Ectopic pregnancy is a dangerous medical condition where the baby instead of embeding in the womb is implanted outside. The most common site is within a Fallopian tube (tubal pregnancy). Very rarely, it can occur in the ovary, the abdomen, and the neck of the womb.
About 85% of the women who have experienced one ectopic pregnancy are later able to achieve a normal pregnancy. A subsequent ectopic pregnancy may occur in 10 to 20% of cases. Some women fail to become pregnant again, while others become pregnant and spontaneously abort during the first trimester. Click here to read more about ectopic pregnancy.

Ectopic pregnancy is a serious condition when a fertilized egg implants outside the womb. After fertilization, the developing baby travels down the fallopian tube to the womb. If the tube is damaged or partially blocked (usually due to sexually transmitted infections), the baby implants and grows in the tube until it ruptures, resulting in heavy internal bleeding. This may lead to death if the bleeding is not arrested promptly.

You can still have a normal pregnancy as long as the other tube is normal. However, chances of having a successful pregnancy may be lower than normal. Studies have shown that chances of having another normal pregnancy are about 85 to 90 percent.

Although you mentioned that X-ray of the other tube is normal, subtle damages to the tube caused by asymptomatic infections may not be obvious. The risks of getting another ectopic pregnancy are therefore increased. From medical statistics, chances are about 10 to 15 percent.

You should also note that an ectopic pregnancy does not always show on a pregnancy test kit. If you suspect that you are pregnant again, you should see your gynaecologist early so that you can be monitored closely.

The following symptoms require immediate medical attention:

• Abdominal pain or tenderness. It may be mild, sharp or stabbing .It may come and go and vary in intensity. You may feel it only on one side, but the pain can be anywhere in your tummy and is sometimes accompanied by nausea and vomiting..
• Spotting or bleeding. The blood may look red or brown, and may be continuous or intermittent
• Shoulder pain especially when you lie down. This may indicate a ruptured ectopic pregnancy. The cause of the pain is internal bleeding, which irritates nerves that go to your shoulder area.
• Weakness, dizziness, or fainting

You have what we called delayed ejaculation or retarded ejaculation. Please see our web page on Ejaculatory Incompetence for its causes and treatment.

Emergency contraception means pregnancy is prevented by temporarily blocking ovulation, by stopping fertilization, or preventing a fertilized egg from becoming implanted in the uterus. It is used in unprotected sex.
Emergency contraception is usually done in two ways: taking contraceptive pills or inserting a copper-releasing intrauterine device (IUCD).

1. Emergency Contraceptive Pills are most commonly used and are taken in two doses. The first dose is taken within 72 hours of unprotected intercourse, and the second dose 12 hours later. The most common side effects associated with emergency contraception include nausea, abdominal pain, fatigue, headache and menstrual irregularity. However, it is about 70% effective when taken within 72 hours of unprotected sex.
2. An IUD is inserted to prevent pregnancy up to five days after unprotected intercourse.

Emergency contraception should not be used by women who are already pregnant because it is ineffective in aborting established pregnancies and does not prevent sexually transmitted diseases.

Endometriosis is a common and troublesome condition affecting many women of childbearing age and occasionally in teenagers as well. It is a progressive disease when the lining of the womb (endometrial tissues) is spilled into other parts of the reproductive organs including the fallopian tubes ,ovaries and the back of the womb. These abnormal and wayward endometrial tissues bleed every month during menstruation. The surrounding areas become irritated and form scars. The exact cause of endometriosis is not well understood although many theories have been proposed to explain its development. There is a genetic basis for the disease as it can run in the family.
You can find more information on endometriosis in a separate page in this web site.

Endometriosis is generally a difficult disease to treat as there is no definitive cure. The disease will die off only at menopause when there is no stimulation of the endometrial tissues by the ovarian hormones. If the disease is very mild causing menstrual discomfort only, pain killer such as panadol, aspirin and ponstan may alleviate the pain.
You should discuss together with your doctor to select the most appropriate treatment according to your condition.
Click here for more information on endometriosis and its treatment.

Engagement, also called lightening or dropping, is used in obstetrics to describe when the widest part of the fetal skull has descends or negotiated into the pelvic cavity. This means that the baby's head is now fixed at the mid plane of the pelvis.
In first-time mothers, this usually happens two to four weeks before delivery; babies of women who have already had children usually do not engage until labor begins. There is feeling of increased pressure in the lower part of the tummy. Breathing and eating may become easier as the stomach is less stretched. However, walking may become increasingly uncomfortable. Some mothers may feels as if the baby is going to fall out while others may feel as if she needs to pass urine all the time.
If the baby does engage, this does not mean that labor is about to begin: it may take a few days or weeks to begin. Conversely, if the baby's head is not engaged, labor may begin the next day.

Most exercises are safe during pregnancy provided one exercises with caution and does not overdo it. Swimming, brisk walking, stationary cycling and low-impact aerobics carry little risk of injury and can be done in moderation. One should choose exercises that do not require too much balance or coordination. Exercise may not be advisable if there are medical problems, such as asthma, heart disease or diabetes.
Please visit Exercises during Pregnancy for more details.