Why does an ectopic pregnancy cause sharp pelvic pain?

Why does an ectopic pregnancy cause sharp pelvic pain?

A normal pregnancy will result in normal fetal growth and implantation within the uterus. Ectopic pregnancy is when the implantation of the product of conception takes place in other sites, for example, the fallopian tube. We all must take this condition seriously as the bleeding due to ectopic pregnancy is still the leading cause of maternal death in the first trimester or the first three months of the pregnancy. Ectopic pregnancy is responsible for 4% of all maternal deaths. This figure is still worrying as the advancement of technology for diagnosing and treating is already at a high level. Book appointments by DoctoronCall will make it easier for you to see your preferred doctor or specialist for medical checkups or medical consultation.

  The causes of ectopic pregnancy are:

  • Pelvic inflammatory disease
  • Genital infections
  • Previous ectopic pregnancy
  • Infertility
  • Invitro fertilization (IVF)
  • Tubal reconstructive surgery
  • The use of fertility drugs
  • Intrauterine contraceptive device (IUCD)
  • Sterilization procedures
  • Estrogen and progesterone contraceptives
  • Progesterone only contraceptive
  • Smoking
  • In utero diethylstilbestrol exposure
  • Vaginal douching
  • Increase in age

  There are few extrauterine locations at which implantation may take place. The sites are:

  • Fallopian tube
  • The interstitial portion of the fallopian tube
  • Intramural
  • Cervical
  • Ovarian
  • Abdominal

Tubal pregnancy may be due to any problems that cause delay to the ovum movements or any issues related to the embryo that cause premature implantation. Interstitial fallopian tube pregnancy can be mistaken as a normal pregnancy as some portion of the embryo is still implanted within the muscle layer of the uterus. Intramural pregnancy is a rare form of ectopic pregnancy in which the embryo is implanted in the myometrium of the uterus. Cervical pregnancy is when the product of conception is implanted inside the cervix. Ovarian pregnancy is when the embryo is implanted in the ovary while abdominal pregnancy is when the embryo grows in the abdomen.

The majority of ectopic pregnancy occurs in the fallopian tube which accounts for about 96% of total ectopic pregnancies. Ectopic pregnancy is usually asymptomatic. However, it is not uncommon for the development of symptoms. The main symptoms are vaginal bleeding and abdominal pain. The steps in confirming a lady are having an ectopic pregnancy are:

  1. Confirming the pregnancy status
  2. Check the cardiovascular system and the hemodynamic status as ectopic pregnancy can cause bleeding
  3. Confirming whether it is a normal pregnancy within the uterus or ectopic pregnancy
  4. If it is confirmed that the pregnancy is ectopic, check what structure is harbouring the embryo and whether any rupture has taken place
  5. Do additional investigations which are necessary

History taking and physical examination are crucial before investigations can be done to confirm a diagnosis of ectopic pregnancy and to know the current condition of the patient. The investigations are:

  • Focused Assessment with Sonography for Trauma (FAST) ultrasound
  • Full blood count
  • Blood group testing
  • Kidney function test
  • Liver function test
  • hCG level in the blood
  • Transvaginal ultrasound

  Other causes for vaginal bleeding and abdominal pain in early pregnancy are:

  • Physiologic (normal)
  • Spontaneous abortion
  • Gestational trophoblastic disease
  • Cervical, vaginal, or uterine pathology
  • Subchorionic hematoma

  Without any treatment and intervention, fallopian tube pregnancy will result in the following consequences:

  • Rupture
  • Abortion
  • Resolution

The reason why ectopic pregnancy causes sharp pelvic pain is mainly following the rupture of the fallopian tube in the case of fallopian tube pregnancy. Book appointments by DoctoronCall will make it easier for you to see your preferred doctor or specialist for medical checkups or medical consultation.