Posts Tagged ‘fallopian tube’

Ectopic pregnancy

Tuesday, September 1st, 2009

crampsIn an ectopic or “out of place” pregnancy, a fertilized egg implants outside of the uterus, usually in the fallopian tube, and begins to grow. When this happens, the birth of a baby is not possible and the woman’s health is threatened.  It can be pretty scary, so familiarize yourself with symptoms.

With an ectopic pregnancy, about 1 week after a missed menstrual period a woman may experience slight, irregular vaginal bleeding that may be brownish in color. Some women mistake this bleeding for a normal menstrual period. The bleeding may be followed by pain in the lower abdomen, often felt mainly on one side.  If you experience this, call your doc right away or go to the emergency room.  Without treatment, these symptoms may be followed in several days or weeks by severe pelvic pain, shoulder pain (due to blood from a ruptured ectopic pregnancy pressing on the diaphragm), faintness, dizziness, nausea or vomiting.

An ectopic pregnancy can be difficult to diagnose, so several tests need to be performed. If the provider finds an ectopic pregnancy, the embryo (which cannot survive) must be removed so that it does not cause the fallopian tube to rupture, resulting in life-threatening internal bleeding. Most ectopic pregnancies are diagnosed in the first 8 weeks of pregnancy, usually before the tube has ruptured.

There are two treatments for ectopic pregnancy: medication (using a drug called methotrexate which stops growth of the pregnancy and saves the fallopian tube. The woman’s body gradually absorbs the pregnancy); and surgery (the provider usually makes a tiny incision in the fallopian tube and removes the embryo, trying to preserve the tube, although sometimes it must be removed). After either of these treatments, the provider monitors the woman for several weeks with blood tests for hCG until levels of the hormone return to zero.

The most significant risk factor for ectopic pregnancy is sexually transmitted infections (STIs), such as chlamydia. For most women, the cause of an ectopic pregnancy is unknown.

Many women who have had an ectopic pregnancy can have healthy pregnancies in the future. Studies suggest that about 50 to 80 percent of women who have had an ectopic pregnancy are able to have a normal pregnancy. Women who have had an ectopic pregnancy have about a 10 percent chance of it happening again, so they need to be monitored carefully when they next attempt to conceive.

What is hysteroscopy?

Tuesday, August 25th, 2009

doctorHysteroscopy is a procedure that permits a doctor to view the inside of a woman’s uterus.  A hysteroscope is a thin instrument with a light and camera attached to its end.  It is inserted into the vagina, through the cervix into the uterus and, among other things, can investigate the cause of problems such as repeat miscarriage or infertility.  These problems can include abnormal bleeding; the shape of the uterus; the presence of scar tissue, non-cancerous growths like small fibroids or polyps; the blockage of one or both fallopian tubes.  In many cases, other small instruments can be inserted during a hysteroscopy to remove a blockage, polyp or fibroid and correct the problem.

This procedure usually is performed by a gynecologist in the operating room of a hospital or surgery center. A sedative to help her relax and a local, regional or sometimes general anesthesia usually is given, and most women go home in the same day. In some cases, the hysteroscopy can be done in your doctor’s office.

A gas or fluid is inserted into the uterus through the hysteroscope to help the doctor obtain as clear a picture of the uterus as possible. The image from the camera is projected on a screen for easy viewing. The process takes about 30 minutes, unless corrective procedures or a biopsy of the uterine lining are required which can take a little longer.  A woman may experience some light spotting, cramping and gas pains for a day or so afterward.

A woman who is pregnant, has a vaginal or urinary tract infection, or is known to have cancer of the uterus should not have a hysteroscopy.  This is a safe procedure but some risks do exist, so any woman offered hysteroscopy should discuss the benefits and risks of the procedure with her doctor.

What is a hysterosalpingogram?

Tuesday, June 30th, 2009

x-raysThis is a type of X-ray that examines the inside of the uterus, fallopian tubes and surrounding area.  For women who have a hard time becoming pregnant and have already undergone blood tests to check hormone levels, doctors may recommend a hysterosalpingogram for a closer look.

An iodine dye, used for contrast, is placed in the uterus through a thin tube inserted in the vagina and through the cervix.  The dye flows through the uterus into the fallopian tubes and out into the abdominal cavity where it eventually is absorbed by the body.  A continuous X-ray traces the progression of the contrast dye to determine if there are any abnormalities in the uterus such as a septum, polyps or fibroids. The X-ray pictures are displayed on a TV monitor during the test.  Scarring or blockages in the fallopian tubes become evident when the dye stops flowing through them.  These abnormalities or blockages can be causes of infertility and sometimes can be corrected.

A hystersalpingogram is performed 2 to 5 days after the end of a menstrual period to be sure a woman is not pregnant and has not recently ovulated.  The test usually takes 15 to 30 minutes and is performed in a hospital or clinic X-ray room.  There may be mild cramping, like menstrual cramps, during or after the test.  Spotting from the dye and light bleeding for a day or two after the test are common.