Between 2006 and 2021, the causes of an ectopic pregnancy were one of the ten things that Kenyan women searched on Google the most. This huge interest is not far-fetched. Ectopic pregnancies are some of the most dangerous complications during pregnancy.
According to the Johns Hopkins Medicine Hospital, ectopic pregnancy is usually the development of the fetus outside of the uterus. This can happen in the fallopian tubes, ovary, cervical canal, or the pelvic or belly. “In a normal pregnancy, the fertilized egg will usually implant and develop in the woman’s uterus. In an ectopic pregnancy, though, the egg will implant somewhere other than the uterus,” Johns Hopkins Medicine Hospital states.
Although an ectopic pregnancy can implant in other areas within the woman’s reproductive area, it mainly attaches in the fallopian tubes. According to Dr. Janet Thuthwa, an Obstetrician-Gynecologist based in Nairobi, this is one of the reasons why in some communities, in Kenya, ectopic pregnancies are referred to as ‘mimba ya mshipa’ or tubal pregnancies.
What causes ectopic pregnancies?
Dr. Thuthwa says that many women are not aware of what might or might not cause this type of pregnancy complication. This has led pregnant women and women who have lost their pregnancies as a result of ectopic pregnancies to attribute their pregnancy misfortune to things other than the true causes, most of which might be myths.
“On one hand, we have patents who claim that non-hormonal contraception may result in ectopic pregnancies especially with the Intra Uterine Device (IUD). On the other hand we have patients who claim that this type of pregnancy is the result of abusing over-the-counter morning after pills,” she says.
According to Obstetrician-Gynecologist Dr. Dana Christine, about 50 percent of the women who experience an ectopic pregnancy have no predetermined risk factors. This means that they experience an ectopic pregnancy without a reasonable medical issue.
“There are a few factors, though, that can increase the risk of developing an ectopic pregnancy. Women who undergo fertility treatments in order to get pregnant, as well as those who have undergone previous tubal surgeries or who have pelvic inflammatory disease are at higher risk,” says Dr. Christine.
This is echoed by the Johns Hopkins Medicine Hospital which cites that the cause of an ectopic pregnancy is usually the scar tissue in the fallopian tube caused by infection or disease (such as pelvic inflammatory disease (PID) and endometriosis) and the aggravated risk from tubal sterilization procedures, especially among women who were younger than age 30 at the time of sterilization.
“Endometriosis refers to a painful disorder in which tissue that is similar to the tissue that normally lines the inside of your uterus — known as the endometrium — grows outside your uterus. This condition most commonly involves the ovaries, fallopian tubes and the tissue lining the pelvis,” cites Johns Hopkins. Scar tissue from previous abdominal or fallopian surgeries has also been known to be risk factors among previous patients.
The symptoms
Initially after getting pregnant, it will be difficult to tell if you have an ectopic pregnancy. According to Johns Hopkins Medicine Hospital, this is because the signs and symptoms you will start to show will be those that indicate any other normal pregnancy. These will include missed periods, breast tenderness, nausea, vomiting, tiredness, and urinating frequently.
Nonetheless, beyond these symptoms, there are others that will exhibit that will you require urgent medical attention. According to Dr. Christine, the early signs and symptoms include abdominal pain, cramping and spotting early in pregnancy. Spotting early in the pregnancy will mostly occur at around the five to six week mark.
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The pain may be felt in the abdomen, pelvis, neck and even shoulder. The severity of this pain will range from mild and dull to severe and sharp. The other symptoms you may experience could include dizziness or fainting due to the blood loss, lower back pain, and low blood pressure due to blood loss.
Treatment
According to Johns Hopkins, there are times when an early ectopic pregnancy is treated with an injection of methotrexate. This method usually stops the growth of the embryo. The tissue involved is then absorbed by the woman’s body. This is echoed by Dr. Christine.
“When there are pointer symptoms of an ectopic pregnancy, we conduct an ultrasound and, or monitor hormone levels through regular blood draws. If and when an ectopic pregnancy is confirmed, we can sometimes treat the woman through medication, but surgical treatment to remove the abnormal pregnancy is often required,” she says.
She adds that the risk of an untreated ectopic can turn life-threatening where the pregnancy ruptures. “The longer an ectopic pregnancy goes on, the greater the chance that a fallopian tube will rupture.” To avert post-treatment health problems, a patient who has just undergone an ectopic pregnancy treatment procedure will be required to do follow-up clinics. These will help her to ensure that the pregnancy hormone levels she has been having have reverted back to normal.
“This may take several weeks. An elevated level could mean that some ectopic tissue was missed. If so, she might need more methotrexate or surgery,” cites Johns Hopkins Medicine. Interestingly, an ectopic pregnancy doesn’t mean that you won’t ever be able to conceive and carry your own baby.
“A woman who has had an ectopic pregnancy will still get pregnant again and eventually deliver a healthy, full-term baby,” says Dr. Thuthwa. She however cautions that if the woman had experienced conception problems prior to the occurrence of the ectopic pregnancy, there will be an element of risk that the ectopic pregnancy may occur again,” she says.
