Symptoms

Ectopic pregnancy is characterized by abnormal implantation of a fertilized egg outside the womb. Hence, there is no chance that it will develop to a baby. It is usually asymptomatic but signs and symptoms appear between the 5th and 14th week of pregnancy. Some of the common symptoms of ectopic pregnancy are pain which is persistent, severe and unilateral (occurs on one side of the abdomen), vaginal bleeding, which is bright or dark red in color, referred shoulder tip pain that is usually felt when the patient is lying down, pain when passing urine or stools, diarrhea and vomiting.

Causes

Ectopic pregnancy occurs when a fertilized egg fails to attach itself to the uterus. Usually, the fertilized egg abnormally implants itself to the fallopian tubes, abdominal cavity and cervix. As a result, the fertilized egg becomes nonviable and has no chance of survival.

The root cause of ectopic pregnancy is not clear all the time. Some of the health conditions that have been linked to abnormal pregnancy are inflammation and scarring of the fallopian tubes from a previous medical condition or surgery, hormonal factors, genetic abnormalities, birth defects and medical conditions that affect the shape and condition of the fallopian tubes and reproductive organs. Other risk factors associated with increased chance of having ectopic pregnancy are advanced maternal age of 35 years or older, history of pelvic surgery, abdominal surgery, multiple abortions, pelvic inflammatory disease, endometriosis, conception occurred despite tubal ligation or IUD, conception aided by fertility drugs or procedures, smoking, previous ectopic pregnancies and history of sexually transmitted diseases.

Treatment

Historically, treatment of ectopic pregnancy mainly focuses on surgery. However, with further studies, it was found out that certain pharmacotherapy (methotrexate) is effective in treating this condition. Methotrexate is an antimetabolite chemotherapeutic agent that binds to the enzyme dihydrofolate reductase, which is involved in the synthesis of purine nucleotides. This interferes with deoxyribonucleic acid (DNA) synthesis and disrupts cell multiplication. However, this therapy is not applicable to all patients. There are some conditions that should be met once the diagnosis has been established. These include hemodynamic stability, with no signs or symptoms of active bleeding or hemoperitoneum (must be met by every patient), the patient must be reliable, compliant, and able to return for follow-up care (must be met by every patient), the size of the gestation should not exceed 4cm at its greatest, absence of fetal cardiac activity on ultrasonographical findings, no evidence of tubal rupture.