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Ectopic Pregnancy

An Ectopic pregnancy is a pregnancy situated outside its normal location within the uterine cavity. The commonest site outside the uterus is in the fallopian tube. Though it can occur in a perfectly normal tube it usually occurs in a tube partly blocked due to infection or pelvic surgery.

Though at times there may be a history of a missed period , sometimes slight bleeding at the time of the missed period may confuse the issue. One constant feature of an ectopic pregnancy is pain on one or the other side in the lower abdomen. The danger associated with such a pregnancy is that eventually the tube can burst leading to haemorrhage of varying degree in the abdominal cavity. The pregnancy situated outside the uterus can never grow beyond a few weeks and needs to removed.

An ectopic pregnancy can usually be diagnosed by a combination of Beta HCG levels(a hormone test which detects pregnancy)  and sonography though at times laparoscopy maybe required to clinch the diagnosis. Very often an ectopic pregnancy can be identified and the tube possibly saved before it bursts. In most other cases, the tube needs to be surgically removed. Today most cases of ectopic pregnancy which require surgery can be managed through the laparoscope. Only a few cases require open surgery.

In select cases where the tube has not burst (Unruptured ectopic) it may be possible to arrest the growth of the pregnancy by an injection of an anti cancer drug Methotrexate . However there is a risk of the tube bursting with attendant emergency surgery while waiting for the pregnancy to regress. This method may also require initial hospitalisation besides repeated blood tests and sonographies till such a time that the pregnancy stops growing.

The possibility of a future natural pregnancy or the recurrance of an ectopic pregnancy would depend on the condition of the other tube and whether it was possible to conserve the affected tube. When both the fallopian tubes are damaged, pregnancy can still be achieved with IVF-ET.



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