A topical pregnancy

Ectopic Pregnancy (for Parents) - Nemours KidsHealth

What Is an Ectopic Pregnancy?

In a normal pregnancy, the fertilized egg implants and develops in the uterus. In an ectopic pregnancy, the egg implants somewhere other than the uterus — often, in the fallopian tubes. This is why ectopic pregnancies are commonly called "tubal pregnancies." The egg also can implant in the ovary, abdomen, or the cervix.

None of these areas has the right space or nurturing tissue for a pregnancy to develop. As the fetus grows, it will eventually burst the organ that contains it. This can cause severe bleeding and endanger the mother's life. A classical ectopic pregnancy does not develop into a live birth.

What Are the Signs & Symptoms of an Ectopic Pregnancy?

Ectopic pregnancy can be hard to diagnose because symptoms often are like those of a normal early pregnancy. These can include missed periods, breast tenderness, nausea, vomiting, tiredness, or frequent urination (peeing).

Often, the first warning signs of an ectopic pregnancy are pain or vaginal bleeding. There might be pain in the pelvis, abdomen, or even the shoulder or neck (if blood from a ruptured ectopic pregnancy builds up and irritates certain nerves). The pain can range from mild and dull to severe and sharp. It might be felt on just one side of the pelvis or all over.

These symptoms also might happen with an ectopic pregnancy:

vaginal spotting
dizziness or fainting (caused by blood loss)
low blood pressure (also caused by blood loss)
lower back pain

What Causes an Ectopic Pregnancy?

An ectopic pregnancy usually happens because a fertilized egg couldn’t quickly move down the fallopian tube into the uterus. The tube can get blocked from an infection or inflammation. The tube can get blocked from:

pelvic inflammatory disease (PID)
endometriosis, when cells from the lining of the uterus implant and grow elsewhere in the body
scar tissue from previous abdominal or fallopian surgeries
rarely, birth defects that changed the shape of the tube

How Is an Ectopic Pregnancy Diagnosed?

If a woman might have an ectopic pregnancy, her doctor may do an ultrasound to see where the developing fetus is. Often, pregnancies are too small to see on ultrasound until more than 5 or 6 weeks after a woman’s last menstrual period. If an external ultrasound can’t show the pregnancy, the doctor might do the test with a wand-like device in the vagina.

A woman might need testing every few days if the first tests can’t confirm or rule out an ectopic pregnancy.

How Is an Ectopic Pregnancy Treated?

How doctors treat an ectopic pregnancy depends on things like the size and location of the pregnancy.

Sometimes they can treat an early ectopic pregnancy with an injection of methotrexate, which stops the growth of the embryo. The tissue usually is then absorbed by the woman’s body.

If the pregnancy is farther along, doctors usually need to do surgery to remove the abnormal pregnancy.

Whatever treatment she gets, a woman will see her doctor regularly afterward to make sure her pregnancy hormone levels return to zero. This may take several weeks. An elevated level could mean that some ectopic tissue was missed. If so, she might need more methotrexate or surgery.

What About Future Pregnancies?

Most women who have had an ectopic pregnancy can have normal pregnancies in the future. Having had one ectopic pregnancy does increase a woman’s risk of having another one.

What Else Should I Know?

Any woman can have an ectopic pregnancy. But the risk is higher for women who are older than 35 and those who have had:

PID
a previous ectopic pregnancy
surgery on a fallopian tube
infertility problems or medicine to stimulate ovulation

Some birth control methods also can affect a woman's risk of ectopic pregnancy. Those who become pregnant while using an intrauterine device (IUD) might be more likely to have an ectopic pregnancy. Smoking and having multiple sexual partners also increase the risk of an ectopic pregnancy.

When Should I Call the Doctor?

If you believe you're at risk for an ectopic pregnancy, meet with your doctor to talk about your options before you become pregnant. If you are pregnant and have any concerns about the pregnancy being ectopic, talk to your doctor — it's important to find it early. Your doctor might want to check your hormone levels or schedule an early ultrasound to ensure that your pregnancy is developing normally.

Call your doctor right away if you're pregnant and having any pain, bleeding, or other symptoms of ectopic pregnancy.

What Is Ectopic Pregnancy? | Definition and Treatment

In This Section

Ectopic Pregnancy

How do I know if I have an ectopic pregnancy?

Ectopic pregnancy is when a pregnancy grows outside of your uterus, usually in your fallopian tube. Ectopic pregnancies are rare but serious, and they need to be treated.

