Ectopic Pregnancy

Ectopic pregnancy overview

  • An ectopic pregnancy occurs when a fertilized egg (embryo) implants somewhere other than the main cavity of the uterus.
  • Ectopic pregnancies often are caused by a damaged or blocked fallopian tube.
  • Symptoms of ectopic pregnancy include a missed period, nausea, light vaginal bleeding and/or pelvic pain.
  • Because ectopic pregnancies can be life threatening, treatment always involves removal of the ectopic pregnancy tissue, whether through medication or surgery.

What is ectopic pregnancy?

Ectopic pregnancies are pregnancies that occur outside of the main cavity of the uterus. Ectopic pregnancies often occur in the fallopian tubes; this event is known as a tubal pregnancy. In other cases, an ectopic pregnancy can occur in the abdominal cavity, ovary or cervix.

An ectopic pregnancy will not develop into a successful pregnancy, as the fertilized egg can’t survive outside of the natural place of the uterus. Additionally, the growing tissue might destroy various maternal structures, and if left untreated, life-threatening blood loss is even possible.

Causes of an ectopic pregnancy

A damaged fallopian tube is the most common cause of an ectopic pregnancy. Tubal damage can prevent a fertilized egg from passing through the tube into the uterus.

Fallopian tubes can be damaged by several factors:

  • Pelvic inflammatory disease (PID), often as a result of an infection from gonorrhea or chlamydia
  • Previous pelvic surgery that caused adhesions in the tube
  • Scar tissue from endometriosis
  • A birth defect or other abnormality resulting in a misshaped tube

Who is at risk of an ectopic pregnancy?

Women in the following categories are at increased risk of ectopic pregnancies:

  • Smokers – the more you smoke, the higher your risk
  • Anyone having had several induced abortions
  • A woman who has become pregnant with an IUD or after having her tubes tied (known as tubal ligation)
  • Ages 35-plus
  • Anyone who’s had a prior ectopic pregnancy
  • A woman who’s undergone fertility treatments or is using fertility medications

Symptoms of ectopic pregnancy

Early signs of an ectopic pregnancy include a missed period, nausea and breast tenderness. Light vaginal bleeding and abdominal or pelvic pain are often the first warning signs.

Sometimes women also experience gastric distress (pain or discomfort in the digestive tract). Blood can leak from the fallopian tube and cause shoulder pains or urges to have a bowel movement. This depends on where the blood pools and which nerves are irritated.

Heavy bleeding inside the abdomen is likely from a fallopian tube rupture and can lead to lightheadedness, fainting or shock.

Treatment for ectopic pregnancy

Early treatment of an ectopic pregnancy can help preserve the chance for future healthy pregnancies. To prevent life-threatening concerns, a surgeon must remove the ectopic tissue.

In case of early detection of an ectopic pregnancy, an injection of methotrexate, a drug that stops the growth of rapidly dividing cells, can be used to dissolve the existing cells of the pregnancy. However, the diagnosis of ectopic pregnancy must be certain before treatment begins.

Doctors can also treat ectopic pregnancies with laparoscopic surgery. This procedure requires a small incision in the abdomen near the navel. Then the doctor uses a thin tube with a camera lens and light to view the area around the uterus and fallopian tubes.

A doctor can insert additional instruments in the tube or through other small incisions to help remove the tissue and repair the fallopian tube.

Removal of the fallopian tube is necessary only in cases of significant damage. If the fallopian tube is damaged beyond repair or is removed, this can impact a woman’s fertility.