Pregnancy is a time of joy and anticipation for many women. A new life takes hold and gets ready to come into this world. A healthy pregnancy is necessary for a healthy child and the woman. But sometimes a pregnancy may not be normal. Pregnancy can be normal or ectopic. It is a happy time for expecting parents as they prepare for the newborn. They make plans for the new family. However, each pregnancy is different, and a lot for prenatal care along with consultations with the OBGYN can make it better.
Normal pregnancy or gestation is a time when the fetus, embryo or the offspring will develop inside a woman. Childbirth can occur 40 weeks from the woman’s last menstruation, which is around nine months. A normal pregnancy is when the child is conceived naturally through intercourse, and the child is born normally. That is, there is no c-section.
There are three trimesters through which the pregnancy progresses. Each trimester consists of 3 months. The first trimester is week one or week 0, and it ends at 12 weeks time. The second trimester ranges between the beginning of week 13 to week 15 and ends at week 27 or 28. The third and final trimester starts between week 28 or 29 and ends with childbirth.
Signs and symptoms
Pregnancy can involve certain symptoms which do not pose a threat to the child or mother. These are normal and occur in most women. The signs and symptoms of a normal pregnancy include:
- Pain in the pelvic girdle
- Morning sickness
- Urinary tract infection
- Peripheral edema
- Heartburn, regurgitation or nausea
- Breast tenderness
- Low blood pressure
- Varicose veins
Body in a normal pregnancy
Several physical changes take place in a woman’s body, such as:
- Nausea and/or vomiting – Morning sickness can come at any time in the day and usually begins after one month of pregnancy. This happens due to changes in hormonal levels. Women must eat in small quantities and drink plenty of fluids.
- Fatigue – In the early days, the progesterone levels soar, which means the body will want to sleep. Women are advised to rest and include good food and exercise in their regimen for energy.
- Swollen and tender breasts – Hormonal changes after conception makes the woman’s breasts sore and tender. This lasts until the body adjusts to hormonal changes.
- Constipation – Progesterone slows the food movement through the digestive system and can cause constipation. Iron supplements aggravate the issue. Fiber and fluids may help in managing this issue.
- Heartburn – Again hormones relax the valve between the esophagus and the stomach leading to leakage of acid causing heartburn. To avoid heartburn, eat small meals frequently and void fried or spicy foods.
- Urination – The blood in the body increases during pregnancy which causes kidneys to process extra fluids.
Development of Embryo
The egg and the sperm unite in the fallopian tube and the fertilized egg or zygote journeys towards the uterus which can take a week to finish. The cell division begins 24-36 hours after the meeting of the female and male cells. After cell development, the zygote becomes a which attaches itself to the uterine wall. This process is called implantation.
The cells develop on the way to form an infant during the first ten weeks of gestation. The cells begin to differentiate and start forming the baby. The body and nervous system are established, and beginnings of mouth, ears, and fingers start. The umbilical cord and the placenta also begin developing. The placenta connects the embryo to the uterus wall via the umbilical cord to get nutrients, allow gas elimination and waste elimination.
After ten weeks of gestation, the embryo becomes a fetus and is about 30 mm. the body continues to develop, and the heartbeat can be heard. The 5th and 6th week of gestation sees electrical brain activity. Maximum growth occurs during the last weeks of pregnancy, just before birth.
Pregnancy ultrasound and diagnostic use
During pregnancy, an ultrasound will help the doctors see eth baby and determine if everything is alright with him or her. The heartbeat of the baby can also be heard, and the growth can be viewed through this. An ultrasound can be used to diagnose many conditions such as babies’ health problems, multiple fetuses, the health of the woman’s reproductive organs, abnormalities of the placenta such as placenta previa or an ectopic pregnancy.
An ectopic pregnancy is a complication in pregnancy wherein the embryo attaches itself to a place that is outside the uterus. In a normal pregnancy, the fertilized egg makes its way to the uterine wall for implantation. But in an ectopic pregnancy, the egg attaches itself to other areas such as the fallopian tube. This is also known as a tubal pregnancy. The fetus’ development inside fallopian tubes is difficult as it won’t get the necessary environment plus the tube isn’t made to expand the way the uterus does. This isn’t a normally developing pregnancy.
