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Tubal Pregnancy

Tubal Pregnancy

Tubal pregnancy is also known as ectopic pregnancy - a condition where the fertilized egg implants itself in the fallopian tubes or any other tissue outside of the uterus. Tubal pregnancy can be life threatening, if not attended to in time. This is because it can lead to the rupture of the pelvic organ and consequent hemorrhage. It can also affect the woman's ability to become pregnant later. Since it is impossible to carry a tubal pregnancy to term, it becomes imperative to resort to surgery to remove the products of conception since they cannot develop into a fetus. This is done without damage to fallopian tubes, as far as possible. This can be done with laparoscopy in non-emergency situations. Tubal pregnancy can happen to any woman but there are some causes that can increase the likelihood of such a pregnancy condition. Some of the causes for tubal pregnancy are: Pelvic Inflammatory Disease, endometriosis or tubal scarring. Infection of the fallopian tubes such as gonorrhea or chlamydia can lead to a tubal pregnancy. The risk of ectopic pregnancy is manifold in cases of pregnancy after tubal sterilization. The use of the 'morning after pill' - emergency contraception is often noticed as a cause for tubal pregnancy.

An ectopic pregnancy is usually detected in the first 5 - 10 weeks of pregnancy. Ultrasound tests and hCG levels in the blood can help in identifying an ectopic pregnancy. The rate of increase of hCG in the blood is much slower in the case of an ectopic pregnancy or a potential miscarriage. Lower progesterone levels can also be an indication of likely tubal pregnancy. A woman having a tubal pregnancy will experience lower abdominal pain with cramping. There may be abnormal vaginal bleeding and breast tenderness. Lower back pain is another symptom. Severe bleeding and hemorrhage is the most dangerous symptom of ectopic pregnancy and needs prompt medical attention. If there is an emergency situation, there may be a need for blood transfusion.

hCG blood test

hCG blood test or pregnancy blood test measures the accurate amount of pregnancy hormone, human chorionic gonadotropin (hCG) in the bloodstream. Pregnancy hormone hCG is produced by the placenta. It can be assessed in the blood and urine of a woman within 10 days of fertilization. hCG can be measured by:

Quantitative pregnancy blood test: This test measures the accurate amount of hCG in the blood of a woman and plays a vital role in assessing the age of the fetus. This test also helps in checking if the pregnancy is developing normally.

Qualitative pregnancy blood test: This test can only tell if there is hCG present in the blood and can give no further information. This test result is like the home based pregnancy test kit just giving a 'yes' or 'no'.

In men and non pregnant women, the typical levels of hCG is less than 5 international units per liter (IU/L). In pregnant women, it is about 5 - 100 during 24 to 28 days after last menstrual period (LMP). During 4 to 5 weeks after the LMP, the hCG is about 50-500 IU/L and peaks to about 12,000 - 270,000 IU/L during 14 - 16 weeks of pregnancy. High levels of hCG can signify multiple pregnancy or molar pregnancy or Down's syndrome. In non-pregnant women and in men, it can signify cancerous or non-cancerous tumor of the testicles or ovaries. Low values of hCG in pregnant women can signify ectopic pregnancy, death of baby or that the pregnancy is not proceeding the way it has to. It can also indicate a spontaneous miscarriage.

Amniocentesis

During the early days of pregnancy, amniocentesis is carried out on pregnant woman to find out if the developing fetus is free from certain abnormalities. This procedure involves certain invasive methods like inserting a hollow needle into the uterus of the woman through her abdominal wall to withdraw a sample of amniotic fluid that surrounds the fetus. Using ultrasound, the location of the fetus floating in the amniotic fluid is determined. The abdominal skin surrounding the area is cleaned. The procedure may be conducted either by injecting a local anesthetic in that area, or by just applying a tropical anesthetic around the area through which the needle is to be inserted. About 1 cc per week of gestation of the fetus is taken out from the amniotic fluid.

this procedure is used as a tool which can detect chromosomal disorders like Downs Syndrome and many rare metabolic disorders which are normally inherited. Some structural defects like spina bifida and anencephaly can be detected using this test. This procedure is normally carried out for women over the age of thirty five. It is recommended for women who had undergone a triple screen blood test during pregnancy and for those who have a family history of birth defects or some inherited metabolic disorders. This procedure may be conducted even in later stages of pregnancy to detect suspected problems like Rh-incompatibility or infection. This test is also used to determine lung maturity of the infant in the last trimester. A cell culture is done with the fetal cells taken out during the procedure and the analysis of the DNA is conducted to detect chromosomal abnormalities. It may take up to a month for the results to arrive. This is rated as a highly accurate procedure.

After the withdrawal of the amniotic fluid which takes only a few minutes, the pregnant woman is advised to be in bed for several hours, though the entire procedure will last for about 45 minutes. Doctors check the heart beat of fetus to ensure that it is normal. It is wise to call the health care provider, if the woman experiences fever, bleeding or leakage of amniotic fluid for a long time. Though the chances of infection or injury to the fetus are not ruled out, they are quite rare. There is also a slight chance of miscarriage, but the percentage is negligible. During later stages of pregnancy, a Doppler ultrasound is safer than amniocentesis because it is non-invasive. Anemia in the fetus can easily be detected using ultrasound by measuring the velocity of the blood flow in the middle cerebral artery.