What is an ectopic pregnancy?
From fertilization to delivery, pregnancy requires a number of steps in a woman’s body. One of these steps is when a fertilized egg travels to the uterus to attach itself. In the case of an ectopic pregnancy, the fertilized egg does not attach to the uterus. Instead, it may attach to the fallopian tube, abdominal cavity, or cervix. While a pregnancy test may reveal a woman is pregnant, a fertilized egg can’t properly grow anywhere other than the uterus. According to the American Academy of Family Physicians (AAFP), ectopic pregnancies occur in one out of every 50 pregnancies.
An untreated ectopic pregnancy can be a medical emergency. Prompt treatment reduces your risk of complications from the ectopic pregnancy, increases your chance for future, healthy pregnancies, and reduces future health complications.
Who is at risk of ectopic pregnancy?
Women who have abnormal fallopian tubes are at higher risk of ectopic pregnancy. Abnormal tubes may be present in women who have had the following conditions:
- Pelvic inflammatory disease (an infection of the uterus, fallopian tubes, and nearby pelvic structures)
- Previous ectopic pregnancy
- Pelvic or abdominal surgery
- Prior tubal surgery (such as tubal sterilization)
- Sexually transmitted infections
Other factors that increase a woman’s risk of ectopic pregnancy include the following:
- Cigarette smoking
- Increased age
- Infertility treatments
What are the symptoms of ectopic pregnancy?
Ectopic pregnancy may cause the following symptoms:
- Abnormal vaginal bleeding —Bleeding that is not at the time of your normal menstrual period is called abnormal vaginal bleeding. It may be light or heavy.
- Shoulder pain—Blood from the ruptured tube can build up under the diaphragm (the area between your chest and stomach). This can cause pain that is felt in the shoulder.
- Abdominal or pelvic pain —This can be sudden and sharp and ache without relief or seem to come and go. It may occur on only one side.
- Weakness, dizziness, or fainting —This can happen because of blood loss.
These symptoms can occur before you even suspect you are pregnant. If you have these symptoms, call your obstetrician / gynecologist.
How is ectopic pregnancy diagnosed?
If your obstetrician / gynecologist or other health care professional suspects that you may have an ectopic pregnancy, he or she may do the following:
- Perform a pelvic exam.
- Check your blood pressure (low blood pressure may mean internal bleeding) and pulse.
- Perform an ultrasound exam (a test in which sound waves are used to create an image) to see if there are early signs of a pregnancy.
- Test your blood to detect the hormone human chorionic gonadotropin (hCG). This hormone is produced when a woman is pregnant. The test may be repeated to check the levels of hCG.
What treatment is available for ectopic pregnancy?
There are two methods used to treat an ectopic pregnancy: medication and surgery. Several weeks of follow-up are required no matter which type of treatment is used.
- Medication. If the pregnancy is small and has not ruptured the tube, sometimes drugs can be used instead of surgery to treat ectopic pregnancy. Medication stops the growth of the pregnancy and permits the body to absorb it over time. It allows a woman to keep her fallopian tube.
- Surgery. If the pregnancy is small and the tube is not ruptured, in some cases the pregnancy can be removed through a small cut made in the tube using laparoscopy. In this procedure a slender, light-transmitting telescope is inserted through a small opening in the abdomen. It is done in a hospital with general anesthesia. A larger incision in the abdomen may be needed if the pregnancy is large or the blood loss is thought to be a concern. Some or all of the tube may need to be removed.
Is pregnancy possible after surgery?
If you have had surgery and the fallopian tubes have been left in place, there is a good chance that you can have a normal pregnancy in the future. Once you have had an ectopic pregnancy, however, you are at higher risk of having another one.