What are the symptoms of ectopic pregnancy?

What is an ectopic pregnancy?

An ectopic pregnancy is a pregnancy that develops outside the uterine cavity. Under normal circumstances, an ovum is fertilized in the Fallopian tube and then implants in the uterus. In the case of an ectopic pregnancy, the egg fails to reach the uterus and develops in a fallopian tube (tubal pregnancy, which occurs in 96% to 98% of ectopic pregnancies), in an ovary, on the cervix or in the abdomen. 

What's more, in an ectopic pregnancy, the fetus cannot develop. It may die of its own accord, or an operation may be required to halt its growth and remove it. In fact, if the fertilized egg is not removed and the pregnancy continues, medical intervention is essential. Treatment is then urgently required, as the growth of the pregnancy can lead to the bursting of the Fallopian tube, causing internal haemorrhage. An ectopic pregnancy remains the leading cause of death for women in the 1st trimester of pregnancy. There are around 2 ectopic pregnancies for every 100 births, and one ectopic pregnancy for every 13 miscarriages.

What are the causes and risk factors for ectopic pregnancy?

The exact cause of an ectopic pregnancy is still unknown. However, it is believed that an ectopic pregnancy can be explained by the fact that a fertilized egg that is too large has not been able to travel all the way down the Fallopian tube to the uterus, and therefore remains trapped there. This is known as a tubal pregnancy.

Sometimes, the spermatozoon has fertilized the egg when it was not in the fallopian tube. The egg is then implanted in an ovary, the peritoneal cavity or the fallopian tube. Moreover, it is often an anomaly in the fallopian tube that has blocked the egg's migration.

It is thought that risk factors such as :

• STDs

• In history of salpingitis (infection of the fallopian tubes following chlamydial infection)

• Pelvic inflammatory disease (fallopian tubes, ovaries or uterus. Often caused by gonorrhea or chlamydia infection)

• Repeated curettage or aspiration

• Active or passive smoking (estimated to cause one in 5 EPs)

• A history of EP

• Surgery to overcome infertility diethylstilbestrol (synthetic hormone prescribed to women in France between 1950 and 1977 during pregnancy to prevent miscarriage, prematurity, etc.)

• Mother's age during pregnancy

• Medically assisted procreation (MAP)

• IUD (in very rare cases)

• Tubal, pelvic or abdominal surgery

• An abortion

What are the symptoms of an ectopic pregnancy?

At the start of an ectopic pregnancy, lthe fertilized egg develops normally.

The symptoms are : 

• Delayed periods

• periods unusual and/or inconsistent

• Discomfort

• Dark bleeding

• Pelvic pain

• Shoulder pain

During an ectopic pregnancy, a woman has the same symptoms as during a conventional pregnancy (nausea, vomiting, intense fatigue, breast pain, etc.), but sometimes the EP is asymptomatic.

However, if the EP is not detected in time, the fertilized egg does not develop in the uterus, so it does not have the space and nutrients needed to continue its development. It will gradually detach, leading to cataclysmic haemorrhage, and become encysted in the fallopian tube, which in turn will distend and sometimes rupture, causing internal haemorrhage.  

At the time of the breakup, the woman may have :

• Irregular, often dark, and very heavy bleeding, in which case we advise you to wear protection or a very absorbent pad. period pants very absorbent

• Cramps or pelvic pain of varying intensity, sometimes felt from the shoulder to the knee, with successive episodes of discomfort due to blood loss and a drop in blood pressure,

• Pallor or dizziness due to significant blood loss,

• Intense pain on one side of the lower abdomen,

• Vomiting and/or diarrhea
  
  

If the fallopian tubes rupture:

• Intense abdominal pain and heavy vaginal bleeding.

• A drop in blood pressure leading to symptoms of shock, such as paleness, sweating and fainting.

In rare cases, the tube does not burst, but instead cracks into the peritoneal cavity. The blood then slowly drains out and collects behind the uterus, where it coagulates and pushes out the neighbouring organs. Symptoms include

• A pallor

• Pelvic pain

• Urinary and rectal disorders

• Unusual bleeding

If you experience any of these symptoms, rush to hospital or call an ambulance.