What’s an ectopic pregnancy?

Normal pregnancies develop inside your uterus, after a fertilized egg travels through your fallopian tube and attaches to your uterine lining. Ectopic pregnancy is when a fertilized egg attaches somewhere else in your body, usually in your fallopian tube — that’s why it’s sometimes called “tubal pregnancy.”

Ectopic pregnancies can also happen on your ovary, or somewhere else in your belly.

Ectopic pregnancies are rare — it happens in about 2 out of every 100 pregnancies. But they’re very dangerous if not treated. Fallopian tubes can break if stretched too much by the growing pregnancy — this is sometimes called a ruptured ectopic pregnancy. This can cause internal bleeding, infection, and in some cases lead to death.

Am I at risk for an ectopic pregnancy?

We don’t always know the cause of ectopic pregnancy. But you may be more likely to have an ectopic pregnancy if you:

have had an STD, pelvic inflammatory disease or endometriosis
have already had an ectopic pregnancy
have had pelvic or abdominal surgery
are 35 or older
smoke cigarettes

If you get pregnant after you’ve been sterilized or while you have an IUD, it’s more likely to be ectopic. But this is very rare, because these types of birth control are super effective at preventing pregnancy.

Can I get pregnant again after an ectopic pregnancy?

Most people who have an ectopic pregnancy can have healthy pregnancies in the future, depending on the treatment you had and the condition of your fallopian tubes. If one of your fallopian tubes was removed or your tubes are scarred, it may be more difficult to get pregnant. If you have an ectopic pregnancy, you’re more likely to get another one in the future.

New study helps to better understand the impact of COVID-19 on pregnant women and their babies

New study helps better understand the impact of COVID-19 on pregnant women and their babies

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New study helps to better understand the impact of COVID-19 on pregnant women and their babies

WHO / Blink Media - Nana Kofi Acquah
Woman waiting for postpartum care visit, Ghana

Last updated: March 17, 2022

Fewer than 2% of newborns whose mothers were infected with SARS-CoV-2 at the time of birth have been diagnosed with coronavirus, according to new data. At the same time, it is important that the symptoms of the disease develop in an even smaller number of newborns.

The study also demonstrates the importance of skin-to-skin contact between mother and newborn. Natural childbirth and breastfeeding do not increase the risk of SARS-CoV-2 transmission to the newborn.

These data were obtained as part of what is known as the “ongoing systematic review”, an ongoing global study that collects and summarizes data on the status of pregnant women infected with COVID-19 in various countries of the world. The study is led by a team of scientists from the University of Birmingham (United Kingdom), as well as the World Health Organization and the UN Special Program on Reproductive Health person and a number of other partners.

Risks for newborns and mothers

Although mother-to-child transmission appears to be rare, the study found that pregnant women or women who have recently post-pregnant women who contract COVID-19 are at higher risk of being admitted to an intensive care unit or needing respiratory support compared to non-pregnant women of reproductive age.

Pregnant women with COVID-19 are also more likely to have a preterm birth. According to the study, every fourth baby born to a mother with COVID-19 is admitted to the neonatal unit, but data on the reasons for hospitalization are not available. At the same time, stillbirth and neonatal mortality rates are low.

As in the general population, pregnant women are at increased risk of developing severe complications from COVID-19 if they have underlying medical conditions such as diabetes or hypertension; ethnic groups are also at higher risk groups with dark skin, women bearing a child at a later age or overweight.

“ Evidence tells us that regardless of whether you are pregnant, you are at increased risk for comorbidities such as diabetes or high blood pressure, ,” comments situation, one of the authors of the study, Mercedes Bonet.

Health relevance of the study

Health care professionals should understand that pregnant women with COVID-19 and their newborn babies may be more likely to need specialized care and ensure that they are able to receive such care. This is especially true for pregnant women with COVID-19who have other comorbidities or risk factors.

It should also be emphasized that a woman's right to a positive pregnancy and birth experience must be protected whether she is infected with COVID-19 or not. Find out more

In addition, it is important to consider that COVID-19 increases levels of stress and anxiety, and such experiences are particularly common among pregnant and newly pregnant women, as well as their partners, children and family members; and health professionals must also be competent and responsive in responding to the needs of pregnant women.

WHO continues to further study the specifics and risk periods of vertical transmission of SARS-CoV-2. Learn more

COVID-19 and pregnancy

Little is known about the impact of COVID-19 on pregnant women and infants at this time.

