Women of Sierra Leone lets us have our first health talk today on this platform. Women’s health education is such a huge and daunting task, and in a country like ours, where societal/ cultural ideals do not favour women this has made it even difficult to access some of the information we need. Women are left at the mercies of quacks and quick fixes which usually result in so many irreversible consequences. Sexual and reproductive health for women needs more attention in this country. Women go through a lot of issues, and most times we don’t have absolutely any idea of what our symptoms are. Even though its incidence ratio is lower when compared with the early decades. It is still the main reasons for maternal morbidity and mortality in the first trimester of pregnancy, especially in developing countries. These are some of the reason why we should not be in awe when there are discussions about high maternal morbidity and mortality in Sierra Leone. There is little or no access to information that will help women of this country make informed decisions and seek proper help from the experts.
Today, we will be looking at ectopic pregnancy. Have you heard of ectopic pregnancy before now? Has your gynaecologist ever mentioned the word ectopic to you before? Have you experienced it? If you have, what were your signs and symptoms? How was it diagnosed and treated? Did you confide in anyone about your condition? By the way, I am not a health practitioner and I am just here to share some of my experience, research and curiosity with you.
WHAT IS ECTOPIC PREGNANCY?
Otherwise known as extrauterine pregnancy or tubal pregnancy is when a fertilized egg grows somewhere outside the uterus, precisely, the egg attached itself on the fallopian tube. Because the egg is not inferred to develop outside the womb if left to grow, can damage nearby organs and cause life-threatening conditions. For the understanding of the layman, an ectopic pregnancy is a pregnancy that happens out of the womb. It is a condition wherein the fertilized egg attached itself on the fallopian tubes, where it will start to grow and develop instead of the womb which is the safest place for it to develop. This condition is life-threatening if not diagnosed and treated immediately. We don’t have the statistics here in Sierra Leone but according to other sources, 1 out of every 50 pregnancy is ectopic.
CAUSES OF ECTOPIC PREGNANCY
Ectopic Pregnancy more often than not is caused by damage to the fallopian tubes. A fertilized embryo may have a problem passing through a distress tube resulting in the egg attaching and thriving in the tube. Some may happen without any perceived cause. Ectopic Pregnancy can cause your fallopian tube to rupture which can lead to drastic inside bleeding that if not treated with quickness might lead to death. The causes are not clear but here are some;
• Smoking- women who smoke or use to have higher chances of getting ectopic pregnancy.
• Women older than 35
• Genetic irregularities
• A previous Ectopic pregnancy
• Pelvic Inflammatory Disease (PID)- such as some form of chlamydia, and gonorrhoea as they can create scar tissues in the fallopian tubes.
• If you have an Endometriosis history.
• Fertility drugs and In vitro fertilization.
• Pelvic Surgery.
• Tubal Ligation and Reverse Tubal Ligation as it causes damaging.
SIGNS OF ECTOPIC PREGNANCY
• Not too heavy vaginal bleeding
• Sharp abdominal pain
• Severe one-sided abdominal pain
• Throwing up
• Shoulder and neck pain
• Passing out
• Pelvic pain
• Rectal pressure
• Severe cramps
DIAGNOSIS FOR ECTOPIC PREGNANCY
This can be done by a gynaecologist or specialist through tests such as pregnancy test, pelvic examination, a transvaginal ultrasound, ultrasound of the uterus and fallopian tubes. After an Ectopic pregnancy has been diagnosed, below are the two ways it could be rectified;
If your Fallopian tubes are fine and the pregnancy isn’t up to twelve-weeks, the specialists can give you methotrexate (trexall). This shot can stop the cells(embryo) from enlarging and your body will eventually absorb them.
SURGERY AND TYPES
There are two types of Ectopic surgery known as Laparoscopy and Laparotomy. Laparoscopy is further divided into two; Salpingostomy A small opening will be made in your lower abdomen and a flexible and thin tube will be used to extract the embryo when it ruptures and the tube is left to heal on it own. On the other hand, Salpingectomy is where the embryo and the tube are both removed. The procedure you will have will depend on the amount of bleeding and damage and whether the tubes are ruptured. The second factor is whether your other tube is normal or show signs of prior damage.
Laparotomy– Here the doctor might perform emergency surgery, and a much larger opening will be made to remove both the embryo and the fallopian tube. If there is heavy bleeding, This can be done laparoscopically or through an abdominal tear. In some circumstances, the fallopian tube can be preserved. Typically, however, a ruptured tube must be removed.
But if the fallopian tube is damaged.
Prompt treatment lessens the danger of developing difficulties from an ectopic pregnancy. Its also improves your likelihood for future successful pregnancies and lessens prospective health complications.
POST ECTOPIC PREGNANCY
After ectopic medication or surgery, consider talking to your gynaecologist or fertility specialist, if you want to have a child or have more children especially if your tube(s) was removed.
Try to also know how long to wait before you try again though, some expert has suggested at least twelve weeks, as this will allow your body to heal adequately.
The important thing also at this stage is to know that one ectopic pregnancy can increase the risk of another. Therefore, one should be mindful of how your body changes until you can get your doctor’s confirmation the pregnancy is in its natural rightful place.
Deterrence is not possible in most cases. You can reduce your risk through good sexual and reproductive health education and maintenance. Use protection during sex to avoid sexually transmitted diseases/infections that may inflame or scar your fallopian tubes. A regular visit to your gynaecologist for examination and screening. If you are a smoker quit smoking and take care of your personal health.
If you are a woman in Sierra Leone who had suffered quietly from miscarriage(s) due to ectopic, feeling alone and not having the correct information my heart goes out to you. Look for a professional, a trusted family or friend you can confide in. Your mental health is as important as your physical health. Stay strong and I hope this helps.
©By Rahima Vandy Kargbo known as Dasalonetiti Rahima