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Ectopic pregnancy is a rare, life-threatening complication that requires emergency care. If left untreated, it can lead to bleeding and even death. Although most treatment options for ectopic pregnancy are termination, many new lawshave created confusion about how to legally treat someone with an ectopic pregnancy. Here’s what you need to know about ectopic pregnancies and how to get a Supreme Court annulment may affect some people’s ability to care.
What is an ectopic pregnancy?
An ectopic pregnancy is when a fertilized egg attaches itself to a place other than the uterus (where a healthy pregnancy occurs). Most ectopic pregnancies occur in a person’s fallopian tubes. More rarely, an ectopic pregnancy can occur in the ovary, cervix, or c-section scar. These places are not big enough for the growth and development of the baby; therefore, a fertilized egg rarely survives outside the uterus.
Ectopic pregnancy accounts for approximately 2% of all pregnancies, but is one of the leading causes of pregnancy-related deaths. They account for 10%-15% of maternal deaths in the first trimester. Technically, some ectopic pregnancies can resolve on their own, but this is very rare.
An ectopic pregnancy cannot be carried to full term and can be very dangerous. Often, when a fertilized egg attaches to the fallopian tubes, the growth of the egg can cause the fallopian tubes to burst and bleed. This massive internal bleeding can be fatal if left untreated.
An ectopic pregnancy is usually detected within 6-10 weeks, when there are no major symptoms such as rupture. Pelvic examination, in addition to blood tests, can also diagnose transvaginal ultrasound to determine the location of pregnancy. This life-threatening condition must be treated immediately. Delays in seeking emergency medical care increase the risks.
Symptoms of ectopic pregnancy
The symptoms of an ectopic pregnancy will initially be the same as any other pregnancy. These can include swollen breasts, missed periods and nausea. More subtle symptoms may include:
- Mild pain and cramping in the pelvis
- Abnormal vaginal bleeding
- Lower back pain
Although these symptoms may mimic a normal pregnancy, there are other signs that indicate an ectopic pregnancy and rupture. According to the American College of Obstetricians and Gynecologists, these severe symptoms include:
- Sudden, stabbing pain in the pelvis
- Shoulder pain
- Sudden dizziness or fainting
It is important to contact your doctor if you experience these symptoms or suspect that something is wrong.
Who is at risk?
There are several risk factors to be aware of, including:
- If you have had an ectopic pregnancy before
- If you become pregnant while using an IUD birth control device
- If you have increased inflammation due to an infection, such as a sexually transmitted infection
- If you have had in vitro fertility treatment or surgery on your fallopian tubes in the past
- If you have scars after any surgery near the pelvic area (for example, your appendix)
- If you are a smoker
What is the treatment for ectopic pregnancy?
Doctors cannot transfer an ectopic pregnancy to the uterus. The only way to treat this potentially life-threatening condition is to remove the tissue with medication or surgery. There is also a chance that an ectopic pregnancy will end in spontaneous abortion, but this is rare and difficult to determine. Doctors usually do not advocate monitoring for miscarriage because of the life-threatening complications of ectopic pregnancies.
Methotrexate, a chemotherapy drug, is administered by injection. The chemotherapy agent will attack and stop the cell growth and the body will absorb the rest. This method is often given to women who have had an early ectopic pregnancy and have not experienced any internal bleeding. Your doctor will continue to do blood tests while you are taking this medicine.
Another option is surgery, especially if the fallopian tube has burst or is already damaged. If it is a surgical intervention, either the ectopic pregnancy or the fallopian tube must be removed. Doctors try minimally invasive surgery first, but depending on the severity or how unstable the patient is, they may need to do an open procedure.
Will you still be able to get treatment?
After the Supreme Court overturned Roe v. Wade, there are many questions and concerns about ectopic pregnancies and abortion bans in several states. Determining what constitutes an abortion is confusing, especially when dealing with a pregnancy that cannot be carried to full term.
If you have an ectopic pregnancy, can you still be treated? The answer is yes, at least in theory, because the language surrounding abortion bans does not specifically refer to the termination of an ectopic pregnancy as an abortion. Even states that ban abortions have exceptions for people with life-threatening conditions, and ectopic pregnancies would fall into that category. In addition, the procedure for terminating an ectopic pregnancy is not the same as an abortion procedure.
However, there is still debate around this issue – such as whether people should wait until a condition becomes life-threatening before termination, and how long it should take. This debate can confuse patients and doctors.
What do medical professionals say?
We spoke to two medical experts about the uncertainty and confusion surrounding anti-abortion laws. Both wonder if this uncertainty will prevent patients from getting timely care.
“[Ectopic] the treatment would terminate the pregnancy, and depending on the language of the law, if the abortion is illegal, it would technically be an abortion. Sometimes these pregnancies last long enough for the heart’s electrical activity, called a heartbeat, and can we intervene in these cases? Reproductive Health Physicians She is concerned that while ectopic pregnancy needs to be treated as soon as possible, people may have to wait before seeking treatment.
As the laws are now written, ectopic pregnancy treatment is protected under abortion bans, but it’s the legal aspects that medical professionals fear. Brandi worries that doctors don’t know the legal specifics, such as when they can intervene and make a diagnosis. “How close to death do we have to be to qualify for the ‘maternal health’ clauses of most abortion bans?”
Dr. Linda Fan, associate professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine, also spoke about the nuances of the new laws. “There have been times when you’ve misdiagnosed an ectopic pregnancy and given medication for a normal pregnancy,” Fan said. “It happens every once in a blue moon, but the problem is that it can be a problem. I’m not sure how that might play in the minds of doctors—maybe I don’t want to give the drug at all. With misinformation and panic, I think that can happen.”
Fan also talked about the type of ectopic pregnancy that occurs in cesarean scars. “C-section scar ectopic pregnancies are more common. Technically, about 20% to 30% may be viable. I think there are going to be a lot of nuances,” Fan said. Doctors may think they are legally allowed to treat an ectopic pregnancy even if it has a low chance of carrying it to full term.
Brandi said, “As a doctor, I would never want to stop life-saving treatment to check with my attorney to make sure it’s legally ‘okay’ to treat someone. It’s really scary when doctors’ hands get tired. And patients can suffer worse outcomes because of legal concerns.”
The fan was more optimistic. “I don’t know if there’s real fear,” he said. “I don’t think it would be a problem in an academic medical center where we could be sure of the diagnosis. But I don’t know how it would be in states with abortion bans. I’d be interested. .”
The information in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult your physician or other qualified health care provider with any questions you may have regarding a medical condition or health goals.