Ectopic pregnancy is when an egg implanted and grows outside of the main cavity in the uterus. This most commonly occurs in the fallopian tubes. Untreated, this condition can lead to death as the fallopian tubes cannot support the growing embryo. Ectopic pregnancy surgery is one of the most important steps to manage this condition, especially if it is advanced or causes internal bleeding.
What is Ectopic Pregnancy Surgery (Epi-Teo)?
Ectopic pregnancy surgery is the surgical procedure used to remove an ectopic embryo. Most common surgical procedures include:
- Laparoscopy is a minimally-invasive procedure that uses a camera and small incisions to remove ectopic tissues.
- Laparotomy is an open surgery performed in complex or emergency cases, particularly if there is severe internal bleeding.
The surgeon will:
- Salpingostomy: Remove the ectopic and preserve the fallopian tubes
- Salpingectomy: Remove the affected tube in its entirety
Ectopic pregnancy: What causes it?
Any woman can experience an ectopic pregnancy, but there are several factors that increase the risk of it.
Previous Ectopic Pregnancy
- Women who have had a previous ectopic pregnancy are at a greater risk of having another one.
Pelvic Inflammatory Disorder (PID)
- The fallopian tube can be damaged by infections, which are often caused sexually transmitted diseases.
Tuberculosis
- Scarring or obstruction may result from surgeries on the fallopian tube (such as tubal ligation, reversal or reversal).
Fertility Treatments
- Some assisted reproductive technologies, such as IVF, may increase risk.
Smoking
- Smoking can alter the fallopian tubes’ function and increase the likelihood of an implantation outside of the uterus.
Ectopic pregnancy symptoms
The symptoms of an ectopic pregnancies usually appear between four and twelve weeks of pregnancy. They may look like a miscarriage or a normal pregnancy.
- Sharp abdominal or pelvic discomfort, usually on one side
- Vaginal bleeding is not related to periods
- Shoulder pain at the tip of the shoulder (caused by internal bleeds irritating diaphragm).
- The feeling of dizziness and fainting can be a sign of low blood pressure or internal bleeding.
- Nausea or vomiting
- Weakness and confusion
If you have these symptoms, and a positive pregnancy result, see a doctor immediately.
Diagnosis for Ectopic Pregnancy
Early detection is crucial to avoid complications. Diagnosis usually involves:
Pelvic Examination
- A doctor might feel tenderness in the abdomen or a lump.
Ultrasound
- Transvaginal ultrasound allows you to see the reproductive organs, and determine if the pregnancy is inside or outside of the uterus.
Blood Tests
- Human Chorionic Gonadotropin (hCG) levels: In ectopic pregnancy, hCG rises more slowly than during a healthy pregnancy.
- Low progesterone levels can indicate abnormal pregnancy.
Treatment options for Ectopic Pregnancy
Treatment depends on size, location and symptoms.
Medical Management
Methotrexate is a drug that can be used if the ectopic pregnancies are detected early and there has not been a rupture. It will stop the cell growth and dissolve it. This non-surgical procedure requires close monitoring.
Surgery
When is surgery required?
- Internal bleeding or rupture is present.
- When medical treatment fails, it is a sign that the patient has not received the best possible care.
- The ectopic birth is large.
There are many types of surgery.
Laparoscopic Surgery
- Preferable in stable cases
- Use 2-3 small incisions.
- Recovery is faster
- Scarring is reduced.
Laparotomy (Open Surgery)
- Useful in emergency situations
- This involves a deeper abdominal incision.
- Recovery period is longer
The surgeon can either:
- If the tube is not damaged, it should be preserved.
- If the tube is ruptured or severely damaged, remove it.
Recovery from Ectopic Pregnancy Surgery
The recovery time depends on what type of surgery was performed.
Laparoscopic Surgery
- Hospital stay: One day or same-day discharge
- Recovery time: 2 to 4 weeks
Laparotomy:
- Hospital stay: 2 to 3 days
- Recovery Time: 4-6 Weeks
Post-Surgery Care:
- Avoid heavy lifting during the next few weeks.
- Infections can be detected by checking the site of the incision.
- Continue to monitor hCG levels to ensure they are zero.
Emotional and psychological impact
Even an ectopic pregnancy can be emotionally difficult. You may feel sadness, anxiety or depression. Consider:
- Speak with a counselor, support group or other person.
- Self-care is important. Allowing time for healing and self-care are both essential.
- Talking with your gynecologist about future options for pregnancy
Future Fertility after Ectopic Pregnancy
A previous ectopic pregnancies does not mean that you cannot have a future successful pregnancy. Your chances of having another ectopic birth may be increased.
How to improve your fertility after an ectopic pregnancy
- Treat any underlying conditions, such as infections or endometriosis.
- Smoking is harmful to your health.
- Follow-ups are important, as is early ultrasounds during future pregnancies.
Conclusion
Ectopic pregnancy surgery can save a woman’s life if she is experiencing a pregnancy that occurs outside of the uterus. Regular prenatal care is the best way to prevent complications. No matter if the condition is treated surgically or medically, it’s important to receive prompt treatment for a healthy recuperation and future fertility.
Do not wait if you suspect a ectopic birth. Consult a doctor immediately — your future fertility and health depend on it.
