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Ovarian Ectopic Pregnancy | Causes | Diagnosis | Treatment

What Is Ovarian Ectopic Pregnancy?

Ovarian ectopic pregnancy is the implantation and development of an embryo outside of the uterine cavity and considered to be a significant medical condition. The early diagnosis of the condition is very crucial.

Otherwise,  it may become life-threatening and require urgent surgical intervention. Ovarian ectopic pregnancy is generally managed with medical treatment in cases of early determination.

The condition is usually an uncommon variant of ectopic implantation that ends with rupture before the beginning of the second trimester. The frequency of ovarian ectopic pregnancy after normal conception varies from 1 in 2000 to 1 in 60,000 births, comprising 3% of all ectopic pregnancies.

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    How Does An Ovarian Ectopic Pregnancy Happen?

    The condition happens when an ovum retained in the peritoneal cavity gets fertilized, which leads to implantation on the ovarian surface.

    Women with ovarian ectopic pregnancies usually experience lower abdominal pain. As with some other ectopic and corpus luteum cyst conditions, additional signs also include menstrual abnormalities.

    While preoperative diagnosis seems to be difficult, the treatment generally requires an early diagnosis.

    How Does The Doctor Determine Ovarian Ectopic Pregnancy?

    An ovarian ectopic pregnancy is determined in a number of methods. While your doctor can carry out a pelvic exam in order to find out the areas where tenderness, pain, or a mass in the ovary is present, he won’t be able to diagnose the situation without ultrasound and blood tests.

    The first step in determining the condition is a blood test which measures the levels of human chorionic gonadotropin (HCG) to confirm the pregnancy. Ectopic pregnancy may be diagnosed within 6 weeks after conception by ultrasound testing.

    Determination Of Ovarian Ectopic Pregnancy With Ultrasound

    The exact area of the pregnancy is determined by a transvaginal ultrasound by using a wand-like device that is placed into the vagina. Ultrasound diagnosis helps to create images of your fallopian tubes, uterus, as well as ovaries.

    Do I Have Ovarian Cyst Or Ectopic Pregnancy?

    Having ovarian cyst and ectopic pregnancy can be quite different:

    When you are in your first trimester of pregnancy, having an ovarian cyst is quite normal. This type of cyst results from an undissolved follicle sac and is referred to as a corpus luteum. By the beginning of the second trimester, these kinds of cysts dissolve.

    When you experience an ectopic pregnancy, however, a fertilized egg is implanted in an area outside of the uterus. The condition generally occurs in fallopian tubes, but sometimes its also observed on the ovary. When caused by an ectopic pregnancy, it’s necessary to get the cyst removed by a surgical operation or medication.

    Can It Be Mistaken For An Ovarian Cyst?

    An ectopic pregnancy can sometimes be mistaken for an ovarian cyst due to certain symptoms, such as abnormal bleeding, amenorrhea, abdominal pain, etc. In the first trimester, ruptured ectopic pregnancies cause bleeding and shock and are the major cause of maternal mortality. Even though the development of conservation surgeries and tuboplasties have strengthened the ectopic patient’s fertility outlook, a live baby would only be born to one-third of those women.

    Difference Between Ovarian Cyst And Ectopic Pregnancy

    The main difference that distinguishes a simple cyst from an ectopic pregnancy is a thin, avascular wall, which is located adjacent to the ovary. Although ultrasound tests reveal variable appearances, dermoid cysts are generally seen as a focal hyperechoic mass in the ovary.

    Management

    Since the situation may lead to life-threatening complications, the ectopic tissue is generally removed by a surgical operation. Depending on the stage of the disease, you may either be administered medication or undergo a laparoscopic surgery.

    A surgical operation is often considered a traditional management method in ovarian pregnancies. Early bleeding has been controlled by ovarian wedge resection or cystectomy for minor lesions. However, in cases of larger lesions, the situation is most often handled by ovariectomy, where the surgeon uses laparoscopy to resect or to perform laser ablation. Unrupruted ovarian is treated by methotrexate.

    Certain ectopic pregnancies are managed with salpingectomy and salpingostomy. In these operations, the surgeon makes a small incision in the abdomen, near or in the navel. Later, by using a thin tube equipped with a camera lens the doctor views the tubal area.

    During a salpingostomy, the fallopian tubes are left to heal on their own after the removal of ectopic pregnancy. Salpingectomy, however, includes complete removal of the fallopian tubes together with the ectopic pregnancy.  

    Treatment With Methotrexate

    Methotrexate is generally used to treat ectopic pregnancies diagnosed in the early stages of pregnancy. The medication, which is administered by injection, deletes existing cells by preventing them from developing. However, before getting an injection it’s crucial to get clearly diagnosed. Following the treatment, your doctor will carry out further hCG tests to find out how the procedure is effective and whether you need any further prescription.

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