Pregnancy

The ectopic pregnancy or eccyesis represents a complication of the pregnancy, in witch the embryo implants outside the uterus, in the fallopian tube (tubal pregnancy, occurs in 95% of the ectopic pregnancies), in the cervix, in the ovaries or in the abdomen. The ectopic pregnancies are not viable, but in rare exception they can be taken to due term. The ectopic pregnancies can put the mother’s life in danger because of the internal bleeding that may cause.

The signs of an ectopic pregnancy are either absent or subtle and are similar to the normal pregnancy symptoms. The clinical presentation of the ectopic pregnancy appears at 5 to 8 weeks after the normal menstruation period. For less developed countries, in witch the medical offices, clinics and hospitals don’t have modern technical the later presentation is more common.

The early signs of an ectopic pregnancy are:

• pain in the lower part of the abdomen, and sometimes inflammation ( some women may confuse this symptom with a strong stomach pain, or with a strong cramp);


• pain at the urination ( the pain may be sharp and associated with a sort of pressure in the lower part of the abdomen);


• mild pain and discomfort. (a corpus luteum on the ovary in a normal pregnancy may give very similar symptoms);


• mild vaginal bleeding (an ectopic pregnancy is a false pregnancy and falling levels of progesterone from the corpus luteum on the ovary cause withdrawal bleeding. This sign is similar and is usually confused to the 'implantation bleed' of a normal early pregnancy);


• mild pain while having a bowel movement

The women who have an advanced ectopic pregnancy usually experience pain and bleeding.

The women might experience bleeding vaginal and internal, caused by two discrete pathophysiologic mechanisms:

• external bleeding (determined by the falling progesterone levels);


• internal bleeding (determined by the hemorrhage from the affected fallopian tube).

Because of the similar symptoms, at this point the diagnose may be of miscarriage, ectopic pregnancy or early normal pregnancy ( the bleeding to represent the implantation of the fertilized egg into the uterus). The most common diagnosed put by the health care providers at this stage of the pregnancy is pelvic inflammatory disease instead of ctopic pregnancy

The severe medical problems caused by the bleeding of an ectopic pregnancy cause:

• lower back, abdominal, or pelvic pain;


• shoulder pain;


• cramping or  tenderness on one side of the pelvis;

The signs of an ectopic pregnancy can mimic symptoms of other diseases such as appendicitis, other gastrointestinal disorder, problems of the urinary system, pelvic inflammatory disease and other gynaecologic problems.

The causes of an ectopic pregnancy haven’t been identified, but health care providers think that the main risk factors for producing an ectopic pregnancy include:

• pelvic inflammatory disease;


• infertility;


• contraceptive intrauterine devices;


• tubal surgery;


• smoking;


• previous ectopic pregnancy;


• tubal ligation.

It is very important for all women to have regular gynecological check ups in order to detect in time the eventual gynecological problems that women may have and therefore to treat them and avoiding complications.