An ectopic pregnancy is a disorder where a pregnancy occurs outside the uterine cavity. The embryonic egg does not migrate to the uterus, and remains in the fallopian tube in the majority of cases. However, it may also implant itself elsewhere. Several factors have been identified as increasing the risk of having an ectopic pregnancy: the use of tobacco, certain types of birth control (namely microprogestatifs), IUDs, in vitro fertilization, and disorders affecting the tubes (salpingitis in particular).
An ectopic pregnancy is a pathological pregnancy.
Suggestive signs are:
- lack of menstruation;
- bleeding occurring outside of menstruation ;
- pelvic or lower abdominal pain.
The diagnosis is made after a gynecological consultation. Upon palpation, the gynecologist can trigger pain or feel a pelvic mass. An examination with a speculum and a complete vaginal examination will be performed. Two other exams are necessary to confirm the diagnosis of an ectopic pregnancy: a test to measure the amount of BHCG, a hormone that gradually increases in early pregnancy, and an ultrasound that confirms the absence of pregnancy in the uterine cavity. In the most severe cases, ectopic pregnancy can be detected after the rupture of a fallopian tube. In this case, abdominal bleeding will occur and must be treated quickly.
Hospitalization is indicated in cases of ectopic pregnancy. Monitoring is carried out during the treatment. Treatment is either medical or surgical depending on the progression and the location of the pregnancy. Medical treatment involves a drug, methotrexate, injected intramuscularly. The monitoring of the declining rate of BHCG will help to determine the end of the pregnancy. Another alternative is preferred if possible and requires the surgical aspiration of the pregnancy. In some cases, the entire fallopian tube should be removed; this procedure is called a salpingectomy.