Ectopic pregnancy: complications and treatment

On Elia's blog, we've already talked to you about ectopic pregnancy. Today, in this second part, we're going to tell you how an ectopic pregnancy (EP) is diagnosed, what treatments are available and s'there are complications.

Can ectopic pregnancy be prevented?

An ectopic pregnancy cannot be avoided, but risk factors can be reduced and complications prevented. In particular, you can : 

• Protect yourself during intercourse to avoid catching an STD or pelvic inflammatory disease. This reduces the risk of ectopic pregnancy.

• Take a pregnancy test if you no longer have your periods

• Go to your doctor as soon as you have the slightest doubt, to get a diagnosis and undergo the necessary tests.

How is an ectopic pregnancy diagnosed?

To detect a possible ectopic pregnancy, a vaginal examination can be performed. If the woman is experiencing an ectopic pregnancy, the practitioner can feel a small mass next to the uterus. This is quite painful in the "cul-de-sac" where the vagina meets the uterus.

Complementary tests may also be carried out, as a vaginal examination is not sufficient. Most often, a blood sample is taken to measure a hormone produced by the placenta: chorionic gonadotropin (HCG). This hormone is characteristic during pregnancy, but varies differently in the case of an ectopic pregnancy. In a conventional pregnancy, the level of this hormone doubles every 48 hours, while in an ectopic pregnancy, it changes much more slowly. An ultrasound scan will also be performed to confirm the diagnosis (pelvic, uterine). In fact, if a woman is pregnant but her uterine cavity is empty, she has an ectopic pregnancy. In addition, an ultrasound scan can detect accumulated blood in the abdominal and pelvic cavities. Sometimes, a laparoscopy can also be performed to detect an EP (fiber-optic tube, attached to a camera, incised inside the uterus), as well as monitoring progesterone levels in the blood.

Ectopic pregnancy is a surgical emergency. Once detected, it is treated directly. The longer a woman waits, the greater the risk of hemorrhage, which can be fatal. If the pregnant woman is treated before a potential haemorrhage occurs, things rarely become extremely complicated. 

How is an ectopic pregnancy treated?

If an EP is diagnosed, as we have just said, surgery must be performed as a matter of urgency. Since lthe embryo is not developing in the right place, there is a risk of the fallopian tube rupturing and causing internal bleeding. 

It should also be noted that in 10% to 20% of cases, EPs lead to spontaneous miscarriage, and lhe egg is eliminated spontaneously by the human body.

Two medical procedures are then considered, depending on the case: 

• In the case of unruptured EPs (usually at the start of pregnancy): an injection of a drug (methotrexate) by a health professional, which will stop cell development and destroy lthe egg. The drug is injected intramuscularly into the Fallopian tube, using a needle l.

• Laparoscopic surgery: the surgeon performs a laparoscopy under anaesthetic, making an incision in the navel and inserting an optical tube. The aim is to open the Fallopian tube (which is where the egg most often develops in the case of an EP) and extract/release the egg, while stopping any bleeding. This is a completely benign surgical procedure, since the navel only needs to be opened a few millimetres.

• Removal of the fallopian tube: in the most serious cases, i.e. ruptured fallopian tube or recurrent EP, the practitioner performs a laparoscopy as explained above, but must perform a surgical resection, i.e. the surgical removal of part of a pathological organ or tissue. For example, the Fallopian tube is removed. This procedure may sometimes require opening lthe abdomen, as for a Caesarean section.

What are the complications and consequences of an ectopic pregnancy?

Contrary to what you might think, an EP as such has no impact on fertility. In fact, around 60% of pregnancies are spontaneous or undergo IVF within 2 years of an EP. However, the rate of recurrence of an EP in subsequent pregnancies is higher, at between 10% and 30%.

However, a woman's fertility will largely depend on the treatment she has received. If a woman has had both fallopian tubes removed (particularly in the case of recurrence), natural pregnancy is no longer possible. The only way to have a child is through IVF or adoption.

After an ectopic pregnancy, medical follow-up is all the more important, especially during a subsequent pregnancy, to check that the embryo has implanted in the right place this time.

Whatever the circumstances and stages of your life, Elia is close to you, with a range of menstrual pants designed to ensure your comfort at the most delicate moments.