Ectopic Pregnancy: Symptoms, Causes & Treatment
الحمل خارج الرحم
Ectopic pregnancy is implantation of the fertilized egg outside the uterine cavity, often in the fallopian tube, so it cannot continue and threatens the mother's life if it ruptures. Its signs are one-sided abdominal pain, vaginal bleeding, and dizziness in early pregnancy. It is an emergency needing prompt diagnosis and treatment with medication or surgery.
What is Ectopic Pregnancy?
Ectopic pregnancy is a condition in which the fertilized egg implants and begins to grow outside the uterine cavity, and more than ninety percent of cases are in one of the two fallopian tubes (the tube connecting the ovary to the uterus), so it is sometimes called tubal pregnancy. Since these places are not equipped to hold and grow a pregnancy, this pregnancy cannot continue or be moved to the uterus, and as it grows it may cause rupture of the tube and serious internal bleeding that threatens the mother's life.
The chances of ectopic pregnancy increase with certain factors, including: previous pelvic infections or a sexually transmitted infection that affected the fallopian tube, previous surgery on the tube or pelvis, a previous ectopic pregnancy, smoking, pregnancy with an IUD in place, and assisted reproduction. But it may also occur without any clear risk factor. Symptoms usually appear in the first weeks of pregnancy and include pain in the lower abdomen often on one side, abnormal vaginal bleeding, sometimes shoulder pain (a sign of internal bleeding irritating the diaphragm), and dizziness or fainting and pallor when bleeding occurs.
Ectopic pregnancy is an emergency because delayed diagnosis may lead to tube rupture and severe bleeding. Therefore, any woman of reproductive age with abdominal pain and bleeding with a missed period or a confirmed pregnancy must be evaluated urgently. Diagnosis relies on the pregnancy-hormone test (serial) and transvaginal ultrasound to determine the pregnancy's location. Treatment differs by case: in early unruptured cases a medication that stops the pregnancy's growth under close monitoring may suffice, while advanced or ruptured cases need urgent surgery (often laparoscopic). Early detection saves life and preserves future fertility as much as possible.
Symptoms
- Pain in the lower abdomen often on one side.
- Abnormal vaginal bleeding with a missed period or confirmed pregnancy.
- Shoulder pain (a sign of internal bleeding).
- Dizziness or fainting and pallor with bleeding.
Causes
- Previous pelvic infections or an STI that affected the fallopian tube.
- Previous surgery on the tube or pelvis, or a previous ectopic pregnancy.
- Smoking, pregnancy with an IUD in place, and assisted reproduction.
- May also occur without a clear risk factor.
Diagnosis
- Pregnancy-hormone test (serial to track its rise).
- Transvaginal ultrasound to determine the pregnancy's location.
- Urgent evaluation of any pain and bleeding in early pregnancy.
Treatment
Early unruptured cases
- A medication that stops the pregnancy's growth under close monitoring of the pregnancy hormone.
Advanced or ruptured cases
- Urgent surgery (often laparoscopic) to stop bleeding and remove the pregnancy.
Early detection saves life and preserves fertility as much as possible. This content is educational and does not replace urgent medical care.
Complications
- Rupture of the fallopian tube and severe life-threatening internal bleeding.
- Effect on future fertility.
- A psychological impact deserving support.
Prevention
- Treating pelvic infections and STIs early.
- Avoiding smoking.
- Early pregnancy follow-up, especially with risk factors or a previous ectopic pregnancy.
When to see a doctor
Go to the emergency department immediately for one-sided abdominal pain with vaginal bleeding in early pregnancy, especially if accompanied by shoulder pain, dizziness, fainting, or pallor. Any pregnant or period-late woman with these symptoms needs urgent evaluation, as ectopic pregnancy is a life-threatening emergency. Do not delay seeking medical help.