Ectopic Pregnancy: Learn About This Condition

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What is an Ectopic Pregnancy?
An ectopic pregnancy occurs when a fertilized egg implants itself outside of the uterus. The most common place for implantation to occur in an ectopic pregnancy is in the fallopian tubes, hence the moniker “tubal pregnancy”. However, the fertilized egg may also implant in the ovary, cervix or abdomen. It is extremely rare for an ectopic pregnancy to result in a live birth.

Because the egg implants itself somewhere other than the uterus, it is not able to develop properly. As the egg grows, it stretches the organ in which it has implanted itself. Eventually, this organ, most likely the fallopian tube, will burst, increasing a woman’s risk of hemorrhaging, which requires immediate medical attention.

Signs of Ectopic Pregnancy
On the surface, symptoms of ectopic pregnancy mimic those of pregnancy, making it difficult to notice the warning signs. In general, though, typical ectopic pregnancy symptoms include:

late period
irregular vaginal bleeding
lightheadedness, dizziness or fainting
pain in the abdomen, shoulder, bladder and/or bowel

The most notable signs of ectopic pregnancy are sharp, stabbing pains, particularly in the abdomen. If you have had a positive pregnancy test and notice any of these tubal pregnancy symptoms, make an appointment with your health care provider right away.

Diagnosing a Tubal Pregnancy
Due to increased awareness about ectopic pregnancies, more prenatal health care practitioners are screening their female patients for this pregnancy complication. This increased vigilance is part of the reason why maternal death rates are declining despite the fact that ectopic pregnancy numbers are going up.

In order to diagnose an ectopic pregnancy, your health care provider will first administer a pregnancy test (if you do not already have a positive pregnancy test). Once a pregnancy is confirmed, a blood test will be performed to evaluate your levels of hCG. In a healthy pregnancy, this hormone doubles roughly every two days until the 11th week pf pregnancy. However, in tubal pregnancies, hCG levels increase at a much slower rate.

In order to determine how your hCG levels are rising, your health care provider may monitor your levels over a period of days or she may calculate what they should be based on your last menstrual period and the approximate length of your pregnancy. Blood tests done to measure the level of progesterone in your system may also be helpful as an ectopic pregnancy often produces lower than normal progesterone levels.

An ultrasound is commonly done in the early stages of pregnancy to see how the fetus is developing. During this routine procedure, your health care provider will be able to see not only your uterus, but also your fallopian tubes and ovaries. During this exam, it is possible for your health care provider to see whether the embryo has implanted in the correct location or not.

Treating an Ectopic Pregnancy
Because it is unlikely that the embryo will survive when it is implanted somewhere other than the uterus, and due to the risk of organ rupture and possibly maternal death, ectopic pregnancies are normally terminated. So long as your fallopian tube has not ruptured, this can be accomplished through the use of methotrexate, an injection drug that dissolves the embryo, allowing the body to reabsorb it. This is often preferred as it is a noninvasive procedure and helps to reduce the amount of scarring to your reproductive organs.

If it is not possible to use methotrexate, the embryo may be flushed out through a salpinostomy or removed through laparoscopy. However, if the organ in which the embryo has implanted itself ruptures, an emergency laparoscopy must be performed to remove both the embryo and the organ, most likely the fallopian tube.

Once the embryo has been removed, you will receive follow-up care and monitoring. This is done to ensure that your hCG levels return to zero. If they do not go down, you may receive further treatment with methotrexate to dissolve any lingering embryonic tissue remaining in the tube.

Affects on Fertility
Experiencing a tubal pregnancy can affect your future ability to get pregnant. If scarring, trauma or damage has occurred to your reproductive organs, either because of the pregnancy or methods used to treat the ectopic pregnancy, it can make it more difficult to conceive in the future. Additionally, experiencing an ectopic pregnancy puts you at risk of suffering another one in the future.

However, just because you have had one ectopic pregnancy does not automatically mean you will be infertile. While losing a fallopian tube does reduce your chances of pregnancy to about 40%, pregnancy is still possible. Many women who have had a tubal pregnancy are able to successfully conceive again within a year of their ectopic pregnancy.

If you are concerned about your fertility, speak with your health care provider about what you can do to preserve your fertility as well as increase your chances of pregnancy after a tubal pregnancy.

Are You at Risk?
Certain factors can put a woman at increased risk of an ectopic pregnancy. In numerous incidents, a tubal pregnancy results due to a blockage or narrowing in the fallopian tube, preventing the fertilized egg from traveling to the uterus. Factors that can increase your risk of having an ectopic pregnancy include:

Pelvic inflammatory disease
STDs
Pregnancy over age 35
Previous surgery on the fallopian tubes
Previous ectopic pregnancy
Endometriosis
Use of certain ovulation medications

Moreover, if become pregnant while using an IUD, you have a significantly increased risk of developing an ectopic pregnancy.

