A Tubal pregnancy occurs when implantation occurs outside the womb. Implantation can occur in the ovary, the abdomen, the cervix, at the join between the tube and the womb, but the most common place is in the fallopian tube. Pregnancy can even occur in both the womb and the tube at the same time (heterotopic pregnancy), but this is very rare.
The percentage of pregnancies which are Tubal is between 0.25 and 1%
A Tubal pregnancy is usually caused by conditions which slows down or obstructs the movement of the egg down the fallopian tube into the uterus. Any condition which may have damaged the fallopian tubes increases the risk of a Tubal pregnancy. The possible causes of Tubal pregnancies include:
The most common symptoms of Tubal pregnancy or signs of Tubal pregnancy include:
Always consult your physician for a diagnosis if you experience any of the symptoms of a Tubal pregnancy.
The diagnosis of a Tubal pregnancy can be difficult. Your doctor may perform some tests to help confirm s suspected Tubal pregnancy. These tests include:
If a Tubal pregnancy is strongly suspected, then a gynaecologist will perform a laparoscopy to confirm it. During a laparoscopy, the fallopian tube is often removed at the same time. Sometimes open surgery is required to remove the pregnancy.
Methotrexate can be used as a chemical treatment. It is used in non-urgent cases to dissolve the pregnancy without harming the tubes and other organs. Repeat hCG levels will be taken to ensure that the pregnancy is dissolving and that further treatment is not needed.
The outlook for future pregnancies depends on whether the fallopian tube appeared normal or not. Generally 1 in 5 women who experienced a Tubal pregnancy will experience another Tubal pregnancy. An Ectopic Pregnancy occurs when the fertilized egg attaches itself in a place other than inside the uterus. Almost all ectopic pregnancies occur in a fallopian tube, and are thus sometimes called tubal pregnancies. The fallopian tubes are not designed to hold a growing embryo; the fertilized egg in a tubal pregnancy cannot develop normally and must be treated. An ectopic pregnancy happens in 1 out of 60 pregnancies.
Ectopic pregnancies are caused by one or more of the following:
Women who are more at risk for having an ectopic pregnancy include the following:
The following symptoms may be used to help recognize a potential ectopic pregnancy:
It is important for you to seek emergency care if you are experiencing sharp pain or have bleeding.
Ectopic pregnancies are diagnosed by your physician who will probably first perform a pelvic exam to locate pain, tenderness or a mass in the abdomen. Your physician will also use an ultrasound to determine whether the uterus contains a developing fetus.
The measurement of hCG levels is also important. An hCG level that is lower than what would be expected is one reason to suspect an ectopic pregnancy. Low levels of progesterone may also indicate that a pregnancy is abnormal.
Your physician may do a Culdocentesis, which is a procedure that involves inserting a needle into the space at the very top of the vagina, behind the uterus and in front of the rectum. The presence of blood in this area may indicate bleeding from a ruptured fallopian tube.
An ectopic pregnancy may be treated in any of the following ways:
Your hCG level will need to be rechecked on a regular basis until it reaches zero if you did not have your entire fallopian tube removed. An hCG level that remains high could indicate that the ectopic tissue was not entirely removed, which would require surgery or medical management with methotrexate.
The chances of having a successful pregnancy after an ectopic pregnancy may be lower than normal, but this will depend on why the pregnancy was ectopic and your medical history. If the fallopian tubes have been left in place, you have approximately a 60% chance of having a successful pregnancy in the future.
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