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Ectopic Pregnancy: Causes, Symptoms, Diagnosis & Treatment

ectopic pregnancy

What is an Ectopic Pregnancy?

Ectopic pregnancy occurs when a fertilized egg implants and grows outside the uterus, commonly in the fallopian tube. It is a serious and  potentially life-threatening condition requiring immediate medical attention.

The term “ectopic” originates from the Greek word ektopios, meaning “out of place.”

Incidence of Ectopic Pregnancy
  • 1-2% of natural conceptions result in ectopic pregnancies.
  • 4% of pregnancies conceived via assisted reproductive technology (ART) are ectopic.
  • 6% of maternal deaths in the first trimester are caused by ectopic pregnancies if left undiagnosed or untreated.
  • Many cases come as a surprise, turning the joy of pregnancy into a medical emergency. Ruptured ectopic pregnancies can lead to internal bleeding, shock, and even death.
  • With increased awareness and advanced diagnostic tools, early detection has reduced severe complications.

More than 90% of ectopic pregnancies occur in the fallopian tubes, but they can also occur in other locations:

  • Fallopian Tube (most common)
  • Ovary
  • Previous Cesarean Scar
  • Heterotopic Pregnancy (one pregnancy inside the uterus, another outside)
  • Abdominal Pregnancy (very rare)

Several risk factors increase the chances of ectopic pregnancy:

  • Multiple Sexual Partners
  • Infertility
  • Age (higher risk if under 18 or over 35)
  • Assisted Reproductive Techniques (ART)
  • Previous Ectopic Pregnancy
  • Tobacco Smoking
  • Tubal Ligation or recanalisation Surgery
  • Use of an Intrauterine Device (IUD)

Early Symptoms:

  • Nausea
  • Vomiting
  • Dizziness
  • Occasional lower abdominal pain
  • Vaginal spotting or irregular bleeding

Symptoms of Ruptured Ectopic Pregnancy:

  • Severe lower abdominal pain
  • Abdominal distension
  • Internal bleeding (can lead to shock and fainting)

Ectopic pregnancy is diagnosed using:

  • Clinical Examination by a gynecologist
  • Urine Pregnancy Test
  • Ultrasound (to detect pregnancy location and signs of rupture)
  • Serial Beta-hCG Blood Tests (to monitor pregnancy hormone levels)

Conservative (Non-Surgical) Approach:

  • Watchful Waiting: If detected early, doctors may monitor beta-hCG levels before intervening.
  • Medical Management: Methotrexate injections stop fetal cell growth. Patients require hospital monitoring for any complications.

Surgical Approach:

  • Laparoscopy (Minimally Invasive Surgery) – Gold standard for treatment
  • Tiny incisions are made on the abdomen.
  • Carbon dioxide gas inflates the abdomen for better visibility.
  • A laparoscope (camera-equipped instrument) guides the procedure.
  • The ectopic pregnancy is removed with minimal scarring and faster recovery.
  • Laparotomy (Open Surgery):
  • Used in emergency cases with severe internal bleeding.
  • Requires a larger abdominal incision (8-9 cm).

Types of Surgeries:

  • Salpingotomy/Salpingostomy (Preserving the fallopian tube)
  • Salpingectomy (Removal of the affected tube)

Diet:

  • Liquids can be started 6 hours post-surgery.

Mobilization:

  • Patients can start walking 4 hours after surgery.

Hospital Discharge & Follow-Up:

  • Most patients are discharged within 24 hours.
  • Follow-up is scheduled 6 days after surgery.
  • Shorter hospital stay
  • Less post-operative pain
  • Minimal scarring (small keyhole incisions)
  • Faster recovery compared to open surgery

A ruptured ectopic pregnancy can cause massive internal bleeding and shock. Emergency surgical removal of the pregnancy and damaged fallopian tube is the only life-saving option.

Many women successfully conceive after an ectopic pregnancy. Doctors generally recommend waiting for at least 3 months or 2 menstrual cycles before trying again.

Success Rates:

  • 65% of women conceive naturally within 18 months.
  • 85% of women conceive within 2 years.
  • Success depends on the health of the remaining fallopian tube.

Dr. Dimple Doshi is a highly experienced gynecologist specializing in ectopic pregnancy management. At Vardaan Hospital, Mumbai, she provides:

  • Expert Diagnosis & Treatment – Advanced ultrasound and laparoscopic techniques for accurate detection and treatment.
  • Personalized Care – Tailored treatment plans based on individual patient needs.
  • Minimally Invasive Surgery – Expertise in laparoscopic procedures for faster recovery and minimal scarring.
  • Comprehensive Women’s Health Services – Holistic care from diagnosis to post-treatment follow-ups.
  • Trusted & Experienced – Years of experience handling complex gynecological cases with high success rates.

For expert consultation on ectopic pregnancy, visit Dr. Dimple Doshi at Vardaan Hospital, Mumbai.

ICD-10 & CPT Codes for Ectopic Pregnancy

ICD-10 Codes:

  • O00.1 – Tubal pregnancy
  • O00.2 – Ovarian pregnancy
  • O00.8 – Other ectopic pregnancy (e.g., cervical or abdominal)
  • O00.9 – Unspecified ectopic pregnancy

CPT Codes:

  • 59120 – Surgical treatment without salpingectomy
  • 59121 – Surgical treatment with partial or total salpingectomy
  • 59150 – Laparoscopic treatment without salpingectomy
  • 59151 – Laparoscopic treatment with salpingectomy

For expert consultation on ectopic pregnancy, visit Dr. Dimple Doshi at Vardaan Hospital, Mumbai.