Signs and symptoms
An ectopic pregnancy can have typical pregnancy symptoms, but additional symptoms include:
- Sharp pains in the abdominal area which radiates towards the pelvis.
- Vaginal bleeding.
- Fainting, dizziness, and weakness.
Bleeding and dizziness could mean that the tube has ruptured and is a medical emergency.
Chances of an ectopic pregnancy
An ectopic pregnancy’s chance of occurrence is only 1 out of 8-0 pregnancies. However, in order to know if a pregnancy is ectopic or not, the doctor must check for certain symptoms. Some women may be susceptible to having an ectopic pregnancy, but it cannot be definitely predicted before it occurs.
Causes of Ectopic Pregnancy
The causes of an ectopic pregnancy can be:
- Scar tissue from fallopian tube surgery or prior infections.
- Abnormal shape of the fallopian tube from a birth defect or abnormal growth.
- Fallopian tube adhesions from prior surgeries.
- Inflammation or infection of the fallopian tube, causing it to be blocked.
Women are at risk of an ectopic pregnancy are usually in the age bracket of 35-44. Pelvic Inflammatory Disease, previous ectopic pregnancies or endometriosis can also make the risk of an ectopic pregnancy higher. Tubal litigation, abortion, and abdominal or pelvic surgeries also increase this risk. If a woman gets pregnant while having an IUD in place, then there is a high chance, it is an ectopic pregnancy.
Diagnosis and treatment
Blood tests, ultrasound, and pelvic exams can help in diagnosing an ectopic pregnancy. HCG and progesterone levels can also point to an ectopic pregnancy if it exists. Progesterone levels are low in an ectopic pregnancy. There can be a culdocentesis done to check if there is any bleeding from the rupturing of fallopian tubes. A needle is inserted in an area between the rectum and uterus to see if there is any blood there.
Once the diagnosis is confirmed, the doctor needs to set out the treatment plan. Drugs like Methotrexate may be used so that the body absorbs the pregnancy, and it can save the fallopian tube if the pregnancy hasn’t progressed too far. If the tube has ruptured or there is bleeding, then it requires surgical removal. The hCG levels must reach zero after surgery to ensure there is no ectopic tissue remaining. Find more information on management and treatment of Ectopic Pregnancy in our previous blog post.
Development of Embryo
In a lot of ectopic pregnancies, the egg will implant in the fallopian tubes and can create large amounts if vascular structures and tissues. This pregnancy can be dangerous and fetal death is all but certain. The risk to the mother is very high, and termination is recommended. In an ectopic pregnancy, there is no embryo as such.
There is a high chance that the symptoms of an ectopic pregnancy can mimic a miscarriage. But there are differences between the two. The first is that because an ectopic pregnancy occurs in a fallopian tube, it can burst to cause internal bleeding and to endanger of life. The second difference is that it isn’t a viable pregnancy.
Women may also feel gastrointestinal symptoms and diarrhea, as well. So, if any woman faces that she must do a pregnancy test and a scan to ensure that it isn’t a case of an ectopic pregnancy. Heavy bleeding may look like miscarriage, but it can be an ectopic pregnancy as well. Hence monitoring and tests are crucial. Learn more about Ectopic Pregnancy in our recommended post Ectopic Pregnancy: Everything You Need To Know.
Difference Between a Normal and Ectopic Pregnancy
Normal pregnancy and ectopic pregnancy has one crucial difference. A normal one is a viable pregnancy where a normal baby will be born after nine months. It is an embryo that grows. But in an ectopic pregnancy, the fertilized egg is not an embryo. Hence there will be no child, and the egg has to be removed for the woman’s health.
A normal pregnancy is safer for women, even though there is always a slight risk attached. But an ectopic pregnancy is a major health risk.