Ectopic pregnancy literally means "pregnancy in the wrong place", that is outside the womb. Statistically one in every 100 pregnancies ends up as a ectopic pregnancy. In case of this pregnancy the embryo implants in one of the fallopian tubes that is why the ectopic pregnancy is also called "tubal pregnancy". Ectopic prgnancy occurs if permeability oft he tube is decreased (mainly due to inflammation). In such a case the embryo may remain in the tube and get implanted to the tubal wall. After a few weeks this pregnancy can break the tube and the patient will have to be urgently operated.
Early symptoms of tubal pregnancy might be the same as those of the normal pregnancy: a missed menstrual period, fatigue, nausea, increased urination. First signs oft he tubal pregnancy may also include:
Having experienced one of this symptoms, please, don't hesitate to call an emergency. Treatment of an ectopic pregnancy can be conservative (some ectopic pregnancies are terminated spontaneously, with a tubal abortion), pharmacological (taking methotrexate) or surgical (performing a laparoscopy).
The treatment type depends on the physical condition of the patient, type of ectopic pregnancy and on the results of the ultrasound. The most common cause for the emergence of an ectopic pregnancy is the tubal inflammation. Chlamydia, staphylococcus and gonococcus infection cause damage to the mucous membrane, which impairs the fertilized egg, preventing it from further moving into the uterus.
The untreated endometriosis can lead to a relocation or constriction of the fallopian tube. Appendicitis can cause adhesions, which lead to a narrowing or obstruction of the fallopian tubes.
Tumors of the fallopian tube and uterine fibroids (benign tumors) can constrict the fallopian tubes from outside. Polyps in the fallopian tubes make also the barrier for a fertilized egg.
The poor quality of IVF also increases the risk of ectopic pregnancy. To cut the risk of ectopic pregnancy the team of the gynecology department emphasizes the importance of the early check-ups of pregnant women, improved imaging and early treatment of the tubal pregnancy. We also pay special attention to the quality of IVF procedure. Due the state-of-the-art technologies of assisted reproduction, the risk of tubal pregnancy after in vitro fertilization at the clinic of Friedrichshafen is reduced to zero.
In case of surgical treatment of fallopian tubes our specialists do their best to preserve the organ. In 30% of cases the tube gets badly damaged and must be partially or completely removed. Laparoscopy-assisted surgery (surgery using keyhole technology) allows to perform the surgery in a most sparing way. The laparoscopy is characterized with less blood loss, less pain and less adhesions in the abdominal cavity. There are two main methods of surgical treatment:
If the diagnosis is made early, in many cases of ectopic pregnancies both the fallopian tubes and the ovaries can be retained. In case of acute danger to life, severe adhesions and severe bleeding in the abdominal cavity a larger incision is made in the abdominal wall. After surgery beta-hCG controls will be continued to ensure that the ectopic pregnancy has been completely removed.
After successful removal of an ectopic pregnancy, be sure to go through and endocrinological examination, especially since hormonal problems may precede the actual ectopic pregnancy.
Basically women can get successfully pregnant even with one tube. After a fallopian surgery 50-60% of affected women can get pregnant over the remaining fallopian tube. If sterility (infertility) persists, it's possible to get a child via artificial insemination or in vitro fertilization. On averge after three IVF attempts around 90% of the treated women get pregnant. If due to persistent ectopic pregnancies, two tubes have been removed, the in vitro fertilization is the only chance for a woman to get pregnant.
The interdisciplinary team oft he Friedrichshafen Clinic would be glad to help you. If you have questions, concerning the treatment cost, methods and IVF success rates, please, do not hesitate to get in touch with our international office. If you suspect having the ectopic pregnancy, do apply for the professional medical help as soon as possible.