06 Jun 2023

When a woman conceives what usually comes to mind is the gender, the looks and the name they will call their baby; often overlooking the possible complications that could occur during pregnancy.

According to Obstetrician and Gynaecologist at Sedilega Private Hospital, Dr Ndiwo Memo, one such complication could be pregnancy that grows outside the womb (uterus), termed ectopic pregnancy.

In most cases, this condition is mistaken for irritable bowel syndrome (diarrhoea, constipation, or both) and such misdiagnosis could lead to missing out on getting swift treatment, said Dr Memo.

According to Dr Memo, in Botswana statistics for this kind of pregnancy were 1.4 per cent and 5.7 per cent in 2018 and 2019 respectively.

Given the prevalence of the condition, Dr Memo said, 95 per cent and 3 per cent occurred in the fallopian tube and ovarian area, respectively, whereas the abdomen, previous caesarean scar and within the womb muscle had 1 per cent occurrence.

Dr Memo said the common symptoms of the condition included missed periods, and could be confirmed with a pregnancy test, lower abdominal pains and bleeding.

“Most of the time, these symptoms occur in the first two to four months of pregnancy. So, bleeding and pains in early pregnancy need to be evaluated to make sure it is not because of ectopic pregnancy,” he said.

With the increasing incidence of the condition, a person who has had ectopic pregnancy before has higher chances of getting another one, he said.

Dr Memo said most of the time ectopic pregnancy was related to poor fallopian tube health, citing that smoking, and previous infection that involved the tubes, especially from sexually transmitted infections, also gave rise to chances of attracting the condition. Moreover, he identified previous operations on the fallopian tubes themselves or nearby structures and prior tying of tubes as other circumstances that could give rise to the condition.

Dr Memo said patients ought to be properly examined by a doctor to diagnose the ectopic and at times blood tests and possibly an ultrasound scan would be needed to confirm the analysis.

Under worst case scenario, Dr Memo said the pregnancy could  rupture and bleed internally, sometimes to a point where it could be life-threatening if not attended to promptly.

He said at times patients only learnt they were pregnant after they collapsed from bleeding too much, citing that the management of these patients depended on how unstable they were, and if they had bled a lot, they would be very unstable.

Dr Memo said this was why patients would require emergency care (drips and fluids) to replace the blood lost before taking them to theatre for an operation to remove the wrongly placed pregnancy and stop the bleeding.

He said these patients would most times require to be transfused blood if they lost significant amount, and if the ectopic was not ruptured yet, then the management would be less accelerated, mentioning that some could be managed without an operation.

Dr Memo said bleeding in early pregnancy, especially associated with pains, needed to be attended at a health facility to exclude ectopic pregnancy.

He emphasised that it was important to book for pregnancy visits early in pregnancy so that the location of the pregnancy could be verified. ENDS