What is an ectopic pregnancy?
Ectopic pregnancy is a problem with the implantation of a fertilized egg. In a formal pregnancy, the fertilized egg attaches to the lining of the uterus. Ectopic pregnancy involves the fertilized egg implanting and growing outside the uterus, in places such as:
- The fallopian tube
- The ovary
- The cervix
- The abdominal cavity
Slightly more than 1% of pregnancies are ectopic. Unfortunately, the fertilized egg cannot survive in an ectopic pregnancy.
Prognosis
The severity of the condition depends on where the egg is growing. If the egg is growing in the fallopian tube and is not detected early enough, it can lead to rupture of the fallopian tube and heavy bleeding, which can be life-threatening.
Symptoms of ectopic pregnancy
An ectopic pregnancy can cause:
- Vaginal bleeding
- Pain when going to the bathroom
- Pain on one side of the abdomen
- Shoulder pain
Not everyone with an ectopic pregnancy experiences symptoms, and it may only be diagnosed during a routine pregnancy examination. However, emergency help should be sought if you have sudden severe abdominal pain, accompanied by dizziness or nausea, as this may be an indication of a ruptured fallopian tube. In this situation, you will need emergency surgery to repair or remove the tube and control the bleeding.
How is ectopic pregnancy diagnosed?
After an evaluation of your symptoms, your doctor will order some blood tests and a vaginal ultrasound. The blood work can help not only with diagnosis but also with treatment, as a blood transfusion may be needed.
In some cases, a minimally invasive form of surgery called laparoscopy may be recommended if it is still difficult to make a diagnosis. If an ectopic pregnancy is found, the fertilized egg can be removed during the same procedure.
What causes ectopic pregnancy?
The following can increase the chances of having an ectopic pregnancy:
- Sexually transmitted infections
- Scarring from pelvic surgery.
- Infertility treatment such as IVF
- Pelvic inflammatory disease
- Smoking
You are also more likely to experience an ectopic pregnancy if you are between the ages of 35 and 40.
Tubal pregnancy (where the egg attaches to the lining of the fallopian tube) is caused by a blockage that prevents the egg from moving into the uterus. This may be the result of fallopian tube surgery or damage caused by inflammation.
Can ectopic pregnancy be prevented?
You can reduce the risk of ectopic pregnancy by quitting smoking and reducing your chances of getting sexually transmitted infections.
How is ectopic pregnancy treated?
Treatment for ectopic pregnancy depends on how early it was detected.
If the diagnosis was made early and you do not have unstable bleeding, the ectopic pregnancy can be treated with an injection of methotrexate, which should dissolve any existing cells. You will be monitored with follow-up blood tests and may need to continue taking birth control medication for the next few months.
If the medication does not work, or if the pregnancy is more advanced, surgery is usually recommended. Laparoscopy is performed under general anesthesia and involves the insertion of small surgical instruments to remove the ectopic pregnancy. If the fallopian tube is damaged and the other tube is healthy, the surgeon may also remove the damaged fallopian tube.
After treatment, you may have a follow-up appointment with a fertility specialist to discuss your chances of getting pregnant and get advice on when to start trying again.