seeks to monitor the effect of the drug on the organs. This treatment route leaves the fallopian tubes intact.

Laparoscopic Treatment

Performed under general anaesthesia, laparoscopic surgery may be opted for if the pregnancy is too advanced for medical intervention. Often, this treatment option results in the removal of the affected fallopian tube.

Emergency Treatment

In cases where the ectopic pregnancy is left to advance too far, the tube may end up rupturing and bleeding. In such cases, emergency surgery may be required and part or all of the tube may be removed. In cases that are diagnosed early, this eventuality is seldom reached.

The Effect of an Ectopic Pregnancy on Fertility

While an ectopic pregnancy increases your risk of another one in the future, your odds of conceiving healthily are still very high. Your chances of conceiving naturally again depend on the causes of your existing ectopic pregnancy as well as your previous medical history.

If your fallopian tubes have been left intact, you have about a 60% chance of having a successful pregnancy.

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Coping With an Ectopic Pregnancy

Different women deal in different ways when it comes to an ectopic pregnancy. While some mourn the loss of the pregnancy, others do not feel such a profound sense of grief. There is no right or wrong way to come to terms with an ectopic pregnancy.

However, if you do feel overbearing grief, it is important to open your lines of communication with your partner and rely on your close family and friends for support. Online support groups are also wonderful sources of positivity and strength. They can raise your spirits and offer encouragement for the future.

As heartbreaking as ectopic pregnancy can be, it is important to regard it as a small bump on the road to parenthood. Once you’ve cleared it and left it far behind you, you can look to the future and work towards building a family again.

Must Read: How To Survive The Longest Stage Of Pregnancy – The Final Two Weeks

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