Definition of Ectopic pregnancy
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Our Ectopic pregnancy Main Article provides a comprehensive look
at the who, what, when and how of Ectopic pregnancy
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< b>Ectopic pregnancy: A pregnancy that is not in the uterus. The fertilized
egg settles and grows in any location other than the inner lining of the uterus.
The large majority (95%) of ectopic pregnancies occur in the Fallopian tube. However,
they can occur in other locations, such as the ovary, cervix, and abdominal cavity.
An ectopic pregnancy occurs in about 1 in 60 pregnancies. Most ectopic pregnancies
occur in women 35 to 44 years of age. The term "ectopic" comes from the Greek "ektopis"
meaning "displacement" ("ek", out of + "topos", place = out of place). The first
person to use "ectopic" in a medical context was the English obstetrician Robert
Barnes (1817-1907) who applied it to an extrauterine pregnancy: an ectopic pregnancy.
Ectopic pregnancies are frequently due to an inability of the fertilized egg
to make its way through a Fallopian tube into the uterus. Risk factors predisposing
to an ectopic pregnancy include:
- Pelvic inflammatory disease (PID) which can damage the tube's functioning
or leave it partly or completely blocked;
- Surgery on a Fallopian tube;
- Surgery in the neighborhood of the Fallopian tube which can leave adhesions
(bands of tissue that bind together surfaces);
- Endometriosis, a condition in which tissue like that normally lining the
uterus is found outside the uterus;
- A prior ectopic pregnancy;
- A history of repeated induced abortions;
- A history of infertility problems or medications to stimulate ovulation;
and
- An abnormality in the shape of the Fallopian tube, as with a congenital
malformation (a birth defect).
A major concern with an ectopic pregnancy is internal bleeding. If there is any
doubt, seek medical attention promptly.
Pain is usually the first symptom of an ectopic pregnancy. The pain is usually
sharp and stabbing. It is often on one side and may be in the pelvis, abdomen or
even in the shoulder or neck (due to blood from a ruptured ectopic pregnancy building
up under the diaphragm and the pain being "referred" up to the shoulder or neck).
Weakness, dizziness or lightheadedness, and a sense of passing out upon standing
can represent serious internal bleeding, requiring immediate medical attention.
Diagnosis of an ectopic pregnancy includes a pelvic exam to test for pain, tenderness
or a mass in the abdomen. The most useful laboratory test is the measurement of
the hormone hCG (human chorionic gonadotropin). In a normal pregnancy, the level
of hCG doubles about every two days during the first 10 weeks whereas in an ectopic
pregnancy, the hCG rise is usually slower and lower than normal. Ultrasound can
also help determine if a pregnancy is ectopic, as may sometimes culdocentesis, the
insertion of a needle through the vagina into the space behind the uterus to see
if there is blood there from a ruptured Fallopian tube.
Treatment of an ectopic pregnancy is surgery, often by laparoscopy today, to
remove the ill-fated pregnancy. A ruptured tube usually has to be removed. If the
tube has yet not burst, it may be possible to repair it.
The prognosis (outlook) for future pregnancies depends on the extent of the surgery.
If the Fallopian tube has been spared, the chance of a successful pregnancy is usually
better than 50%. If a Fallopian tube has been removed, an egg can be fertilized
in the other tube, and the chance of a successful pregnancy drops somewhat below
50%.
Common Misspellings: ectopic pregnacy, ectopic pregancy, ectopic pregency, ectopic
pregnanacy, eptopic pregnancy, eptopic pregnacy, eptopic pregancy, eptopic pregency,
eptopic pregnanacy
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