Make an Appointment
Talk to DoctorOverview
An ectopic pregnancy is characterized by the implantation and growth of a fertilized egg outside the normal uterine cavity. Typically, the process of pregnancy begins when a fertilized egg attaches itself to the lining of the uterus. However, in the case of an ectopic pregnancy, this attachment occurs in a location other than the primary uterine space.
The most common occurrence of ectopic pregnancy is within one of the fallopian tubes, which are responsible for transporting eggs from the ovaries to the uterus. This specific type of ectopic pregnancy is referred to as a tubal pregnancy. On occasion, ectopic pregnancies can also develop in other parts of the body, such as the ovary, the abdominal cavity, or the lower portion of the uterus known as the cervix, which connects to the vagina.
If left untreated, a rupture of the ectopic pregnancy can lead to severe internal bleeding, presenting a life-threatening emergency situation that necessitates immediate surgical intervention.
Symptoms
You might not notice any symptoms at first if you have an ectopic pregnancy. However, some women experience the typical early signs of pregnancy such as a missed period, breast tenderness, and nausea. If you take a pregnancy test, it will show a positive result. But it’s important to know that an ectopic pregnancy cannot progress normally.
As the fertilized egg grows in the wrong place, you’ll start to notice more noticeable signs and symptoms.
Early warning signs of ectopic pregnancy:
The first signs of an ectopic pregnancy often include:
- Light vaginal bleeding.
- Pelvic pain.
If the fallopian tube leaks blood, you might also feel shoulder pain or have an urge to have a bowel movement. The specific symptoms can vary depending on where the blood collects and which nerves are affected.
Emergency Symptoms:
If the fertilized egg continues to grow in the fallopian tube, it can lead to the tube rupturing. This is a life-threatening situation and is characterized by:
- Severe lightheadedness.
- Fainting.
- Shock.
- Heavy bleeding inside the abdomen.
If you experience any of these emergency symptoms, seek immediate medical attention.
Causes
A tubal pregnancy, which is the most common form of ectopic pregnancy, occurs when a fertilized egg becomes trapped on its journey to the uterus, typically due to inflammation-induced damage or structural abnormalities in the fallopian tube. Hormonal imbalances and irregular development of the fertilized egg can also contribute to this condition.
Risk factors
You are more likely to experience an ectopic pregnancy if you:
- Inflammation or infection. Sexually transmitted diseases like gonorrhea and chlamydia can inflame the fallopian tubes and other surrounding organs, which raises the possibility of an ectopic pregnancy.
- Previous ectopic pregnancy. You are more likely to experience another pregnancy of this kind if you have already had one.
- Fertility treatments. According to some studies, women who undergo In Vitro Fertilization (IVF) or other similar procedures may be more prone to experience an ectopic pregnancy. Your risk may increase if you experience infertility.
- Tubal surgery. The chance of an ectopic pregnancy can rise following surgery to repair a closed or damaged fallopian tube.
- Smoking. The chance of an ectopic pregnancy can increase if you smoke right before getting pregnant. The risk increases with the amount of smoking.
- Choice of birth control. Getting pregnant while using an intrauterine device (IUD) is uncommon, but if it does happen, the pregnancy is more likely to be ectopic. Similarly, having your tubes tied (tubal ligation), a permanent birth control method, increases the risk of ectopic pregnancy if pregnancy occurs after this procedure.
Diagnosis
A pelvic exam can help your doctor find areas of discomfort, tenderness, or unusual masses in your fallopian tubes or ovaries. However, diagnosing an ectopic pregnancy through this exam alone is not possible. To confirm or rule out an ectopic pregnancy, your doctor will use a combination of tests:
- Pregnancy test: Your doctor will order a blood test to check for a hormone called human chorionic gonadotropin (HCG), which increases during pregnancy. This test is done to confirm that you are pregnant. It may need to be repeated every few days until an ultrasound can provide more information, usually around five to six weeks after conception.
- Ultrasound: A transvaginal ultrasound involves placing a small device into your vagina to create images of your uterus, ovaries, and fallopian tubes. This helps your doctor determine the exact location of your pregnancy. Sometimes, an abdominal ultrasound, where a device is moved over your belly, may also be used to confirm the pregnancy or check for internal bleeding.
- Other blood tests: A complete blood count will be performed to look for signs of anemia or blood loss. If an ectopic pregnancy is diagnosed, your doctor may also order blood type tests in case a transfusion is needed.
Treatment
Ectopic pregnancy, which occurs when a fertilized egg develops outside the uterus, is a serious condition necessitating immediate treatment to prevent life-threatening complications. The choice of treatment depends on various factors, including the symptoms and timing of diagnosis, as well as the stage of the condition, the extent of damage, and the condition of the fallopian tubes. Early diagnosis and prompt medical attention are crucial for achieving the best possible outcome. Treatment options may include:
- Medication: If an ectopic pregnancy is discovered early and you’re not experiencing severe bleeding, you may receive a medication called methotrexate. This medication stops the abnormal cell growth and dissolves existing cells. Methotrexate is given through an injection, but it’s crucial to confirm the ectopic pregnancy diagnosis before using this treatment. After the injection, your doctor will monitor your progress with human chorionic gonadotropin (HCG) tests and may provide more medication if needed.
- Laparoscopic surgery: There are two types of laparoscopic surgeries used for treating ectopic pregnancies – salpingostomy and salpingectomy. During these procedures, a small incision is made near the navel, and a tiny camera (laparoscope) is used to examine the fallopian tube area.
- Salpingostomy, the ectopic pregnancy is removed, and the tube is left to heal on its own.
- Salpingectomy, both the ectopic pregnancy and the affected fallopian tube are removed.
The choice between these procedures depends on the extent of bleeding and damage, whether the tube has ruptured, and the condition of your other fallopian tube.
- Emergency surgery: If the ectopic pregnancy is causing severe bleeding, emergency surgery may be necessary. This surgery can be done either through laparoscopy or a larger abdominal incision (laparotomy). While in some cases, the fallopian tube can be saved, often, a ruptured tube must be removed to prevent further complications.
