Content
Ectopic pregnancy is characterized by the implantation and development of the embryo outside the uterus, which can happen in the tubes, ovary, cervix, abdominal cavity or cervix. The appearance of severe abdominal pain and blood loss through the vagina, especially in the first trimester of pregnancy, may be indicative of ectopic pregnancy, and it is important to consult the doctor to make the diagnosis.
It is important to know exactly where the embryo is, because it is possible for the most appropriate treatment to be determined, since when it is in the abdominal cavity the pregnancy can continue, despite being a rare and delicate situation.
Symptoms of ectopic pregnancy
The ectopic pregnancy is when the embryo is developing in the tubes and is already big enough to rupture the woman's tube. In this case the woman has the following signs and symptoms:
- Severe abdominal pain, only on one side of the belly;
- Irregular vaginal bleeding, especially between the 5th and 14th week of pregnancy;
- Feeling of heaviness in the vagina;
- Severe pain on palpation of the uterus;
- Swollen abdomen;
- Beta HCG exam is usually negative.
In the case of pregnancy outside the uterus, but without signs of rupture of the tubes, the symptoms can be:
- Abdominal pain or discomfort;
- Vaginal bleeding after the last menstruation;
- Severe pain on palpation of the uterus;
- Pain during intimate contact or during pelvic examination;
- Beta HCG exam is usually positive.
In case of suspicion, one should immediately go to the hospital for the doctor to do an ultrasound scan that can confirm the ectopic pregnancy and indicate the most appropriate treatment to solve the problem. The best way to know if the embryo is developing outside the uterus is through ultrasound performed by the doctor because the Beta HCG test does not always give a positive result.
How long can it be an ectopic pregnancy?
Pregnancy in the tubes or ovaries can develop up to 14 weeks of gestation, and if this happens it is not possible to save the life of this embryo as there are no drugs or procedures that can move the embryo from the tubes to the uterus. When ectopic pregnancy develops in places other than the tubes, such as the abdominal cavity, it can be discovered later, but always through ultrasound.
Main types of ectopic pregnancy
Ectopic pregnancy is a rare condition in which the embryo can be implanted in various parts of the body, such as the tubes, ovary, abdominal cavity or cervix, which is when the fetus grows in the cervix. The less common types of ectopic pregnancies are:
- Ecstatic interstitial pregnancy: Occurs when the embryo develops in the interstitial segment of the tube. In this case, there is an increase in Beta HCG and the treatment is usually done with the drugs and potassium chloride, in several doses;
- Cervical pregnancy: It is when the embryo develops in the cervix, which can generate intense bleeding. Treatment can be done with embolization, curettage or local injection of methotrexate, for example;
- Ectopic pregnancy on cesarean scar: It is very rare, but it can happen, requiring treatment with methotrexate and folinic acid remedies, for about 1 week;
- Ovarian pregnancy: Sometimes it is only discovered during curettage and therefore methotrexate is not used;
- Heterotopic pregnancy: It is when the embryo develops between the uterus and the tube, but it is usually only diagnosed after the rupture of the tube and therefore the most used treatment is surgery.
In addition to these types, there is also ectopic abdominal pregnancy, which is when the baby develops in the peritoneum, between the organs. This is a very rare condition and each case must be assessed individually. This is a complicated pregnancy because as the baby grows, the mother's organs are compressed and blood vessels can be ruptured, potentially fatal. However, there are reports of women who managed to get the baby to reach 38 weeks of gestation, having a cesarean section for the birth.
How the treatment is done
Treatment for ectopic pregnancy should be guided by an obstetrician, because it depends on the exact location of the embryo, but it can be done with the use of drugs to promote abortion or surgery to remove the embryo and reconstruct the uterine tube, for example.
In some cases, when an ectopic pregnancy is discovered before 8 weeks of gestation, and the embryo is very small, the doctor may recommend taking a drug called Methotrexate to induce abortion, but when the pregnancy is more advanced, it must be performed surgery for its removal.
Find out more details of treatment in case of ectopic pregnancy.