Treatments For Tubal Pregnancy
Out of all the pregnancies, one percent are Tubal pregnancies- also known as Ectopic pregnancies. It is a complication of pregnancy in which the fertilized egg attaches itself to the walls of the fallopian tubes instead of the walls of the uterus.
Unfortunately, such pregnancies cannot be converted back to normal pregnancies and the patient must be treated as its affects can be fatal, severely damaging the fallopian tube and damaging chances of future pregnancies. Hence the pregnancy must be terminated before the growing egg causes harm to the fallopian tube.
Tubal pregnancy can be caused if the fallopian tube is damaged. After the egg from the ovary has been fertilized in the tube, the tube moves the fertilized egg to the uterus. This happens as a result of combination of contractions of the muscles in the lining of the tube and due to the movement of fine hair- like cilia which are located on the internal surface.
Damage to the cilia is the main cause of ectopic pregnancy. STD infection, an abnormal shaped fallopian tube, excessive smoking, use of Intrauterine Contraceptive Devices (IUD) and repeated abortions also cause tubal pregnancies.
The symptoms include pain while urinating, while bowel movement and mild vaginal bleeding along with shooting pain in abdomen and pelvic region. At a later stage, the symptoms include heavy internal and external bleeding. This causes severe cramps.
The mother can undergo an ultrasound to determine whether her pregnancy is ectopic or normal. Or by monitoring the hCG (a hormone associated with pregnancy) levels which are different for normal and Tubal pregnancies.
Mostly all the tubal pregnancies are self- limiting as the embryo dies soon and the woman resumes with her menstrual cycles. It is often called a miscarriage. For the other cases, where the embryo starts growing, there are basically two treatment options available for Tubal pregnancies.
The first treatment avoids surgery completely. It is for those cases where the pregnancy is diagnosed as Tubal pregnancy in the first few weeks only. It involves the administration of antimetabolite methotrexate. It terminates the pregnancy by disrupting the growth of the embryo and by dissolving the ectopic cells.
However these methotrexate shots may cause some side- effects.
If the pregnancy is not treated during the first few weeks and if there is excessive blood loss then the second treatment is required, this is through surgical procedures.
There are two surgical treatments available, one being laprascopy. This surgery is done through small incisions at the belly button. This surgery has a short recovery time and the chances of hemorrhage are reduced along with less pain. The patient resumes all activity by the next day.
The other is one called a laparatomy which includes a larger cut in the lower abdomen. It is also called a 'bikini cut' as the scar is hidden even by a bikini. Surgery by laparatomy is carried out when the extent of damage to the fallopian tube is quite large, the incisions made are much bigger so that the fallopian tube can be easily removed.
In this case the recovery time is longer, almost five to six weeks. Only after then can the patient resume all activities.
When the tube is not damaged to a large extent, only the pregnancy tissue is removed. The fallopian tube is left as it is so that it heals. Usually the tube is left inside to allow future pregnancies but if the patient does not desire future fertility, the fallopian tube is removed.
In tubal pregnancies its best that the treatment is carried out as soon as possible to secure chances for future pregnancy and to avoid any permanent damage.
