Ectopic Pregnancies

Syllabus: Health & Social Issues – Public Health (UPSC Prelims)
Source: TH

Context:

A rare case of intrahepatic ectopic pregnancy was reported in Bulandshahr, Uttar Pradesh, where a foetus developed inside the liver.

What is an Ectopic Pregnancy?

• A condition where a fertilised egg implants outside the uterus, most commonly in the fallopian tube.
• The uterus is the only organ capable of sustaining a pregnancy — hence ectopic pregnancies cannot continue normally and require urgent medical care.

Causes & Sites of Implantation

• Normal Path: Egg travels from ovary → fallopian tube → uterus.
• Disruption: Inflammation, scarring, surgery, or structural defects can block the path, causing implantation elsewhere:
  • Fallopian tube (tubal pregnancy) – most common
  • Ovary
  • Abdominal cavity
  • Cervix

Symptoms

• Early signs: missed periods, breast tenderness (similar to normal pregnancy).
• Danger signs: sharp abdominal/pelvic pain, vaginal bleeding, dizziness/fainting, shoulder pain, low blood pressure.
• A ruptured fallopian tube is a medical emergency.

Prevalence

• India: 0.91–2.3% incidence in hospitals (2023 study).
• Global Trend: Overall decline (1990–2019), but still high in low-SDI countries (2025 study).

Diagnosis

• Blood and urine tests.
• Transvaginal ultrasound.
• Most cases detected in early pregnancy stages.

Treatment Options

Medical Management:

• Methotrexate stops cell growth and dissolves embryonic tissue.
• Only for unruptured, early-stage ectopic pregnancies.

Surgical Intervention:

• Laparoscopic surgery to remove the embryo or affected fallopian tube.
• Emergency surgery if rupture occurs.