Good afternoon. I am an obstetrician-gynecologist, candidate of medical sciences Yelatentseva Irina Gennadievna.

Today I will present you information about the current problem:

COVID 19 and pregnancy

There is currently little information about the impact of COVID 19 on pregnant women and infants.

The available data do not indicate a more severe course of COVID 19 in pregnant women compared to the general adult population

According to WHO experts, pregnant women are susceptible to coronavirus infection due to changes in the immune and respiratory systems.

The high risk group for developing severe forms of COVID 19 is pregnant women with somatic diseases: chronic lung diseases, arterial hypertension, diabetes mellitus, obesity, kidney and liver diseases, antiphospholipid syndrome.

It is currently unknown if a pregnant woman with corona virus can transmit the virus to her baby during pregnancy or childbirth. Transmission of coronavirus from mother to fetus during pregnancy is unlikely. Cases of infection in born children have been attributed to close contact with a sick mother or other caregivers.

Complications in pregnant women with COVID 19 include: miscarriages, fetal growth retardation, preterm labor, and operative labor.

Forms of the clinical course of coronavirus infection in pregnant women:

Asymptomatic course (carriage). A positive laboratory test result without symptoms of the disease.

Mild and moderate course without the development of pneumonia or with the development of moderate pneumonia.

Severe course with the development of acute respiratory failure.

Extremely severe course with the development of acute respiratory failure, septic shock, multiple organ failure syndrome.

In what cases can coronavirus infection be suspected in pregnant women?

1. These are cases of clinical manifestations of acute respiratory infection (body temperature rise above 37.5 degrees, sore throat, runny nose, decrease in smell and taste, cough, shortness of breath, feeling of stuffiness in the chest, decrease in blood oxygen saturation) in the presence of at least one from epidemiological signs (return from a foreign trip within 14 days before the onset of symptoms or close contact in the last 14 days with a person who is ill or has laboratory-confirmed coronavirus or works with patients with confirmed or suspected cases of COVID 19.

2. The presence of clinical manifestations of severe pneumonia with characteristic changes in the lungs according to computed tomography or plain chest x-ray, regardless of the result of the test for coronavirus.

Features of the use of diagnostic methods in pregnant women:

Computed tomography of the chest organs. This is the main diagnostic method that can be reasonably used during pregnancy, with the consent of the patient and protection of the abdomen with an X-ray protective apron.

Magnetic resonance imaging without the use of contrast. Can be performed at any stage of pregnancy for diagnosis and differential. diagnosis of lung injury.

Indications for hospitalization of pregnant women with COVID 19 are moderate and severe forms of the disease. In mild forms, a pregnant woman can receive treatment at home under the supervision of a local therapist and an obstetrician-gynecologist of the antenatal clinic.

All obstetrician-gynecologists are unanimous in their opinion that in a pandemic, pregnancy management should not be interrupted, all necessary examinations should be performed in a timely manner, according to the gestational age. Denial of antenatal care will lead to a high risk of maternal and perinatal mortality.

But !!! Of course, during a pandemic, there are features of observing pregnant women.

ultrasound research. Screenings of the 1st and 2nd trimester are mandatory, screening of the 3rd trimester is performed in the maternity hospital. The rest of the ultrasound examinations are carried out strictly according to indications.

Appoint visits to patients with the maximum possible interval.

Remote consultations are allowed.

Pregnant women should be in touch with their doctor, talk and discuss all their concerns. This is very important in conditions of increased stress and uncertainty.

It is recommended to observe social distancing and use a face mask when visiting antenatal clinics and hospitals.

Management of COVID 19 up to 12 weeks of gestation:

With a mild course of infection, due to an unproven negative effect on the fetus, pregnancy is possible.

With a moderate and severe course of the disease up to 12 weeks of gestation, due to a high risk of perinatal complications associated with both the indirect effect of a viral infection (hyperthermia) and the embryotoxic effect of the drugs used in the treatment, it is possible to terminate the pregnancy after recovery. If the patient refuses to terminate the pregnancy, a biopsy of the chorionic villi or placenta is necessary at a period of 12-14 weeks or amniocentesis at a period of 16 weeks to exclude fetal CA, which is performed at the request of the patient.

With regard to pregnancy planning in a natural way or by IVF, the recommendations of all international and Russian associations of reproduction are advised not to plan.

I hope the information provided will be useful, and most importantly, it will help reduce the level of anxiety for our expectant mothers.

Thank you for your attention.
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