During a normal, healthy pregnancy, the fertilized egg implants in the uterus. In an ectopic pregnancy, the fertilized egg gets stuck during its journey and instead implants elsewhere. These pregnancies are often called tubal or tubular because in most cases the egg implants in a woman's fallopian tubes. In rare cases tubular pregnancy can also occur in the ovary, abdomen or cervix. In all cases, early treatment can be lifesaving and preserve the chance for future healthy pregnancies.
Risk Factors
Tubular pregnancies are more likely when the fallopian tube is damaged, misshaped or has scar tissue. Sexually transmitted diseases like gonorrhea or Chlamydia can cause inflammation of the fallopian tubes and/or uterus and also increase the chance for an ectopic pregnancy. The presence of endometriosis, a condition that causes uterine tissue to develop outside the uterus, can also increase the risk. Pregnancies that occur while using birth control pills, intrauterine devices (IUDs) and ovulation stimulation medication for fertility can also elevate the risk for a tubular pregnancy. FamilyDoctor.org adds that women who smoke, are over the age of 35 or who have had a previous tubal pregnancy are also at higher risk for tubular pregnancy.
Symptoms
During an early tubal pregnancy, many women experience no symptoms or symptoms similar to those of a normal pregnancy in its early stages. The first warning signs of a tubular pregnancy include light vaginal bleeding together with cramping on one side of the pelvis and lower abdominal pain. As a tubular pregnancy advances, symptoms are more severe. They include sharp pains in the pelvis, abdomen or even the shoulder and neck; extreme dizziness/lightheadedness or even fainting; and the urge to defecate without results. These symptoms all require immediate medical attention.
Dangers
An undetected tubular pregnancy can be permanently life-altering, resulting in the loss of an ovary or a fallopian tube. If the fertilized egg continues to grow and causes the fallopian tube to rupture, life-threatening blood loss is possible, according to the Mayo Clinic.
Treatment
A pelvic exam, blood work and an ultrasound are usually performed to detect a tubular pregnancy. In cases where the fertilized egg is not implanted in the uterus, the uterus shape and size will remain unchanged, and blood work will indicate low levels of the growth hormone human chorionic gonadotropin (hCG). An ultrasound or sonogram will then be ordered to try and visually pinpoint the egg's location. To prevent life-threatening complications, the ectopic tissue must be removed. In an early pregnancy, the drug methotrexate is injected into the egg to make it dissolve and reabsorb into the body. When it is too late to use methotrexate, laparoscopic surgery is performed to remove the ectopic tissue and repair or remove the fallopian tube if necessary. During this surgery, a small incision is made near or in the naval in order to insert a tube. Surgical instruments are inserted in the tube, along with a video camera, to perform the operation.
Future Pregnancy
Successful pregnancy after an ectopic pregnancy is still possible for many women, according to the Mayo Clinic website, although FamilyDoctor.org points out women with an ectopic pregnancy are more likely to have another one. In the case of a damaged or removed fallopian tube, many are able to successfully conceive using the remaining tube. In vitro fertilization, where mature eggs are fertilized in a lab and implanted directly to the uterus, is also an option for women who wish to get pregnant following a tubular pregnancy.
