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Out of Place
Ectopic Pregnancy
By Michele St. Martin
She's pregnant. They're thrilled. Both husband and wife have all kinds of hopes and plans and dreams for this baby ... and then the pain begins, and they learn that no baby will be born as a result of this pregnancy. No, it's not a miscarriage: the pregnancy is ectopic.
The word "ectopic" means out of place, and that's exactly what an ectopic pregnancy is – a pregnancy where the embryo implants not in the uterine cavity but elsewhere, most often in one of the fallopian tubes. "However, in rare instances, the cervix, ovary or abdominal organs can be the site of abnormal implantation," says Dr. David Barrere, OB/GYN.
The classic symptoms of ectopic pregnancy include pain, amenorrhea (no menstrual period) and vaginal bleeding. However, only about 50 percent of women have these symptoms, says Dr. Barrere, who adds that abdominal or pelvic pain is the most common symptom. Many women with ectopic pregnancies have no symptoms at all.
Although in its early stages the symptoms of ectopic pregnancy can be few or none, an ectopic pregnancy that progresses can cause symptoms that are hard to miss, including severe, sharp abdominal pain, dizziness, fainting and shock. As the fetus grows in the fallopian tube, the risk of the tube rupturing – and of serious health and fertility consequences – increases.
"Physical examination may reveal a mass in the fallopian tube, but most commonly, only a vague tenderness can be elicited," says Dr. Barrere. Other ways to diagnose an ectopic pregnancy are through a sonogram (ultrasound) and through repeated administrations of a Beta pregnancy test, which measures the amount of pregnancy hormone in the woman's body. If the hormone level does not rise rapidly enough, a problem pregnancy (ectopic or miscarriage) is suspected. Dr. Barrere says that often combinations of these diagnostic methods are used.
