Ectopic pregnancy

Recognised by physicians from at least the tenth century, an ectopic pregnancy is when a fertilized ovum develops and implants outside the womb, either in a Fallopian tube or, more rarely, in the abdominal cavity. The developing ovum outgrows its blood supply and dies, causing severe bleeding. This condition is rare. Less than 2% of pregnant women have an ectopic pregnancy.

SYMPTOMS AND TREATMENT

If you are experiencing severe pain in your abdomen (usually on one side), heavy vaginal bleeding and you feel faint (particularly if you have already had a positive pregnancy test), go to a hospital at once. If it is discovered to be an ectopic pregnancy, it can't be saved. The situation may be life threatening and will need prompt surgery. In serious cases, the affected fallopian tube may need to be removed. Sometimes an early ectopic pregnancy can "miscarry" itself, known as a tubal abortion, without your knowledge.

Common symptoms are lower abdominal pain, often on one side at the beginning, light bleeding, nausea and vomiting, dizziness or weakness, and/or pain in the shoulder or rectum. If the fallopian tube ruptures, the pain and/or internal bleeding can be severe, enough to cause fainting.

CAUSES OF ECTOPIC PREGNANCY

You are more likely to have an ectopic pregnancy if you have previously had an infection in your fallopian tube or a pelvic inflammatory disease or your fallopian tubes have been otherwise damaged. The chances also increase if you become pregnant while wearing a coil (IUD) or while taking the Mini-pill.

The rate of ectopic pregnancy increased more than fourfold between 1970 and 1990, in part because of damage to women's reproductive systems caused by sexually transmitted diseases, in particular chlamydia and gonorrhea, as well as pelvic inflammatory disease which is often, but not always, sexually transmitted.

Other causes of ectopic pregnancy include a previous ectopic pregnancy, the use of an intrauterine device (IUD), congenital abnormality of the fallopian tubes, the Pill (minipills, progestogen-only oral contraceptives), prior pelvic or abdominal surgery, and a failed tubal sterilisation. The consequences of an ectopic pregnancy depend on many factors and range from no damage to your reproductive organs to the complete removal of a ruptured fallopian tube.

ABORTION AND ECTOPIC PREGNANCY

You can still have a healthy pregnancy after having had an ectopic pregnancy, although your chances of conception are slightly reduced.

Ectopic pregnancy is not an issue in the abortion debate. The removal of an ectopic pregnancy is not an abortion and has never been considered as such either under the terms of the 1861 Offences Against the Person Act or the 1983 Eight Amendment to the Irish Constitution. Since the first description of the surgical management of ectopic pregnancy by Lawson Tait in 1884 there has never been even a suggestion that a doctor who removes an ectopic pregnancy should be prosecuted.

There has not been a single death from an ectopic pregnancy in Ireland over the last 20 years, where abortion is illegal.

In Britain, however, where abortion is legal, 4 - 6 women die from ectopic pregnancies each year.

Proof, if any were needed, that Ireland's maternal care is second to none and that our obstetricians have established life affirming alternatives to abortion.

DIAGRAM OF WHERE ECTOPIC PREGNANCY CAN LODGE

 

 

Miracle Baby - The ectopic pregnancy who survived

The treatment of ectopics gets better and better all the time with advances in medicine making it possible now to transfer the pregnancy from the tube into the uterus.

However some miracles do happen and the Kings College Hospital in London delivered a baby boy in 1999, who had grown inside his mother's fallopian tube together with two sisters who developed normally in the womb.  Jane Ingram, 32, had not been taking fertility drugs but discovered she was carrying triplets 18 weeks into the pregnancy. Ten weeks later, a routine scan revealed that one of the embryos had developed outside the womb in the fallopian tubes - a situation known as an ectopic pregnancy, which is potentially life-threatening.

In an ectopic pregnancy the woman's fallopian tube ruptures, usually leading to loss of the pregnancy and massive internal bleeding which can prove fatal for the mother. But in Ronan's case, when the tube ruptured the embryo attached itself to the mother's uterus and created its own "womb", with its own blood supply, in the mother's abdominal cavity.

Scans at the time showed only a normal twin pregnancy and it was not until much later doctors discovered the truth. Consultant obstetrician Dr Davor Jurkovic, who delivered Ronan, along with his two sisters, said it was a "miracle" that the triplets and the mother had survived.

And Mrs Ingram's bravery had been central to the success of the birth. "Jane was absolutely incredible. The attitude of the patient in situations like this is crucial and her attitude was always positive," he said.  

 

 

Ronan developed outside the womb