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Ectopic pregnancy is a medical condition where a fertilised egg implants outside the uterus, usually in the fallopian tube. Though it accounts for only a small percentage of all pregnancies, it is a serious situation for an expectant mother to be in. If left untreated, the growing embryo can cause the tube to rupture and lead to internal bleeding. 

While any woman can have an ectopic pregnancy, factors that increase risk include previous ectopic pregnancies, inflammation or infection of the fallopian tube, fertility treatments, certain medical conditions, smoking, and age.

Amid the concern, there’s an undercurrent of hope. For one, medical advancements have come a long way to prevent and address ectopic pregnancy. Moreover, with early detection, timely intervention, and the support of an obstetrics and gynaecology specialist, many women successfully navigate this challenging circumstance — to recover, heal, and look forward to future opportunities of motherhood.

Book a consultation with Dr. Pam Tan today.

 

Common Signs and Symptoms of Ectopic Pregnancy

Ectopic pregnancy can be difficult to diagnose because the early signs and symptoms are similar to those of a normal pregnancy. However, as the fertilised egg grows in the wrong place, indications of the condition become more noticeable. 

  • Abnormal Vaginal Bleeding can range from light spotting to heavy bleeding and may be accompanied by cramping.
  • Pelvic Pain and Cramping, from mild to severe; may be felt on one side of the pelvis or all over. It may also be accompanied by low back pain.
  • Shoulder Pain is a less common symptom but can occur if blood from a ruptured ectopic pregnancy builds up and irritates certain nerves.
  • Feeling Lightheaded or Faint may be caused by blood loss and low blood pressure.

Word to the wise: not all women with ectopic pregnancy experience symptoms, and some may have symptoms that are similar to other conditions such as gastroenteritis, urinary tract infection, pelvic inflammatory disease, and miscarriage, which are the most common ways to misdiagnose an ectopic pregnancy. If you experience any of these symptoms and think you might be pregnant, it is important to seek medical advice as soon as possible.

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Diagnosing Ectopic Pregnancy

Identifying an ectopic pregnancy can be difficult as its initial signs often mimic a typical pregnancy. However, with modern medical technology and availability of extensive information, doctors can more accurately and promptly detect these cases. The following are common diagnostic procedures conducted in suspected ectopic pregnancies.  

  • Pelvic Examination. Your OB-GYN will conduct visual and bimanual examinations, and palpate your abdomen to detect tenderness in or an enlarged, tender fallopian tube.
  • Blood Tests. To test for the hormone human chorionic gonadotropin (hCG). In a normal early pregnancy, the hCG levels double approximately every two days. Slower-than-expected increases can indicate an ectopic pregnancy.
  • Ultrasound. The most common and effective way to diagnose an ectopic pregnancy. Through transvaginal ultrasound, where the ultrasound probe is inserted into the vagina, your OB-GYN can get a clearer view of the womb to see where the embryo has implanted.
  • Laparoscopy. If other methods don’t provide a clear-enough picture, your doctor might use a laparoscope — a slender, flexible instrument — inserted through a small incision in the abdomen to view the fallopian tubes directly.
  • Medical History and Physical Exam. Expect to be asked about any symptoms you’ve experienced and other questions pertinent to your pregnancy. It’s always best to give extensive and detailed answers, so your doctor can assess your risk factors accurately.

If you are at risk for ectopic pregnancy, diligent monitoring and regular doctor consultations are imperative. Through it all, maintaining a positive outlook is key and, given the advances in diagnostic techniques. Thanks to the medical and technological advancements of today, ectopic pregnancies can be detected earlier, thereby improving outcomes and reducing risks for mothers.

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Ectopic Pregnancy Treatments in Singapore

Non-Surgical Treatment

Methotrexate is one non-surgical treatment option for ectopic pregnancy. It is a medicine that stops cells from dividing by interfering with the folic acid in the body. This is a medication that is delivered by injection, to be administered by your doctor. Methotrexate is suitable for early detected, smaller ectopic pregnancies without rupture. 

However, treatment with methotrexate can be complex and may involve a number of blood tests and doctor visits over the next several weeks. Your OB-GYN would tell you that methotrexate treatment is not suitable for all patients. The decision to use methotrexate depends on several factors, including the size of the ectopic pregnancy, and the level of pregnancy hormone in the blood. It is also dependent on the patient’s ability to follow up with blood tests that check their blood levels of hCG.

Surgical Treatment

LAPAROSCOPY is a minimally invasive procedure that involves making small incisions in the abdomen to remove the ectopic pregnancy. Recovery time after laparoscopy for ectopic pregnancy varies depending on when the pregnancy was diagnosed and the treatments received. Patients can generally resume normal activities within a week after undergoing laparoscopic ectopic pregnancy surgery.

LAPAROTOMY, on the other hand, is an open surgery approach with a larger incision. It is rarely performed nowadays. Recovery time after laparotomy for ectopic pregnancy may take longer, and patients may need to take it easy for 2-4 weeks. 

As in any surgery, it is important to follow the doctor’s instructions for aftercare and follow-up appointments to ensure proper healing and recovery.

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The Takeaway

Awareness, early intervention, and support are crucial in managing ectopic pregnancy. Luckily for us, there’s a wealth of information resources available in Singapore, including SingHealth and Health Hub,

and of course, our obstetrics articles here at Dr. Pamela Tan Clinic on Thomson Road. 

At the Dr. Pamela Tan Clinic, we offer professional guidance and medical intervention on ectopic pregnancies. We are here to help you overcome this health concern and understand its impact, so you can make informed decisions on how to move forward. To schedule an appointment with us, please call +65 6254 2878 or send a message here.

Meanwhile, please watch out for our next blog as we navigate the  implications of ectopic pregnancy on future pregnancies, and how we can help you move forward with confidence and peace of mind. Until then, take care and be kind to yourself.

 

Dr Pamela Tan
About Dr Pamela Tan

Dr Pamela Tan is a board certified obstetrician and gynecologist in Singapore. She finished her undergraduate studies at the National University of Singapore and earned her post-graduate degree at the Royal College of Obstetricians and Gynaecologists in the UK. She is an accredited specialist by the Specialist Accreditation Board (Ministry of Health), and a fellow of the Academy of Medicine, Singapore. She subspecialises in colposcopy and is certified to perform Level 3 minimally invasive keyhole surgeries such as laparoscopic hysterectomy, myomectomy and cystectomy. Dr Pam also supports the natural birthing method and she strives to provide a personalised care and treatment for each patient.