Ectopic Pregnancy

Definition: Implantation of the Fertilized ovum in a site other than the Uterine cavity is termed as Ectopic Pregnancy.

The commonest site is the Fallopian tube. This is often referred to as tubal pregnancy, even though implantation can occur in the ovary, cervix or peritonial cavity.

Causes: Previous pelvic inflammatory disease is by and large the main cause. Other possible causes are in-appropriate use of oral contraceptive pills, tubal surgery, etc.

The patient presents with one of the following symptoms along with a missed period, which may not always be mandatory:

• Fainting: usually a ruptured ectopic pregnancy has varying degrees of abdominal bleeding and hence the patient presents with shock, fainting, blackouts

• Pain: they can have chronic abdominal pain, acute episodes of bursting pain with fainting

• Vaginal bleeding

• Pallor: due to massive blood loss the patient looks very pale

The following investigations help the Gynaecologist come to a diagnosis:

• Urine pregnancy test

• Serum Beta HCG estimation

• Trans-vaginal sonography

• Laparoscopy

• Curettage

The thumb rule is to use as many investigations as possible to make a positive diagnosis of the condition so that the problem is not missed, as it can be really life threatening.