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Your Belly Has Grown by the Time You are 25 Weeks Pregnant

By the time you are 25 weeks pregnant, you feel as if you are carrying around a soccer ball all the time. There is more to come and you will get bigger. One of the common experiences of women in the 25th week is leg cramps. These can be extremely painful and wake you from your sleep. Most of the time the cause is that you are not getting enough calcium in your diet, which is why you do have to ensure that you drink plenty of milk. if you are lactose intolerant, almonds, broccoli and fish are good sources of calcium that you should include in your diet. Soaking your legs in warm water and having leg massages really helps you avoid this pain.

You can find out whether you are having a boy or girl by the 25th week either through an ultrasound or a test called an amniocentisis. This test involves inserting a needle into the uterus to draw off some amniotic fluid and is also helpful in determining the health of the baby.  It is only done in cases where there may be complications in the pregnancy and an ultrasound is the normal route of determining the gender of the baby.

The baby at this point is about 13 inches long, which accounts for you feeling that you have a swollen belly. It doesn’t weigh a lot though usually less than 2 pounds. The babys skin, while still looking somewhat wrinkled, is starting to fill out with baby fat. If you have a 3D ultrasound done at this point, you may be able to see the color of the babys hair and eyes. The color usually changes, though, after the baby is born.

The babys arms and legs are about the same length they will be at birth in the 25th week. He/She can also breathe through the nose. The structures of the ligaments, bones and tissues are in place in the spine and the capillaries are forming in the circulatory system. This is what gives the baby a pinkish glow at this stage. The blood vessels are also starting to take shape in the lungs, which haven’tyet developed to allow the baby to breathe on its own.

Since the baby is able to hear, and has been able to do so for some weeks, you can read and talk to the baby. Entertaining it with music is a good idea as well, which you will notice in the increase of movement when you play music.

Even though you are taking folic acid supplements as recommended by your health care provider, you can increase the amount in your body through the foods you eat.  Broccoli is an excellent source of this mineral as well as calcium, but it will produce a large amount of gas in your digestive system. Maybe you might want to keep this food for eating at home when there are no guests around when your body makes embarrassing sounds.

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Pregnant women need milk and milk products for protein and calcium. You need extra calcium for your baby’s growing bones and teeth, as well as your own. Dieting during pregnancy is not recommended as it may result in a smaller and unhealthy baby, and it could also affect your health. Vigorous exercise is also not recommended.

Folate (known as folic acid when added to foods) is a B-group vitamin found in a variety of foods. Some breakfast cereals, breads and juices are fortified with folic acid. This will be listed on the nutrition label of these products.

As well as a healthy diet, it is also recommended that a folic acid supplement be taken prior to conception and for the first three months of pregnancy to reduce the risk of neural tube defects such as spina bifida. Folate taken over this period can prevent up to seven out of 10 cases of neural tube defects.

Eat four to six smaller meals a day instead of three bigger ones to help relieve the heartburn and discomfort you feel as your baby grows bigger.

Whether or not you’re pregnant, a healthy diet includes proteins, carbohydrates, fats, vitamins, minerals, and plenty of water. The U.S. government publishes dietary guidelines that can help you determine how many servings of each kind of food to eat every day. Eating a variety of foods in the proportions indicated is a good step toward staying healthy.

This is not the time to cut calories or go on a diet. In fact, it’s just the opposite – you need about 300 extra calories a day, especially later in your pregnancy when your baby grows quickly. If you’re very thin or carrying twins, you’ll need even more. But if you’re overweight, your health care provider may advise that you consume fewer extra calories. Healthy eating is always important, but especially when you’re pregnant. So, it’s important to make sure your calories come from nutritious foods so they can contribute to your baby’s growth and development.

Foods rich in protein such as lean meat and chicken, fish (aim for at least two servings of fish a week, including one of oily fish), eggs and pulses (such as beans and lentils). These foods are also good sources of iron.

Butter, ghee, milk, shrikhand, honey, fennel seeds, sweets made from jaggery rather than white sugar can also be taken in small quantity. Rice, pulao, Khichri, Murmure, Chapati, Bhakari, Paratha, Gujarati thepla are the items made from wheat and rice and are beneficial. Items such as bakery bread, bun, sandwich, pizza, handva, dhokla, khaman, idli, dosa, tomato, tamarind, curd, kadhi they increase the swellings and acidity. If such problems do not exist, you can take in small quantity. If you are allergic, do not take even if they are tasty.

During pregnancy, a woman’s body needs more iron than usual to produce all the blood needed to supply nutrition to the placenta. Good sources of iron are green vegetables such as broccoli and spinach, strawberries, muesli and whole meal bread.

Iron is more easily absorbed if it is taken in conjunction with vitamin C – either as a supplement or in citrus fruit or juice. Tea and coffee can interfere with the body’s absorption of iron.