Ectopic Pregnancy

Ectopic pregnancy is a life-threatening condition where a fertilized egg implants and begins to develop outside the uterine cavity.

In over 95% of cases, the implantation occurs in the fallopian tube (known as tubal pregnancy), but it can also occur in the ovary, abdomen, or cervix. Since the fallopian tube is not designed to sustain a growing embryo, this leads to serious complications, the primary one being a rupture of the tube.

Risk Factors and Symptoms

Key risk factors include a previous pelvic inflammatory disease (PID), endometriosis, previous fallopian tube surgery, or a prior ectopic pregnancy. Symptoms usually appear between the sixth and tenth weeks of pregnancy. They may include light vaginal bleeding (different from a normal period) and pelvic or abdominal pain, often localized to one side. In the case of a rupture, there is a sudden, sharp, and extremely severe pain accompanied by symptoms of internal bleeding and shock (e.g., dizziness, fainting).

Diagnosis and Treatment

Ectopic pregnancy is a medical emergency. Diagnosis is made through a combination of a blood test to monitor beta-hCG hormone levels (which are present but do not rise normally) and an ultrasound that shows the absence of a gestational sac in the uterus and often visualizes a mass in the fallopian tube. Treatment is mandatory, as the pregnancy cannot be sustained. Depending on the patient’s stability and the size of the tube:

• Medication Treatment: Methotrexate (a cytostatic drug) is used to stop the development of the embryo if the pregnancy is early and there is no rupture.
• Surgical Treatment: Performed through laparoscopy to remove the ectopic pregnancy, and in case of rupture or severe damage, to remove the affected fallopian tube.

Synonyms: Low hCG levels during pregnancy, Ruptured tube, Pregnancy outside the uterus, Tubal pregnancy