||[Jul. 6th, 2005|10:11 am]
Survivors of Ectopic Pregnancy
Causes & Symptoms |
What are the causes of an ectopic pregnancy?
The fertilised egg normally spends 4-5 days travelling down the tube from the ovary to the cavity of the womb where it implants usually 6-7 days after fertilisation. The most common reason for an ectopic pregnancy is damage to the fallopian tube, causing a blockage or narrowing. There could also be a problem with the walls of the tube, which should normally contract and waft the fertilised egg into the womb. Conditions such as appendicitis or pelvic infection can damage the tube by causing kinks or adhesions, thus delaying the passage of the egg, allowing it to implant in the tube. In most cases however, the cause of the ectopic is not known.
What are the symptoms?
Abdominal pain. Can be persistent and severe. The pain may just be on one-side, but not necessarily on the side of the ectopic
Abnormal bleeding. The bleeding may be heavier or lighter than usual and prolonged. Unlike a period, this bleeding is often dark and watery, sometimes described as looking like 'prune juice'
A missed or late period
Bladder or bowel problems. Pain when moving the bowels or on going to the toilet
Pregnancy Test (urine). This may be positive but not always
Sickness and diarrhoea. Often confused with gastroenteritis
Collapse. You may be feeling light-headed or faint, and often this is accompanied by a feeling of something being very wrong.
Who is at risk of an ectopic pregnancy?
Any sexually active woman of childbearing age has a risk of an ectopic pregnancy. However, ectopic pregnancies are more likely if you have had:
Pelvic Inflammatory disease
Any previous abdominal surgery
A coil fitted
Are on the progesterone-only contraceptive pill (mini pill)
At what stage in pregnancy are ectopic pregnancies most likely to occur?
Ectopic pregnancies usually cause symptoms which lead women to seek help between the 4th and 10th week of pregnancy and most commonly between 6-7 weeks.
Do you ovulate while having an ectopic?
Ovulation usually resumes when hCG levels decrease below 100 IU/l. Therefore it is not unusual to diagnose ovulation when an ectopic pregnancy is in state of resolution following expectant or medical treatment.
Could the level of exercise I did contribute to my ectopic? (I do lots of intense cycling and spinning?)
No, exercise makes no contribution to ectopic pregnancy.
Is it likely I could have another ectopic pregnancy?
The overall chances of a repeat ectopic pregnancy is about 10% and this depends on the type of surgery carried out and any underlying damage to the remaining tube(s).
What can I do to prevent another ectopic pregnancy?
Since ectopic pregnancy is more related to past tubal damage rather than the present, there is little that can be done to prevent a future ectopic. However, if you feel that you may have ongoing problems of pelvic infection, (and it is well-known that Chlamydia trachomatis may give no symptoms) then testing and antibiotic treatment for this might help to reduce the risk of a future ectopic.
What are my chances of a future successful pregnancy after an ectopic pregnancy?
This very much depends on the condition of your remaining tube(s). The loss of a tube does reduce success rates, but you can still become pregnant and have a successful pregnancy with only one tube intact. Overall, 65% of women will become pregnant within 18 months after an ectopic.
Is it true that I ovulate on alternate sides each month?
This varies from woman to woman. Many women will ovulate from the same side each month with an occasional ovulation from the other side; others will ovulate randomly from side to side. It depends on which ovary contains the egg that is at the right stage of development. However, it probably does not matter as an egg from one ovary can easily travel down the tube on the other side. In the past, the ovary on the side of the ectopic was removed at operation but this is no longer carried out, as it was not found to be beneficial.
When is it safe to have sex again?
This depends what you mean. You could fall pregnant within 6 weeks of an ectopic but the risk of a further ectopic is higher the sooner you try. You should wait for the first normal period before you attempt to get pregnant again. Having sex itself is not dangerous to you as long as you do not find it painful. Normally it would be better to wait around 6 weeks to allow full healing and by that time you should have had your first period.
When can I try to get pregnant again? You could fall pregnant within 6 weeks of an ectopic but the risk of a further ectopic is higher the sooner you try. You should wait for the first normal period before you attempt to get pregnant again.
Is there anything I can do to improve my chances next time?
Not really, but if you have a history of abdominal pain which persists after the ectopic, then you should see your GP to make sure you do not have persistent infection that might contribute to a future ectopic. Overall, the recurrence rate is around 16%.
Do other people feel scared about trying again?
Yes, most people feel scared about trying again. An ectopic pregnancy is a very frightening experience in which many women thought they were going to die. Because of this, most early pregnancy units would offer early scanning in the next pregnancy to make sure that all is well.
What is hCG?
The hormone beta hCG is produced by the placenta. In normal pregnancy the levels double every two days. When the level in urine is high enough, the home pregnancy test becomes positive. In ectopic pregnancy, the levels are usually lower and rise more slowly (and your pregnancy may not test positive). A combination of ultrasound findings and blood levels of hCG can make a more accurate and earlier diagnosis allowing more treatment options.