Title: Ectopic Pregnancy
Objectives
In normal healthy pregnancy, sperm-egg recognition and binding then egg is fertilized. The
Fertilized egg begins to travel through fallopian tubes and is attached to the lining of the uterus
cavity. An ectopic pregnancy ( Tubal Pregnancy) occurs when a developing blastocyst implants
and grows outside the main cavity of the uterus most of the time in the fallopian tube.
Sometimes, an ectopic pregnancy could occur in other areas of the body, such as the ovary,
abdominal cavity or the lower part of the cervix. With extremely rare exceptions, the fetus can
not survive outside the uterus. Without treatment, the growing tissues may rupture, resulting in
destruction of the surrounding maternal structures and a massive blood loss that could be life
threatening. This needs medical emergency attention.
Methods
An ectopic pregnancy may have no signs, or may feel like a normal pregnancy at first with a
positive pregnancy test result for hCG. First clinical symptoms usually appear after 4 weeks from
the last normal menstrual period and may include abdominal pain, vaginal bleeding.
Ectopic Pregnancy happens when a fertilized egg gets stuck in the fallopian tube on its way to
the uterus, often because the fallopian tube is damaged by inflammation or cilias dysfunction.
Cilias help to move the egg through. Cilias reduction in number of cilia may cause the slow
down of the transport and lead to the stucking. Cilias degeneration may cause by hormonal
imbalances due to chemical,biological, surgical factors . In addition, abnormal development of
the fertilized egg also might play a role.
In the early stage of ectopic pregnancy detection, methotrexate may be injected to dissolve the
pregnancy tissue. In other cases, a keyhole surgery may be performed. If the fallopian tube has
ruptured, an emergency open surgery is required immediately. The ruputured tube is usually
removed.
Results
An ectopic pregnancy can't proceed normally. The fertilized egg can't survive, and the growing
tissue may cause life-threatening bleeding, if left untreated.
Tubal pregnancy symptoms often appear in the first trimester due to the lack of submucosal layer
within the fallopian tube wall. Fallopian tube wall consists of smooth muscle, an inner mucosal
lining and an outer layer of loose supporting tissue. Rapidly growing Fetus within the wall can
erode the muscular layers of the tube. This usually causes tubal rupture at around 7.2 weeks,
leading to hemorrhage and shock. Some rare cases happened on the fallopian tube to dilate to the
point of accommodating , but no more than a second- or third-trimester fetus.