First Trimester

An Ectopic Pregnancy Can Be Life Threatening

Do you know that an ectopic pregnancy is life threatening?

ABC News reports that the family of a pregnant US woman who has been in a coma since Sunday is blaming the hospital that they say failed to realize she was experiencing a ruptured ectopic pregnancy and bleeding internally.

Lisa Avila a 36-year-old mum who has seven other children, was 12 weeks pregnant when she woke up on Valentine’s Day with severe pain in her abdomen.

When the doctors at the hospital, Anaheim Regional Medical Center‘s emergency room did an ultrasound, they said her baby was fine and sent her away with a prescription for painkillers.

It was when her husband left her in their car while he went into a pharmacy and returned that he found her unconscious and not breathing.

Paramedics then rushed her back to the same hospital, where they learned Avila had an ectopic pregnancy, meaning the fetus was developing outside the uterus. The ectopic pregnancy had ruptured, causing her to bleed internally. She needed emergency surgery to stop the bleeding and by the next day, Avila slipped into a coma.

Her aunt, Jule who gave a news conferenced lamented that,

Why did they make my niece leave this hospital when obviously there was something wrong?” Jule said.

“How could they say the baby was fine if it was an ectopic pregnancy and you did an ultrasound?”

An ectopic pregnancy is when a fertilised egg implants itself outside of the womb, usually in one of the fallopian tubes.

Experts suggest that it is a leading cause of pregnancy-related death during the first trimester.

A growing embryo can rupture — burst — a fallopian tube. That can lead to internal bleeding and infection.

According to Dr. Marjorie Greenfield, chief of general obstetrics and gynecology at UH Case Medical Center, ectopic pregnancies are relatively common and occur in about 1 percent of all pregnancies/

“Some of them are very easy to diagnose, and they get diagnosed every day in the emergency room,” she said, explaining that if a woman has a positive pregnancy test, but a doctor can’t spot the embryo in the “frame” of her uterus on an ultrasound, that’s usually enough to diagnose an ectopic pregnancy.

Ectopic pregnancies usually rupture at about five or six weeks, when the fallopian tube can’t stretch to hold the developing embryo as it grows, so a 12-week ectopic pregnancy is unusual, Greenfield said.

Ruptured ectopic pregnancy is the number one cause of maternal mortality in the first trimester and if it ruptures, women can lose liters of blood very quickly.

But sometimes a doctor can’t spot an ectopic pregnancy until he or she operates, says Dr. Keith Eddleman, director of obstetrics at The Mount Sinai Hospital in Manhattan.

“If you have a patient in the first trimester with abdominal pain and bleeding and you can’t see the pregnancy inside the uterus — and you have a positive pregnancy test — you have to assume it’s ectopic until proven otherwise because it is life-threatening,” Eddleman said.

What are the signs of an ectopic pregnancy?

Signs include pelvic pain on one side of the body, dark red vaginal bleeding and a positive pregnancy test, Ashton said. Because they ultimately lead to life-threatening miscarriages, treatment for ectopic pregnancy is usually surgery or medication to end the pregnancy.

Other symptoms of an ectopic pregnancy include; 

  • Nausea and vomiting with pain.
  • Lower abdominal pain.
  • Sharp abdominal cramps.
  • Dizziness or weakness.
  • Pain in your shoulder, neck, or anus.
  • If the fallopian tube ruptures, the pain and bleeding could be severe enough to cause fainting.

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Early Signs That You Might Be Pregnant

Most women don’t suspect or think they are pregnant until they notice that they have missed their menstrual period, but even before then there would have been some signs that you are pregnant.

Pregnancy symptoms begin at 4 weeks. Normally you get your period about 4 weeks from the start of your last period, but if you’re pregnant, the clearest sign at this point is a missed period. Many women still feel fine at 4 weeks, but others may notice sore breasts, fatigue, frequent urination, and nausea. Since every woman is different they have different symptoms during pregnancy.

And some of the earliest signs that you are pregnant include:

  • Shortness of Breath -You might be begin to notice that the normal distance that you would normally take has suddenly become a chore.
  • Sore Breasts – you would probably begin to notice that your breast feel tender and heavy. Pronounced veins and darkened areola are said to be the first sign that you are pregnant.
  • Fatigue – You would begin to get exhausted easily. This tiredness usually continues all through the first trimester and get better by the second trimester.
  • Nausea – For a lot of women nausea usually starts at the about 6 weeks but some might begin to feel nauseous from the 4th week of pregnancy and usually reduces by the second semester. Pregnant women are advised the manage the nausea by taking crackers and ginger tea.
  • Frequent Urination – You might begin to notice that your visit to the toilet has become more frequent than usual. This occurs are mainly because the blood flow to the woman’s kidneys increases. This increased urine production peaks by about 9 to 16 weeks of the pregnancy, then settles down.
  • Headaches – You might begin to notice that you are having headaches frequently this is usually as a result of the changes in hormones happening in your body. If you are pregnant it is advised that to handle the headaches you seek the advice of your doctor for safe painkillers to use.
  • Backaches – If you don’t normally have backaches, you might begin to notice that your back is sore. This happens because your ligaments are becoming loose and this would probably continue all through your pregnancy as your baby becomes bigger.
  • Cravings or Food Aversions – If you begin to crave or suddenly can’t stand some food that you eat normally it might be an early sign of pregnancy.
  • Constipation and Bloating – if you suddenly begin to feel constipated or bloated it could be a sign of pregnancy. It might be extra progesterone due to pregnancy, which slows down your digestive system.
  • Mood Swings – Most pregnant women go through different emotion mainly due to the increase of hormones. Some moms-to-be experience heightened emotions, both good and bad, while others feel more depressed or anxious.
  • Heightened Sense of Smell – If you are suddenly sensitive to different smell it might be because you are pregnant.
  • Dizziness – We have seen it in a lot of movies but its is actually based on reality. If you suddenly begin to feel dizzy it could be a sign that you are pregnant.
  • Spotting or Light Bleeding – It is usually earlier than normal and very light unlike your normal period. You may actually be experiencing implantation bleeding, where the fertilized egg attaches to the uterine wall and causes a little bloodshed.
  • Missed Period– This usually one of the most obvious signs of pregnancy and it is at this point that people begin to take note of the other symptoms they have been feeling. Missed period would only be noticed if the person’s period is usually regular.
  • Positive Pregnancy Test– This usually gives a more definite answer to whether you are pregnant or not and it can be done anywhere.

It is usually advised that after taking a home pregnancy test, you should also go to the hospital to take a blood test. Then if it comes out positive your doctor would be able to advise you on the next step to take to ensure a smooth pregnancy and safe delivery.


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