An ectopic pregnancy is a complication of pregnancy where the ovum is implanted in any tissue other than that of the uterine wall. Get tips and advice on diagnosing and preventing ectopic pregnancy in this medical video.
Consult doctor for persistent symptoms
Discuss treatment options with a doctor
Avoid smoking
Dr. Gibbons is an Obstetrician/Gynecologist with Cascadia Women's Clinic. She has a degree of Osteopathic Medicine from Des Moines University and did her residency training with Doctor's Hospital in Columbus, Ohio in affiliation with Ohio St. University. She enjoys her work and loves the people she works with.
DR. LISA GIBBONS: Hi. My name is Lisa Gibbons and I'm an obstetrician/gynecologist with Cascadia Women's Clinic in Vancouver, Washington. I'd like to talk with you today about ectopic pregnancy. This is a pregnancy that is found elsewhere besides inside the uterus, which is a correct position for a pregnancy, and it is not a pregnancy that is viable. Pregnancy is not viable unless it is inside the uterus. Most commonly, it's in the fallopian tube if it's an ectopic pregnancy but can be anywhere within the abdominal cavity, and the most common symptom of presentation is pain, early in the pregnancy. Also, ladies can present with some atypical bleeding early on, some spotting or amenorrhea or no period with pregnancy symptoms. We also may find an ectopic pregnancy by coming in on your first exam with a mass on exam. The diagnosis is typically made by clinical suspicion so a lady has to come in with the symptoms and then evaluating by a blood draws for the pregnancy hormone. The pregnancy hormone in the normal pregnancy typically elevates about 66% in 48 hours so if it's an ectopic pregnancy, it's usually not doing the normal elevations, and we can do serial blood draws and in conjunction with this, we will do an ultrasound. A transvaginal ultrasound is performed to evaluate where the pregnancy is. If we see a pregnancy hormone that's elevated and no pregnancy in the uterus then we need to be looking and finding where that pregnancy is. The treatment for this ultimately depends on the status of the patient. If the patient is stable then we have lots of different options including monitoring the patient and seeing if the pregnancy will resolve on its own. If the pregnancy hormone is low and is resolving then we just monitor closely with pregnancy hormones and ultrasounds but this needs to be in conjunction with and obstetrician/gynecologist closely following. Another option is methotrexate which is a chemotherapeutic agent that affects quickly dividing cells and has a strict criteria though for being able to be administered so I would strongly encourage talking to your obstetrician/gynecologist to see if this is an option for you. Another option is surgical treatment, most commonly laparoscope with evaluation and removal of the placement of the ectopic and any blood or products of conception. The rare situation where would be a patient coming in with an emergent rupture is an automatic surgical procedure, again, most commonly laparoscopic procedures but also can be also an open procedure depending on the stability of the patient. Prevention of this is largely due to the risk factors of acquiring an ectopic pregnancy, risk factors include any tubal damage or surgeries to your tubes, scarring to the fallopian tubes via infection or a sexually transmitted disease, patients who smoke have an increased risk of ectopic pregnancy, and IUD also has a small associated risk of ectopic pregnancy. One of the most common risk factors is having one prior ectopic pregnancy, so if you fall into this category or have pain early in a pregnancy, I would strongly encourage you to either go to the emergency room or talk to your obstetrician/gynecologist and have it evaluated to make sure that the pregnancy is in the correct location.
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