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Tubal Pregnancy
One of the risks in early pregnancy is that the egg doesn't travel quickly enough to the uterus, and instead becomes implanted in the fallopian tube and begins to grow there. This is known as an ectopic, or tubal, pregnancy. Common causes for this include: infection, inflammation or abnormality in the fallopian tube, scar tissue remaining from previous surgery or infection in the tubal area, having had several induced abortions or pregnancy while an IUD is still in place when you get pregnant.
Symptoms of this condition are likely to be a sharp stabbing pain in the pelvic or abdominal area (although other areas of the body may also feel pain), vaginal bleeding or spotting, dizziness, fainting, lower back pain or lower back pain. If an ectopic pregnancy is present, you don't need to have all of these symptoms, usually the pain with any of the other symptoms is enough to raise concern, especially if the pain is concentrated mainly on one side of the body. During the early weeks of pregnancy when the body is going through major changes, it isn't uncommon to have similar symptoms and nothing be amiss, however because of the implications, if you do experience these kind of symptoms you need to check it out with your ob/gyn or doctor. Early detection can make things simpler should something be wrong.
As an ectopic pregnancy is usually identified in the early weeks of pregnancy, it is difficult to detect especially less than 6 weeks. Once you have discussed the situation with the doctor, there are a number of tests that can be used to try and identify whether or not the egg is in the right position or not. First of these is a normal blood test. During pregnancy hCG levels double every 2 days and so if a blood test is taken and the hCG level is low for the stage of pregnancy you are at, then another blood test will be taken after another few days to see if the number doubles. If it doesn't, then this gives a higher possibility of an ectopic pregnancy. A pelvic exam may be carried out to check for any abnormalities. Occasionally an invasive test known as a culdocentesis will be carried out to check if there is any blood or fluid behind the uterus and in front of the rectum. After week 6 an ultrasound should be able identify the location of the egg. Before that time, it is too small to detect by this method.
Once a tubal pregnancy is confirmed then there is no question of the pregnancy being allowed to continue. There are a number of different procedures by which the egg can be removed, depending on how far into the pregnancy you are. The easiest of these on the body is the injection of a drug which will dissolve the egg and your body will reabsorb it. If you are further along then a surgical procedure will be required. This can be by the use of a laparoscope through a small incision. The laparoscope can remove the egg and repair or remove any damaged organs. It is possible however that the pregnancy has developed too far and major abdominal surgery may be required where the fallopian tube may also need to be removed.
The physical implications of this will be depending on the kind of technique required to remove the egg. If it is dissolved, then a few days of discomfort may be felt and nothing more. Major surgery on the other hand can have a six week recovery attached to it with restrictions on the kind of movement and activities you can undertake during that time. The emotional impact however can be much more complicated, especially if this was a planned pregnancy and a much wanted baby. As with miscarriage there is always the "what if" guilt; the mother feeling in some way responsible for the way things turned out. With a tubal pregnancy however, there is the added guilt of having to agree to the termination of the pregnancy. Despite there being no chance of the egg developing in the fallopian tube, guilt weighs heavy on the mind of the mother and those around her need to be supportive and acknowledge her pain and grief - to the mother, it was a baby that was lost, not an egg. Following the removal of the ectopic pregnancy there will be follow up checks to ensure that there is no sign of hCG in your blood.
Although many women who have had ectopic pregnancies have difficulty in conceiving again, and there is an increased chance of having another ectopic pregnancy, it is very possible to have a successful pregnancy even if a fallopian tube was removed during the tubal pregnancy. Once you find you are pregnant following an ectopic pregnancy, seek medical advice and make sure that your doctor is aware of your history so that they can keep a close check on your hCG levels early on in the pregnancy.
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