Ectopic Pregnancy
When conception takes place, the fertilized ovum travels to its destination and implants itself into the uterine wall. Here the embryo receives its blood supply and it has ample room to develop and grow. However, all pregnancies are not normal. It has been found that nearly 1% of pregnancies are of an ectopic nature. Of these ectopic pregnancies, the vast majority is the kind that is called “tubal” because the embryo implants itself in the fallopian tubes. Other places where the ovum may implant itself include the cervix, ovaries or even the abdomen. The moment the ovum becomes implanted, it needs a blood supply. That is when the problem comes to the fore. An ectopic pregnancy is considered to be a medical emergency. If left untreated, it could cause tissue scarring leading to infertility; it may cause rupture of the fallopian tubes if it is of the tubal kind; and the rupture of the tube can cause either infertility or even death.
In an ectopic pregnancy the embryo fails to reach the uterine lining where it is supposed to make a home. Instead it implants in the fallopian tube. The tube finds it an irritant and expels it, thus the fertilized ovum is aborted. The tubes in such cases do not become inflamed due to this expulsion. If this condition occurs early in the pregnancy, the woman may not even realize that she had conceived. She may just regard it as a normal menstrual discharge.
Sometimes the pregnancy is confirmed, but the fallopian tube aborts the embryo before it can become deeply implanted. This discharge is also not alarming and is accepted as a regular miscarriage. Strangely enough, the pain that the ectopic pregnancy may cause is hardly ever due to dislodging of the embryo. It is generally due to the increase in hormonal activity that accompanies such a condition.
Since ectopic pregnancies normally terminate themselves, they are not a cause for concern. However, they do become a source for concern and a threat when they are not diagnosed in time. In such cases, severe damage may be caused leading to near fatal or fatal conditions.
Early ultra sound ensures that the pregnancy is normal and there is no fear of an ectopic condition. Ultra sound has reduced the number of fatalities occurring due to late diagnosis of ectopic pregnancies. However in places where diagnostic facilities are not easily available and the dependence is on untrained mid-wives, the threat to women of child-bearing years is greater.
As such there is no clear evidence of why an ectopic pregnancy occurs. However, the risk factors include smoking, a previous ectopic pregnancy, pelvic inflammatory disease, infertility, tubal surgery and ligation. Current IUD use and having multiple sexual partners seem to increase the risk of ectopic pregnancies. Advancing age is yet another factor that increases the risk of ectopic pregnancy.