My Journey with Cushing’s disease
At 30 years old, I was fit, healthy and naturally a size 8โ10. I knew my body well, which is why, when it started to
I was so excited. My Uncle Sam and his wife were coming to visit us. She was the most beautiful girl I had ever seen, and I wanted to be just like her when I grew up.
I raced out of my room and into the living room. When I got there, I heard my mom say in a hushed, sad voice, โYes, they are still coming, but they lost the baby. She was showing signs of ectopic pregnancy. This time they had to remove one of her tubes. She might not ever have a baby now.โ
At age 12, I didnโt know what they were talking about. All I knew was that the sorrow was palpable before they even arrived. Iโll never forget my Aunt Sandy, sitting on our porch with silent tears streaming down her beautiful cheeks. I wasnโt supposed to know why, but I did.
Ectopic pregnancy can be fatal to the mother and almost always is to the developing fetus. Signs of ectopic pregnancy can be mistaken for other things, knowing them could save a life.
When a fertilized egg implants outside of the uterus it is referred to as an ectopic pregnancy. Most often found in the fallopian tubes, the embryo could also attach itself to an ovary, the cervix, or even the lower abdomen.ย ย
The signs and symptoms of ectopic pregnancy can start off relatively mild. As the embryo continues to develop, however, the symptoms can get more severe and painful. The earlier the problem is diagnosed, the better.
Ectopic pregnancy symptoms start faintly and may not even be noticed at first. Symptoms and signs of ectopic pregnancy at 4 weeks may include:
Because these symptoms occur so early, often before the person knows they are pregnant, and are โnormal early pregnancy symptomsโ; they may be written off entirely. Sometimes the first signal that something is not right, is when bleeding starts.
The signs of ectopic pregnancy at 6 weeks often include abdominal pain and irregular bleeding. However, if the embryo has not attached itself in the tubes, the symptoms may not come until later in the pregnancy.
Here are more symptoms that may present as the pregnancy progresses:
If a person has missed a period, had a positive pregnancy test, and/ or experiences these symptoms, they should see their doctor right away.
If the pregnancy continues too long, it can cause rupture or bursting. Here are the danger signs of ectopic pregnancy miscarriage symptoms:
These symptoms warrant a trip to the nearest emergency room.
There are several ways to diagnose ectopic pregnancies. Letโs look at them now.
Transvaginal ultrasound can be used to diagnose an ectopic pregnancy. In a study called, Ectopic pregnancy, Ultrasound, we learn: โEctopic pregnancy is a diagnosis that is quite challenging to make. It has been estimated that 40% of ectopic pregnancies go undiagnosed on initial presentation.
Ectopic pregnancy is also a very difficult condition to identify based on history and physical, with both the history and physical examination features being neither sensitive nor specific for the diagnosis. Data suggests that even experienced gynecologists are unable to detect more than half of the masses created by ectopic pregnancy on a physical exam. Due to the nature of the condition, laboratory data and diagnostic imaging are essential components of diagnosing ectopic pregnancy.
Ultrasonography is the diagnostic imaging study of choice for ectopic pregnancy. Even if an ectopic pregnancy cannot be visualized on ultrasound, diagnosing an intrauterine pregnancy greatly reduces the risk of an ectopic pregnancy being present.โ
โThere are findings on ultrasound that are indicative of possible ectopic pregnancy. Positive findings include an empty uterine cavity, decidual cast, a thick echogenic endometrium, or a pseudo-gestational sac in the presence of beta hCG levels above the discriminatory zone.โ
Blood tests can be performed to test the pregnancy hormone HCG levels.
A study called,Diagnosis and treatment of ectopic pregnancy reveals: โThus, demonstration of normal doubling of serum levels over 48 hours supports a diagnosis of fetal viability but does not rule out ectopic pregnancy, and a rising ฮฒ-hCG concentration that fails to reach 50% suggests a failing or ectopic pregnancy, as does a plateau. Falling levels confirm nonviability but do not rule out ectopic pregnancy.โ
Also known as keyhole surgery, this procedure sends a small tube with a light and camera on it into the abdomen through a small incision. This instrument, called a laparoscopy, can examine the uterus, fallopian tubes, ovaries, and abdominal cavity to find an ectopic pregnancy.
If a pregnancy is found attached where it shouldnโt be, surgical instruments can be sent in to remove it. With this procedure having another surgery later is eliminated.
Anyone who can become pregnant can experience an ectopic pregnancy. However, those who have had previous tubal or ectopic pregnancies could be at greater risk. Other things could also affect a higher chance of tubal pregnancy such as:
A person who is experiencing pregnancy with tube tied symptoms should see their doctor immediately. Fallopian tube pregnancy symptoms are nothing to take lightly.
The treatment options depend on the location and development of the pregnancy. The options include medication, laparoscopic procedures (as discussed above), and could even require emergency surgery.
The medication most commonly used for ectopic pregnancy is methotrexate. This medication, administered via injection, stops the growth of new cells and dissolves the pregnancy.
This method of treatment should only be done after pregnancy outside the uterus is confirmed. Doctors will closely monitor the patient to make sure the medication is working, and that a second dose is not necessary.
Blood tests will be done to check the pregnancy hormones. If the medication is working the hormone levels will go down.
In a study called, Methotrexate Treatment of Ectopic Pregnancy: Experience at Nizwa Hospital with Literature Review we learn, โMethotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. Intramuscular methotrexate has the advantage of tubal conservation and saves patients from requiring surgery.
โIt is easier to administer than the intraoperative route, which is by laparoscopy and needs expertise. Our study showed single dose methotrexate to be an effective treatment option for selected patients with unruptured tubal ectopic pregnancy.โ
In the case of rupture, heavy bleeding, or advanced development, emergency surgery may be required to save the patientโs life. Most of the time, if there is a rupture, the fallopian tube will need to be removed along with the pregnancy.
My Aunt Sandy was never able to have children, the technology and medical intervention available to her 30 years ago was not as advanced as it is today.
Many people who have experienced the loss of tubal pregnancy do go on to carry children to term. In cases where the fallopian tubes have been removed, other treatments, such as IVF, are available to help someone become pregnant.
Knowing the signs and symptoms, and being treated as early as possible, can go a long way. If you, or someone you know is experiencing symptoms of ectopic pregnancy, help is available.
Baker M, dela Cruz J. Ectopic Pregnancy, Ultrasound. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482192/
Murray, H., Baakdah, H., Bardell, T., & Tulandi, T. (2005). Diagnosis and treatment of ectopic pregnancy. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 173(8), 905โ912. https://doi.org/10.1503/cmaj.050222
Moini, A., Hosseini, R., Jahangiri, N., Shiva, M., & Akhoond, M. R. (2014). Risk factors for ectopic pregnancy: A case-control study. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 19(9), 844โ849.
Dhar, H., Hamdi, I., & Rathi, B. (2011). Methotrexate treatment of ectopic pregnancy: experience at nizwa hospital with literature review. Oman medical journal, 26(2), 94โ98. https://doi.org/10.5001/omj.2011.24
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