Author: Swikriti Rimal
Teaching Hospital
Live in relationships are more common than you might think. With the people in Nepal becoming more open minded and the obvious western influence and students moving out of their homes at early age, live in relationships have become even more prevalent.
But is it really a good idea? Well, there are many positives for sure. There are no complications compared to the kinds you have in a marriage. You can be in the relationship for as long as you want, and this way you keep it fresh and happy. The bondage of being their with each other for the rest of your life might get heavy on your heart and the slightest provocation or disturbance can bring in that fear. but The downside is that you are still not socially acceptable in most parts of Nepal & India. You will be frowned upon in many social situations and that might take the toll, eventually.
What else can be the problem in living relationship other than society??
Apart from social mental torture the next big problem most of youth may face being in Living relationship is unsafe sexual contact that may lead to most risky Pregnancy named as ECTOPIC PREGNANCY. In case you partner get such pregnancy than the medical team wouldn’t be ready for abortions without parents consult, as this involves serious surgery.
Just a relationship of boyfriend wont give them confidence that you will be responsible for any risk that might happen during operation.
A boy with 20 years of age comes hospital with a girl of around 18 years for ectopic surgery, but Teaching hospital never agrees to operate a girl without a permission of her parents, as a boy himself is too young to handle the situation, and hospital can never believe a boy who can run away anytime in case of risk arises.
What is ECTOPIC PREGNANCY??
We all know that, for pregnancy the ovary releases the egg into the fallopian tube and it stays there for 24 hours. If it meets with sperm then fertilization occurs. The fertilized egg remains in the fallopian tube for 3 to 4 days then it travels to the uterus where it grows as a developing fetus. Unfortunately, sometimes there will be disturbances in this cycle where the fertilized egg implants somewhere else other than the uterus. It will implant in fallopian tube, cervix, ovaries or in your abdomen.
Pregnancy where fertilization occurs other than inside of the uterus is termed as ectopic pregnancy. It is a complication of pregnancy where the embryo attaches outside the uterus. It happens in 1 out of 50 pregnancies. Most of all ectopic pregnancies occur in the fallopian tube which is known as tubal pregnancy and rarely it can occur in abdomen, cervix and ovaries too. It is a serious problem and requires emergency management. It can lead to rupture of the organs with life threatening blood loss because of internal bleeding.
Causes
- Partial or complete block of fallopian tube due to infection and inflammation
- Damaged fallopian tube so that egg can’t travel towards uterus and implants in fallopian tube itself
- Pelvic inflammatory diseases
- Sexually transmitted diseases
- Scarring from previous pelvic surgeries
- History of ectopic pregnancy
- Use of fertility drugs like ipill
- In vitro fertilization
- using intra uterine device
Symptoms
- Initially there will be light vaginal bleeding and pelvic pain
- Sharp abdominal cramps
- Pain in one side of your body, pain may spread to shoulder if bleeding into the abdomen has occurred
- Weakness and dizziness
- Pain in your shoulder, neck or rectal pressure
- Nausea and vomiting with pain
Diagnosis
- Blood test for hCG (human chorionic gonadotropin)
- Ultrasound
- TVS (Trans vaginal ultrasonography)
- In some cases laparoscopy is needed to confirm ectopic pregnancy
Treatment
We all know fertilized egg can’t survive outside uterus, so it has to be removed before it leads to serious complications.
Medication:
If the fallopian tube isn’t rupture, then your doctor can prescribe Methotrexate injection which stops the cells from growing. If diagnosed early then it can be cured by Methotrexate injection. It works well when the beta HCG is low and the size of ectopic is small.
Surgery:
In some conditions, surgery is required. Nowadays the most common surgery is laparoscopy where your doctors will make small incisions in the lower abdomen and they insert a thin and flexible instrument called laparoscope to remove the ectopic pregnancy. If the fallopian tube is damaged, it should be remove as well. If there is rupture fallopian tube with heavy bleeding you might need a larger incision which is called laparotomy.
Complication
If there is rupture ectopic pregnancy then it may lead to internal bleeding with hypovolemic shock and eventually death too.
After ECPTOPIC
You can have normal pregnancy again. If your one or both fallopian tube is removed, you can consult with fertility specialist. They may suggest about in vitro fertilization which involves implanting the fertilized egg directly in the uterus. You can be pregnant again after 3 to 6 months.
Surgery can make scar in fallopian tubes so there is high chance of getting ectopic pregnancy again.
If both fallopian tubes are still intact there is big chance of having a normal pregnancy again in future.
