Ectopic Pregnancy
In some spaces, Ectopic Pregnancy can also be referred to as a Tubal Pregnancy.
Okay, guys- so today we’re going to cover a slightly heavier-than-usual topic. Here are Recharged PT, we are all about supporting mommas at every part of the journey: whether you’re a mother-to-be, pregnant, or on the other side of labor and delivery.
Although a bit rarer, this can also include people who have experienced an ectopic pregnancy. Also known as a tubal pregnancy, this occurs in approximately 1 in 100 pregnancies or about 1% of the time. An ectopic pregnancy is one that occurs outside of the uterus. Most often, this is in one of the two fallopian tubes – although it can also occur in the ovary, cervix, or abdomen.
During a normal cycle, an egg will move from the ovary down the fallopian tube. It normally meets sperm in the fallopian tube and gets fertilized there. After, the fertilized egg then moves into the uterus, where it attaches to the lining and develops into a fetus.
During a tubal pregnancy, the fertilized egg gets stuck or blocked, leading it to implant & develop outside of the uterus. Although anyone can experience an ectopic pregnancy, there are some risk factors that may increase the chances including:
Recent infertility
Endometriosis (where uterine like tissue grows in other areas of the body)
Having a sexually transmitted infection (STI) that can lead to infection and scarring in the pelvic area including the fallopian tubes
Being over the age of 35
Past tubal surgery
Having an IUD in place at the time of fertilization
A history of ectopic pregnancies
Having past usage of birth control for long periods of time
SYMPTOMS OF ECTOPIC PREGNANCY:
Early Symptoms:
The symptoms of an ectopic pregnancy can vary from person to person. Very early on, you may not have any symptoms at all. Others may experience “normal” pregnancy symptoms like breast tenderness, nausea and a missed period. If you take a pregnancy test, it will come back as positive.
COMMONLY ASSOCIATED SYMPTOMS:
As the pregnancy progresses, you may start to experience other symptoms at approximately 6 to 8 weeks.
This includes lower abdominal or pelvic pain (usually one sided) and light bleeding. If the egg is in the fallopian tube, you may experience shoulder tip pain or the feeling of needing to have a bowel movement. Emergent symptoms include dizziness, fainting, low blood pressure, heavy bleeding that fills a maxi pad in 1-2 hours, and severe pelvic pain.
If the fertilized egg continues to grow, it could eventually rupture the tube of implanted there- leading to internal bleeding – among other complications. This is life-threatening and is considered a medical emergency.
Getting a Diagnosis:
Your healthcare provider will diagnose an ectopic pregnancy through multiple tests. Usually, you will provide a urine sample to confirm the pregnancy. Then you may get blood work to measure your human chorionic gonadotropin (HCG) levels, which the body only produces during pregnancy.
In a normal healthy pregnancy, these levels should double approximately every 48 hours. In an ectopic pregnancy, the levels may stagnate or even drop. To confirm an ectopic, your healthcare may perform a transvaginal ultrasound to confirm the location of the fertilized egg.
TREATMENT OF ECTOPIC PREGNANCY:
There are a few options for treatment. In very specific cases, your healthcare provider may advise a “wait and see” approach to see if the body will discontinue the pregnancy naturally and reabsorb those tissues.
Much more commonly, your provider will advise medication or surgery.
WITH MEDICATION: you will most likely use a med called methotrexate, which essentially stops the cells from growing, ending the pregnancy. Given as a (usually) one-time injection, methotrexate will not damage your fallopian tube. However, it does require follow up labs and a visit with your healthcare provider to make sure your HCG levels are dropping appropriately. Side effects include sun sensitivity, mouth ulcers, fatigue, abdominal pain or cramping, nausea and/or vomiting in the first 24 hours, decreased appetite, diarrhea, and difficulty sleeping. Some people have very mild side effects and others experience more severe ones. Sometimes, it can take up to 6-8 weeks for the HCG levels to drop to 0.
SURGICAL: Another treatment approach is surgery. This will be the only treatment appropriate if your tube has ruptured or is at risk of rupture. This is considered an emergency and life-saving treatment. Sometimes, the surgeon can remove the fertilized tissue laparoscopically (thus preserving the tube); other times, the whole tube will have to be removed.
Although this can be a devastating and traumatic experience, the good news is that most people go on to have successful healthy pregnancies. However, your risk of having another ectopic is approximately 10-18% (vs the 1% of the general population who have never experienced an ectopic pregnancy before).
Generally, healthcare providers recommend waiting 3 to 6 months after treatment before trying to conceive again. This gives your body and mind time to process the events of the tubal pregnancy and the treatment required for it as well as work towards returning hormones to a good state for your next pregnancy (if you wish to have another). When the time is right to conceive again, it may be helpful to ask for an HSG, a type of imaging (and potential treatment) that can look for blockages in the tube and potentially improve or eliminate the blockage.
Although no one ever expects to have anything other than a healthy pregnancy, it is important to know the signs and symptoms of an ectopic pregnancy.
Aside from the physical symptoms, recovering from an ectopic pregnancy can be devastating mentally, emotionally, and spiritually. Grieving is a normal and healthy part of the process. It may be helpful to surround yourself with your support community or even see a mental health counselor.
Overall, tubal pregnancies are considered an emergent and sometimes even life-threatening event. Most people do not know they have an ectopic until they see their healthcare provider for the first time. Thus, it is important to know the signs and symptoms so that your health and body can be preserved first and foremost.
If you have any questions- we are here for you. If you have experienced an Ectopic Pregnancy- we are still here for you. Even if it is just to hear your story.
With love,
The Recharged Performance Therapy Team
(321) 802-1630
www.rechargedperformancetherapy.com
References
https://www.hopkinsmedicine.org/health/conditions-and-diseases/ectopic-pregnancy
https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088
https://my.clevelandclinic.org/health/diseases/9687-ectopic-pregnancy
https://uihc.org/educational-resources/methotrexate-ectopic-pregnancy