Diagnosis of Ectopic Pregnancy
Diagnosing an ectopic pregnancy involves a careful combination of medical history, physical examination, and tests. It’s important for women of childbearing age who have symptoms like abdominal pain, vaginal bleeding, or dizziness to be evaluated promptly.Medical History and Symptoms
To begin ectopic pregnancy diagnosis, doctors first ask about symptoms and personal history. Ectopic pregnancies often cause pain on one side of the abdomen or pelvis. This pain can start as mild and colicky but may become sharp or spread if the fallopian tube stretches or ruptures. Other symptoms can include dizziness, fainting, nausea, vomiting, shoulder pain, urinary problems, or rectal pressure. Knowing the date of the last menstrual period and any missed periods helps indicate if pregnancy is possible. Previous ectopic pregnancies and risk factors are also discussed.Physical Examination
After checking the symptoms and medical history, a thorough physical exam follows. Doctors check vital signs to see if the patient is stable, looking for signs like fast heart rate or low blood pressure. The abdomen is gently pressed to find areas of tenderness, which may suggest internal bleeding. A pelvic exam helps assess vaginal bleeding and look for abnormalities like cervical changes or signs of infection. The doctor also feels inside the pelvic area to check for masses or tenderness in the fallopian tubes or ovaries.Diagnostic Tests
The various diagnostic tests for ectopic pregnancy include:Pregnancy Test
A blood test is done to measure the pregnancy hormone hCG. In a normal pregnancy, hCG levels rise steadily. In an ectopic pregnancy, the levels may rise more slowly or stay low. The test is usually repeated 48 hours later to track the changes. These results also help doctors decide on the best treatment.
Ultrasound
A transvaginal ultrasound uses a small probe placed in the vagina to create clear images of the womb, fallopian tubes, and ovaries. This test often shows if the fertilised egg is implanted outside the womb. Sometimes, however, the pregnancy can be difficult to see. An abdominal ultrasound may also be used to confirm pregnancy or check for internal bleeding.
Keyhole Surgery (Laparoscopy)
If the diagnosis is still uncertain, doctors may suggest a laparoscopy. This is a minor surgery done under general anaesthesia. A thin camera is inserted through a small cut in the stomach, allowing the doctor to look directly at the womb and fallopian tubes. If an ectopic pregnancy is found, it may be treated during the same procedure.
Other Blood Tests
Additional blood tests may include a complete blood count to check for anaemia or blood loss. Doctors may also test the woman’s blood type in case a transfusion is required.
Monitoring and Further Evaluation
If the ultrasound and blood tests do not clearly locate the pregnancy, the case is called a pregnancy of unknown location. Doctors continue to monitor β-hCG levels and repeat ultrasounds to make a definitive diagnosis. In some cases, uterine aspiration can help differentiate between a normal pregnancy loss and an ectopic pregnancy.
You may also want to consider the Lifestyle and Health Issues That Increase the Risk of Ectopic Pregnancies
Treatment of Ectopic Pregnancy
Unfortunately, an ectopic pregnancy cannot be saved. Treatment is needed to prevent complications. The choice of treatment depends on the woman’s symptoms, hormone levels, and the size of the pregnancy.Expectant Management
If the pregnancy is very small and the woman has no symptoms, doctors may recommend close monitoring instead of immediate treatment.- Regular blood tests are done to check if hCG levels are falling.
- Light vaginal bleeding may occur; pads are advised instead of tampons.
- Mild abdominal pain may be managed with simple pain relievers like paracetamol.
- The woman is advised to return immediately if symptoms become severe.
Medical Treatment
If monitoring is not suitable, doctors may suggest methotrexate, a medication that stops the pregnancy from growing.- It is given as an injection.
- Blood tests are repeated to confirm that hormone levels are dropping.
- A second dose may be required if the first is not effective.
- If it does not work, surgery may be necessary.
Possible side effects include mild abdominal pain, nausea, vomiting, diarrhoea, or dizziness.
Surgical Treatment
In most cases, surgery is needed to remove the ectopic pregnancy.- Laparoscopy (keyhole surgery) is the most common. Small cuts are made in the abdomen, and surgical tools are used to remove the pregnancy.
- If the other fallopian tube is healthy, doctors may remove the affected tube completely. In some cases, only the pregnancy is removed, and the tube is left intact.
- If the tube has ruptured, emergency surgery is required. This may involve a larger incision (laparotomy) to control bleeding and repair or remove the tube.
Ectopic pregnancy is a serious condition that requires timely diagnosis and treatment. While it cannot continue safely, modern medical care offers several effective treatment options depending on each woman’s condition. Early consultation with a gynaecologist can help protect health, preserve fertility where possible, and prevent complications.
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FAQs on How is Ectopic Pregnancy Diagnosed and What Are the Various Treatment Options?
- Can a woman get pregnant again after an ectopic pregnancy?
Yes. In many cases, women conceive again successfully after an ectopic pregnancy. However, the chances depend on the health of the fallopian tubes and overall fertility. - Are there ways to prevent ectopic pregnancies in the future?
While not all cases of ectopic pregnancies can be prevented, reducing risks like smoking, untreated infections, or tubal damage may help.
