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Pregnancy FAQ – Ectopic Pregnancy 2018

Pregnancy FAQ – Ectopic Pregnancy 2018

Frequently Asked Questions (FAQ) in Pregnancy

This article is a compilation of most frequently asked questions for pregnant women compiled by our author who are experts in O&G. Over 2000 answers & tips are provided to help educate and engage the women in Singapore.

Ectopic Pregnancy

What are the symptoms of ectopic pregnancy?

  • The symptoms of ectopic pregnancy consist of missing your period, abdominal pain/cramps (especially one-sided), and vaginal spotting/bleeding.
  • If the ectopic pregnancy has caused rupture of the tube, there may also be dizziness or fainting due to low blood pressure.
  • If you are having these symptoms in early pregnancy (especially if you have not yet had an ultrasound to confirm that your fetus is safely inside the womb), please visit the emergency room immediately.
  • Ectopic pregnancy is a life-threatening condition! What are the different types of miscarriage?

What causes them?Common FAQ on Miscarriage

  • Generally, we classify miscarriages into five groups, based on the status of the baby and the womb
  • Threatened miscarriage is diagnosed when there is per vaginal bleeding but no cervical change or fetal loss. On ultrasound examination, the heartbeat of the baby is present and normal. The cause of this condition is not clearly understood, but some studies suggest that it can caused by challenges in the maternal hormonal environment (e.g. low progesterone) or even stress.
  • Missed miscarriage is diagnosed when the cervix is closed, and ultrasound shows that although the fetus remains inside the womb, the fetal heart beat has stopped. The majority of the cases are due to intrinsic abnormalities in the fetus itself, such as chromosomal defects. Few cases are due to infections or toxins in early pregnancy A surgical procedure called dilation and curettage may be needed to clean out the womb.
  • Inevitable miscarriage is diagnosed when there is vaginal bleeding accompanied by dilation of the cervix, while an early fetus may still remain in the womb. In this case, miscarriage is inevitable because a dilated cervix is not likely to close and keep the fetus safe inside the womb, and the fetus is not able to survive environment outside of the womb until at least 24 weeks gestation. Inevitable miscarriage can be due to fetal abnormalities or maternal anatomical problems. Speak to your doctor when planning another pregnancy.
  • Partial miscarriage is diagnosed when there is vaginal bleeding with partial passing of products of conception (e.g. part of placenta, fetus). The majority of the cases are due to intrinsic abnormalities in the fetus itself, such as chromosomal defects. Few cases are due to infections or toxins in early pregnancy. A surgical procedure called dilation and curettage may be needed to clean out the womb.
  • Complete miscarriage is diagnosed when there is vaginal bleeding with complete passing out of any products of conception (e.g. entire placenta, fetus). The majority of the cases are due to intrinsic abnormalities in the fetus itself, such as chromosomal defects. Few cases are due to infections or toxins in early pregnancy. Unlike partial miscarriage or missed miscarriage, a procedure to clear the womb may not be needed if there is ultrasound evidence that all products of conceptions have been passed out.
  • The management of threatened miscarriage is still under debate and research.

I have been diagnosed with threatened miscarriage – should I take progesterone pills?

  • There is no clear evidence showing that progesterone pills can prevent a miscarriage, especially when maternal progesterone levels are already in the normal range (in these cases, the threatened miscarriage is not due to lack of progesterone, so supplementation are unlikely to help).
  • Therefore, the usage of progesterone depends on the country and your doctor. In some institutions, a progesterone blood test is available, and progesterone supplementation is only given if levels are below normal. In any case, progesterone supplementation has little side effects.
  • Please note that progesterone may be used for different purposes in the pregnancy, such a luteal phase support in an IVF pregnancy.

I have been diagnosed with threatened miscarriage – should I keep to bedrest?

  • Bedrest may be beneficial if you’re diagnosed with threatened miscarriage, but be sure to prevent other pregnancy complications, such as deep vein thrombosis (bloodclot in the leg veins due to immobility), but purchasing a pair compression stocking.
  • If you’re still experiencing bleeding – see doctor to get rest from work. Do not do strenuous activity. Avoid sexual intercourse for the time being.

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MBBS (S'pore), M.Med(O&G) (S'pore) Head & Senior Consultant Department of Obstetrics and Gynaecology KK Women's and Children's Hospital Director (Clinical), Office of Patient Experience Deputy Director (Education), KKH Campus Associate Professor Duke - NUS Graduate Medical School Singapore

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