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Healthy Outlook

Don't Give Up After Tubal Pregnancy


Published by Contra Costa Times
Posted on Wednesday, June 6, 2012
By Dr. Judy Bliss

If you've had an unsuccessful pregnancy due to a fertilized egg attaching somewhere outside of the uterus, it's reasonable to have feelings of distress about trying again. Despite what may now seem like long odds, it might still be possible to have a successful pregnancy.

An ectopic pregnancy is one that occurs outside of the uterus, usually in one of the Fallopian tubes. In rare cases, ectopic pregnancies (also called tubal pregnancies) can occur in the ovary, cervix or surrounding areas. These pregnancies must be stopped as the fetus cannot develop outside the womb and the mother could suffer life-threatening injury.

This experience can be devastating to a woman and create fear about becoming pregnant again. But she isn't alone; about one out of 50 pregnancies (or 2%) is ectopic.

If you have gone through an ectopic pregnancy and wish to try again, wait at least three months, especially if you were treated with methotrexate. This rest not only allows your menstrual cycle to return to normal and your scar tissue to heal, it gives you a chance to recover and prepare emotionally. You must be ready to deal with a one in 10 chance you will have another ectopic pregnancy or a miscarriage. If you do not want to be pregnant, talk to your health care provider about birth control methods that are best for preventing ectopic pregnancies.

The success of your next pregnancy depends on the cause of the ectopic pregnancy and your medical history. If the ectopic pregnancy was treated early and the Fallopian tubes were not severely damaged, you stand a 66% chance of having a successful pregnancy in the future.

There is not much you can do to increase your odds. If the Fallopian tubes were damaged from scarring or infection, there is a greater chance of an unsuccessful next pregnancy. Ongoing abdominal pain after treatment could be the sign of an infection that might cause future ectopic pregnancies, so check with your practitioner if you experience this symptom.

When you're prepared to try again, schedule a preconception checkup to determine if your body is ready and if it is necessary to adjust intake of folic acid or other prenatal vitamins. If you suffered severe damage to both of your Fallopian tubes, you'll need to consider in vitro fertilization. Your practitioner will also help you treat or reduce factors that could have led to the first ectopic pregnancy, such as infection.

Be extra determined to follow guidelines that help with any pregnancy. This consists of a healthful diet that includes vitamins and minerals, regular exercise, maintaining a low-stress environment and avoiding alcohol, tobacco and medications not prescribed by your practitioner.

Notify your practitioner immediately after a positive pregnancy test. Women who have had an ectopic pregnancy in the past will likely be closely monitored to ensure this pregnancy is developing normally in the uterus. Blood tests and an early ultrasound should be done as soon as the pregnancy is diagnosed to make sure there is not a recurrent ectopic pregnancy.

An ectopic pregnancy is a traumatic experience and many people feel scared to try again. Getting support from friends and family or a counselor can help you make the right decision.

Dr. Bliss practices obstetrics and gynecology at the Contra Costa Regional Medical Center in Martinez. Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at theairdoctor@gmail.com. For more health information, go to www.cchealth.org.

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