Ectopic laparotomy surgery cost in India

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What is Ectopic Pregnancy?

An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus. An ectopic pregnancy most often occurs in a fallopian tube, which carries eggs from the ovaries to the uterus. This type of ectopic pregnancy is called a tubal pregnancy. Sometimes, an ectopic pregnancy occurs in other areas of the body, such as the ovary, abdominal cavity or the lower part of the uterus (cervix), which connects to the vagina. An ectopic pregnancy can't proceed normally. The fertilized egg can't survive, and the growing tissue may cause life-threatening bleeding, if left untreated.

Symptoms

• A missed period, breast tenderness and nausea

• Light vaginal bleeding and pelvic pain

• If blood leaks from the fallopian tube, you may feel shoulder pain or an urge to have a bowel movement. 

• If the fertilized egg continues to grow in the fallopian tube, it can cause the tube to rupture. Heavy bleeding inside the abdomen is likely. Symptoms of this life-threatening event include extreme lightheadedness, fainting and shock.

Causes

Some things that make you more likely to have an ectopic pregnancy are:

• Previous ectopic pregnancy. If you've had this type of pregnancy before, you're more likely to have another.
• Inflammation or infection. Sexually transmitted infections, such as gonorrhea or chlamydia, can cause inflammation in the tubes and other nearby organs, and increase your risk of an ectopic pregnancy.
• Fertility treatments. Some research suggests that women who have in vitro fertilization (IVF) or similar treatments are more likely to have an ectopic pregnancy. Infertility itself may also raise your risk.
• Tubal surgery. Surgery to correct a closed or damaged fallopian tube can increase the risk of an ectopic pregnancy.
• Choice of birth control. The chance of getting pregnant while using an intrauterine device (IUD) is rare. However, if you do get pregnant with an IUD in place, it's more likely to be ectopic. Tubal ligation, a permanent method of birth control commonly known as "having your tubes tied," also raises your risk, if you become pregnant after this procedure.
• Smoking. Cigarette smoking just before you get pregnant can increase the risk of an ectopic pregnancy. The more you smoke, the greater the risk.

Diagnosis

A pelvic exam can help your doctor identify areas of pain, tenderness, or a mass in the fallopian tube or ovary. However, your doctor can't diagnose an ectopic pregnancy by examining you. You'll need blood tests and an ultrasound.

Pregnancy test

Your doctor will ask the human chorionic gonadotropin (HCG) blood test to confirm that you're pregnant. Levels of this hormone increase during pregnancy. This blood test may be repeated every few days until ultrasound testing can confirm or rule out an ectopic pregnancy — usually about five to six weeks after conception.

Ultrasound

A transvaginal ultrasound allows your doctor to see the exact location of your pregnancy. For this test, a wandlike device is placed into your vagina. It uses sound waves to create images of your uterus, ovaries and fallopian tubes, and sends the pictures to a nearby monitor. Abdominal ultrasound, in which an ultrasound wand is moved over your belly, may be used to confirm your pregnancy or evaluate for internal bleeding.

Other blood tests

A complete blood count will be done to check for anemia or other signs of blood loss. If you're diagnosed with an ectopic pregnancy, your doctor may also order tests to check your blood type in case you need a transfusion.

Treatment

A fertilized egg can't develop normally outside the uterus. To prevent life-threatening complications, the ectopic tissue needs to be removed. Depending on your symptoms and when the ectopic pregnancy is discovered, this may be done using medication, laparoscopic surgery or abdominal surgery.

Medication

An early ectopic pregnancy without unstable bleeding is most often treated with a medication called methotrexate, which stops cell growth and dissolves existing cells. The medication is given by injection. It's very important that the diagnosis of ectopic pregnancy is certain before receiving this treatment. After the injection, your doctor will order another HCG test to determine how well treatment is working, and if you need more medication.

Laparoscopic procedures

Salpingostomy and salpingectomy are two laparoscopic surgeries used to treat some ectopic pregnancies. In these procedures, a small incision is made in the abdomen, near or in the navel. Next, your doctor uses a thin tube equipped with a camera lens and light (laparoscope) to view the tubal area. In a salpingostomy, the ectopic pregnancy is removed and the tube left to heal on its own. In a salpingectomy, the ectopic pregnancy and the tube are both removed.

Emergency surgery

If the ectopic pregnancy is causing heavy bleeding, you might need emergency surgery. This can be done laparoscopically or through an abdominal incision (laparotomy). In some cases, the fallopian tube can be saved. Typically, however, a ruptured tube must be removed.

Recovery

The recovery time can vary significantly among individuals. Many other factors, including the person’s age and overall health, will also determine how long it takes them to feel better.

• Resting as much as possible for days to weeks, depending on the doctor’s recommendation
• Continuing to move around and do any exercises that a doctor has set
• Getting other people to help around the home and with daily tasks, where possible
• Following all dietary guidelines from a doctor
• Taking medication as a doctor prescribes
• Avoiding all heavy lifting, including pulling or pushing items, sexual activity, and swimming for 6 weeks.

It is usual to feel tired with low energy during recovery, as the body is healing. It is also quite common to experience a wide range of emotions and have difficulty sleeping. People may be unable to drive during recovery, either because they are allowing their body to heal or due to the medications that they are taking. A person can check with their doctor and inform their insurance company if this is the case. It is important to contact a doctor as soon as possible if any signs or symptoms of infection appear around the wound site. These may include:

• increased pain or tenderness
• redness
• swelling
• discharge from the wound site
• Fever or chills
• vomiting or nausea
• difficulty breathing
• chest pain
• severe leg pain