An ectopic pregnancy is said to have occurred when the fertilized egg implants itself outside the uterus. In most cases, the egg would implant itself in the fallopian tube resulting in a tubal pregnancy. However, in very rare cases, the egg may get implanted in certain areas like the abdomen as well.
If this occurs, then the pregnancy is said to ectopic in nature and is called an abdominal pregnancy. In an abdominal pregnancy, the egg implants itself in the abdomen. In most cases the egg implants itself to the intestines and gets its blood and nutrient supply from the same. And since the signs of an abdominal pregnancy and a normal uterine pregnancy are similar, it is very difficult to diagnose the former without an MRI (magnetic resonance imaging) test.
Abdominal pregnancies are known to have higher mortality rates than other forms of ectopic pregnancies. But in very rare cases, a patient diagnosed with an abdominal pregnancy can deliver prematurely and provide a 50% chance of survival for the infant.
Types of Abdominal Pregnancy
There are two types of abdominal pregnancy that can occur in an individual. They are:-
i) Primary Abdominal Pregnancy
In the case of a primary abdominal pregnancy, the egg attaches to the abdomen directly without stopping anywhere in between. This form of abdominal pregnancy is very rare and has a mortality rate of 45-90%.
ii) Secondary Abdominal Pregnancy
This form of abdominal pregnancy is comparatively common and occurs when the embryo attaches to the abdomen after initially stopping by somewhere else. In most cases, the embryo would first attach itself to the fallopian tube (causing an ectopic tubal pregnancy). A small rupture in the tube could then propel the embryo towards the abdominal cavity where it implants itself.
Common Symptoms of an Abdominal Pregnancy
Since the pregnancy symptoms of a normal uterine pregnancy and an abdominal pregnancy are the same, it would be quite difficult to ascertain the situation until the initial, distinct symptoms of an abdominal pregnancy start showing up.
In the case of an abdominal pregnancy, the individual in question would start to experience mild-severe abdominal pain after the first few weeks of conceiving.
The pain would usually intensify as the fetus develops (grows) inside the abdomen. And this would usually occur from the 26 th week onwards.
Bleeding & Hemorrhage
In certain cases, the fallopian tube carrying the embryo may rupture during the initial stages of pregnancy. The embryo would then travel into the abdomen while the blood resulting from the rupture would collect in the abdominal cavity.
Excessive bleeding can cause severe abdominal pain and the skin can become pale with time. An abdominal pregnancy can also cause excessive bleeding during delivery when the embryo and its placenta are removed from the abdominal implantation site. In some cases, this would cause hemorrhage which would in turn cause maternal death.
A pregnant woman would most probably undergo an ultrasound during the first few weeks of the pregnancy to determine the exact site of the implantation. In the case of an abdominal pregnancy, the fetus would fail to show up in a vaginal ultrasound, indicating that it would most probably be somewhere else in the body.
Abnormal Fetal Movements
In an abdominal pregnancy, the movement of the fetus would be more pronounced (the mother can feel them clearly). This is because the embryo would be in the abdominal cavity and thus would be closer to the other organs of the body. The fetal movements would also not be felt in the usual parts of the body (i.e. the uterus).
This can be attributed to the position of the fetus in the abdominal cavity (in most cases, the fetus would be positioned sideways, transverse or obliquely). Increased fetal movement in an abdominal pregnancy could also lead to increased pain as there is no barrier between the fetus and the nearby organs.
Strange as it may sound, an abdominal pregnancy can be diagnosed sometimes by sounds emanating from the abdominal cavity where the embryo is implanted. This sound is attributed to the expansion of the placenta and the thickening of the ovarian artery.
The sound is heard in the form of faint murmurs that emanate from the site of implantation in the abdominal cavity. If these murmurs are heard from the abdomen, the chances of it being an abdominal pregnancy are very high.
Partial or Complete Intestinal Obstruction
In certain (very rare) cases of abdominal pregnancies, the embryo implants itself to the intestine and starts feeding from the same. As the fetus grows, it would start obstructing the intestine and prevent the intestinal contents from passing through.
When this occurs, the individual in question would start experiencing a series of issues like abdominal distention and gas, abdominal cramps, jaundice, diarrhea, constipation, nausea, bad breath and high fever etc.
An abdominal pregnancy that causes intestinal obstruction can also lead to more serious complications like the development of blood, lung infections and intestinal holes.
Some Uncommon Symptoms of Abdominal Pregnancies
In addition to the above mentioned symptoms, an abdominal pregnancy can be detected by some not so common symptoms as well. These include:-
An Empty Uterus
Usually in an abdominal pregnancy, the individual would feel as if her uterus is empty even after a couple of weeks into the pregnancy.
The individual would not be able to notice a heaviness in her uterus in sharp contrast to other women (with normal pregnancies) who start to notice a bulge or heaviness in their uterus after a few weeks.
In an abdominal pregnancy, the embryo would be present in the abdominal cavity and so would not obstruct other unfertilized eggs from passing through the uterus. And since the embryo is not present in the uterus, the uterine wall would shed, causing periods even when the individual is pregnant. In some cases, the individual would continue having her periods well into her pregnancy or will miss only a few cycles in between.
Weight Loss and Illness
An abdominal pregnancy can disrupt the individual’s eating habits. The fetus would press down on the other organs (including the stomach), causing pain and discomfort. This in turn could cause loss of appetite wherein the individual doesn’t feel like eating or feels nauseated all the time.
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