“The pain was so awful that the happiness I had was gone in the blink of an eye. I lost my hope totally because of the severe pain in my abdomen. The pain lasted one whole night and in the morning bleeding started wherein I called my doctor immediately. As per her advice, she took Transvaginal Sonography (TVS) and rushed to the hospital for emergency surgery.”
Ectopic pregnancy is a complication of pregnancy in which a fertilised egg settles and grows outside the inner lining of the uterus or the fallopian tubes. If ectopic pregnancy occurs in the fallopian tube, it is called tubal pregnancy. It can also happen elsewhere in the cervix, ovary or abdominal cavity.
Such types of pregnancy are not a normal process and therefore lead to the death of the embryo.
Ectopic pregnancy is a life-threatening medical emergency as it causes life-threatening bleeding, if left untreated the fallopian tube may rupture and may lead to internal bleeding, shock and even death.
Some causes might be due to—
- Inflammation or scarring of the fallopian tube
- Hormonal imbalance
- Genetic abnormalities
- Medical conditions that cause the fallopian to misshapen.
Some factors that predispose a woman to have an ectopic pregnancy may include
- Previous ectopic pregnancy
- Sexually transmitted diseases such as gonorrhoea
- Previous tubal surgery
- Pelvic surgery
- Smoking
- Mature age of 35 or older
- Pelvic inflammatory disease
- Reproductive technology
History of infertility:
Symptoms
- Breast discomfort
- Vaginal bleeding in varying amounts
- Sudden lower abdominal pain
- Dizziness or fatigue
- Pelvic pain or discomfort
- No symptoms
Diagnosis:
Occasionally the doctor can carry out a pelvic examination, this may help the doctor in identifying areas of pain, tenderness or mass in the fallopian tube or ovaries.
The doctor may carry out a pregnancy test to ascertain that you are pregnant. This test is done via blood test to check the level of Human Chorionic Gonadotropin (hCG) hormone which usually increases during pregnancy.
An abnormal pattern in the rise of this hormone can be indicative of ectopic pregnancy.
A transvaginal ultrasound is carried out. This allows the doctor to examine the exact location of the pregnancy. In rare cases, laparoscopy might be needed to confirm diagnosis.
Treatment:
Treatment options depend on your symptoms and when the ectopic pregnancy is discovered.
Medication:
Methotrexate medication- Methotrexate medication is often used to treat early ectopic pregnancy. This medication stops the growing cells of the placentas and dissolves existing cells.
This may cause abortion or the developing embryo may pass with a menstrual period.
It is crucial to confirm that it is an ectopic pregnancy before this treatment is given. However, conception may be delayed for several months after taking this medication.
Surgical intervention may be required if bleeding has already occurred. Laparoscopy or laparotomy surgery is used to gain access to the pelvis.
The ectopic pregnancy is either only removed (salpingostomy) or the affected fallopian tube is removed along with the pregnancy (salpingostomy).
Ruptured Ectopic Pregnancy:
In a ruptured Ectopic Pregnancy, one needs to perform immediate surgery. As the blood collected inside may create a shock. Initially, the woman might look normal but if it is delayed it will be fatal.
In my experience as a nutrition expert, recommended dietary modifications are:
In Methotrexate, injections are given to stop pregnancy by striping your body of folate
- Reduce your intake of folate i.e. food including folic acid, folinic acid, methylated folate and 5MTHF.
- Fortified foods that contained folate like bread, flatbread, fruit juice, vitamin waters, shakes and protein bars.
Plus, if an emergency ectopic surgery is being done it is best that we reduce the intake of the following food sources-
- Green leafy vegetables like cauliflower, cabbage, water spinach, beans, legumes and pulses are not advisable.
- No coconut water or green smoothies, etc. are advised.
- Spices like ginger, onion, garlic, chillies, masalas, and vegetable oils should be avoided for a minimum of two weeks and if possible a month, for good gut and healing.
- Red meat, shrimps, snails, lobsters, crabs, egg white should not be consumed during this time.
- No processed foods, fruits, drinks etc. to be consumed.
- Avoid alcohol and all toxic substances for at least six months and more.
The treatment can impact the bowels either with constipation or loose bowel so one should drink lots of fluid and stay hydrated to keep the bowels soft and for easy excretions. A doctor’s prescription should be used if one loses bowel continuously.
Thus, the above mentioned foods are avoided since one is undergoing medications, soreness, swelling, vaginal spotting, bleeding etc.
Women should take maximum rest, avoid lifting heavy objects or infants, stair climbing or roaming around and travelling should be avoided as much as possible. Short walks and some activities can be resumed if one is feeling better. It takes a month and a half to fully recover, so one should be careful with the diet. Bland diets are best for this recovery stage. Exercise, physical movements or intimacies are not advised until six months under the doctor’s supervision.
What food is to be consumed?
- Chicken, egg yolk, fish, milk, and milk products that also helped in recovering easily.
- Nuts like cashews, walnuts, almonds, dates and dried berries are good for health.
- Non-sticky rice (less), atta chapatti, oats, etc. can be a source of carbohydrates.
- Spring onion, cumin seeds, cinnamon, and star anises are good for the gut.
- Vegetables like carrots, pumpkins, squashes etc. are good sources.
- Fruits like apples, bananas, papayas, oranges, watermelons, berries and strawberries can be consumed.
Since, bland-diet is the best way for fast recovery it can be cooked either by steaming, boiling (in the form of soups) or even by air frying it easily.
Lastly, consult your doctor whenever necessary and continue following up with the check-ups and health care necessities as advised by the doctor. Also don’t forget to do the dressing every alternate day if possible.
This is a short article wherein I am sharing the little knowledge I have with me through my experiences so that one can be aware of ectopic pregnancy. Well, my situation was a life-threatening one but thanks to my doctor, Dr Usharani Akoijam, Assistant Professor, Obstetrics and Gynaecology, Regional Institute of Medical Sciences and her team for saving my life. Without her things would have been very complicated. And, heartfelt gratitude to my near and dear ones for their full support, love and care.
“Life is full of beautiful hopes and dreams only because of the people we love”
