Feb 2020 1st Edition

Ectopic pregnancy is a medical emergency

Written by Allison Cooper

The medical complications of ectopic pregnancies bring much heartache to expecting mothers. 

This is according to Dr Bushy Mhlari, the Senior Registrar Ectopic Obstetrics and Gynaecology at Dr George Mukhari Academic Hospital.

“In ectopic pregnancies, the fertilised egg implants on other body surfaces. In 98 percent of cases, the location of ectopic pregnancies is in the fallopian tubes. Uncommon locations include the ovary, abdominal cavity, cervix and the broad ligament,” said Dr Mhlari.

When this happens, the embryo cannot be transplanted and ending the pregnancy is the woman’s only option.

He explained that an ectopic pregnancy is not located in the cavity of the uterus, where a pregnancy is normally located.

Adding that normally, after fertilisation of the egg by the sperm - which occurs inside the fallopian tube, the fertilised egg travels through the tube to the rich uterine cavity where it attaches to the endometrial lining and the baby develops.

Dr Mhlari said a woman has a higher chance of an ectopic pregnancy if she has;

  • damaged or abnormal fallopian tubes, such as from past tubal infections from sexually transmitted infections or tubal surgery;
  • had a previous ectopic pregnancy;
  • has infertility;
  • has multiple sexual partners;
  • smokes cigarettes.

“Ruptured ectopic pregnancy is a life-threatening condition and is the leading cause of pregnancy-related maternal death in the first three months of pregnancy. The incidence of ectopic pregnancy is approximately two percent in the general population,” said Dr Mhlari.

Signs of an ectopic pregnancy

According to Dr Mhlari, the symptoms appear early in pregnancy. Sometimes, even before the woman realises that she is pregnant.

Common symptoms include;

  • lower abdominal pain,
  • a missed menstrual period;
  • vaginal bleeding.

“However, some women have no symptoms until the fallopian tube ruptures. When this happens, the woman may experience severe pain and some may have vaginal bleeding. This is followed by dizziness, a drop in blood pressure, fainting, shock and death if treatment is delayed,” he said.

To diagnose an ectopic pregnancy, a blood or urine pregnancy test is done to confirm that the woman is pregnant. “An ultrasound is then done to confirm if the uterus is empty and to see where the embryo is in the woman’s body,” said Dr Mhlari.

Treating an ectopic pregnancy

“Once an ectopic pregnancy is diagnosed it must be treated to stop its growth, because the woman’s life is at risk if treatment is delayed,” said Dr Mhlari.

“Surgery remains the first choice treatment of an ectopic pregnancy however, early diagnosis allows the option of medical treatment before the ectopic pregnancy ruptures,” he added.

Dr Mhlari said that a woman can still conceive after an ectopic pregnancy.

Women who suspect that they have an ectopic pregnancy must consult their general practitioner, local hospital or clinic as soon as possible.

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