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Ectopic Pregnancy

This page provides basic knowledge about the medical condition known as an ectopic pregnancy.

Refer again to the page about fertilization to refresh your memory about the fertilization process.

An ectopic pregnancy is defined as an pregnancy that implant outside the cavity of the womb. It can implant in the Fallopian tube (the most common type) , in the ovary, anywhere in the peritoneal cavity or in the cervical canal. Only the tubal pregnancy is relatively common, the other types are rare.

Tubal pregnancy.

If the fertilized egg gets trapped in the tube on its way to the cavity of the womb , it will implant in the lining or mucous membrane of the tube and start to develop. The thin wall of the tube can't stretch to accommodate the growing pregnancy and the wall eventually ruptures. This will cause severe pain and internal bleeding.

It possible to diagnose a tubal pregnancy before it rupture. Pain is already present before tubal rupture occurs. We stress again pain should always be investigated. Especially pain after an absent period. Never hope it will go away on it's own. The investigations our doctor will conduct in cases of pain could lead to the detection of a tubal pregnancy before it ruptures.

When the tube ruptures, the pregnancy starts to die and the hormonal levels start dropping. This can lead to endometrial bleeding. This bleeding starts late ( 1 - 3 weeks late). This an ectopic pregnancy can be confused with a miscarriage. In modern times the availability of sonar examinations helps tremendously to exclude intra uterine pregnancies in cases of suspected ectopic pregnancies. Laparoscopies confirm the diagnosis and it is possible to treat this condition in some patients via the laparoscope and this avoiding open surgery.

The treatment is surgical removal of the abnormal pregnancy. If the tube is just stretched but not ruptured , the surgeon will attempt to remove the pregnancy with the minimum possible damage to the tube . In some institutions this will be possible via a laparoscopic technique , otherwise open surgery will be required. If the tube is already damaged ( ruptured) than the ruptured part is removed ( partial salpingectomy). This will cause the tube to be blocked . As long as the other tube is still functioning , it won't cause infertility.

A graphic illustration will appear lower down the page.

An Ovarian Pregnancy

In this case an egg cell is not guide into the tube but is fertilized in the peritoneal cavity and than implants onto the ovary. It causes the same symptoms as a tubal pregnancy and severe internal bleeding will eventually occur. It has to be removed surgically. This is a very rare condition.

A graphic illustration will appear lower down the page.

An Intra Abdominal Pregnancy

The cause is probably the same as in an ovarian pregnancy. An egg cell is not guided into the tube and fertilized in the peritoneal cavity. It than implants any where on the peritoneal cavity. These pregnancies can develop quite far and continue for months before it is diagnosed. There are a few findings that will alert a doctor and lead to further investigations. The diagnosis is usually confirmed by a sonar examination. The fetus is seen separate from the uterus during a sonar investigation. This condition is potentially very dangerous and the pregnancy is usually removed when diagnosed. A few cases of viable life babies were described in the world literature. The incidence of abnormalities are very high due to pressure on the fetus. ( the fetus is outside the womb and lacking the protection of the wombs thick muscles.)

This condition is rare . A graphic illustration will appear lower down on the page.

A Cervical Pregnancy

A cervical pregnancy occurs when the fertilized egg cell passes through the cavity of the womb into the cervical canal and starts developing here. The cervix can't accommodate a pregnancy and bleeding will eventually occur. The pregnancy is also not viable and will also have to be removed surgically. This is a rare condition.

A graphic illustration will appear lower down.

 


 

A Graphic Presentation of Ectopic Pregnancies and their Management

The Development of A Tubal Pregnancy

FIG I


This drawing shows a trapped egg cell in the Fallopian tube.

FIG II


This drawing shows how the pregnancy is enlarging. The trophoblast is invading the lining of the tube. ( Compare)


The ectopic pregnancy is enlarging and stretching the Fallopian tube. The trophoblast is invading the full thickness of the tube in some areas.


The tube ruptured and internal bleeding ( into the peritoneal cavity)is taking place.

 

The Next Drawings Illustrate How A Tubal Pregnancy Is Treated.


A swollen tube with an nonruptured pregnancy is shown.


An incision is made over the swelling and the pregnancy removed.


This illustrates the reconstructed tube after the removal of the tubal pregnancy.


The damage part of the tube is tied and the bleeding controlled.


The damage part is cut and removed. The tube is usually damaged beyond repair.


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End the page : Ectopic Pregnancies Made Simple

LAST UPDATE : 03/05/2002

 

copy right FemaleHealthMadeSimple 2002

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