A fertilized egg implanted outside of the uterus is known as an ectopic pregnancy. It can be found in the fallopian tube or the cervix. If left untreated, ectopic pregnancies can cause permanent damage or even death. If you suspect an ectopic pregnancy, it is important to know the signs and seek emergency care.
Grace Cary/ Getty Images
Types
In a normal pregnancy, a fertilized egg travels via a fallopian tube into the uterus where it implants in the lining. It is known as an ectopic pregnancy if the egg implants somewhere else.
What Are Common Ectopic Pregnancies (Cepo)?
Ectopic pregnancies account for approximately 1 to 2 percent of all pregnancies in the general population. However, this rate is much higher among women who are receiving assisted reproductive technology (ART), which accounts for 2 to 5 percent.
The majority of ectopic pregnancies–90%–occur in the fallopian tube, but 10% take place on an ovary, the outer layer of the uterus, the spaces between the fallopian tube, the abdominal cavity, or within a cesarean section scar.1
Symptoms
The symptoms of an ectopic pregnancy usually look similar to regular pregnancy.
- A missed period
- Fatigue
- Nausea
Sometimes, there may not be any symptoms immediately.
Ectopic pregnancies can not grow into healthy babies if pregnancy tests are done at this time. Two common signs that indicate an ectopic pregnancy are usually present between six and ten weeks after fertilization.
- Vaginal bleeding, including light bleeding
- Pelvic pain Sometimes on one side
- Shoulder pain
- The need to urinate
Ectopic pregnancy pain can be temporary and dull. Sometimes it may only be one side, but can get worse over time. Low blood pressure due to blood loss can cause dizziness and fainting.
How to Get Medical Care
Ectopic pregnancies can be a serious medical emergency. If you suspect you may be pregnant, or if you have any of the following signs, you should contact emergency care immediately.
- Urgent pelvic and abdominal pain
- Vaginal bleeding
- Shoulder pain
- Feeling dizzy or lightheaded
If left untreated, an unectopic pregnancy can lead to severe bleeding and rupture of the fallopian tube. This is a life-threatening condition.
Causes
Ectopic pregnancy can often be caused by a misaligned or inflamed fallopian tube. Another reason is hormonal imbalances, or the inability of the fertilized egg to develop properly.
Half of women diagnosed with ectopic pregnancy have no known risk factors. There are however, some risk factors that have been identified, such as:1
- Smoking
- History of ectopic pregnancy
- Surgery or damage to the fallopian tubes
- Pre-infections of the pelvis or pelvic inflammation disease
- Pregnancy with an intrauterine device (IUD).
- Assisted reproductive technology conception
- Maternal age over 35
- A history of dilation or curettage (D&C), in a previous pregnancy is required for cervical ectopic.
- Endometriosis
- Congenital disability of fallopian tube
Diagnosis
After an examination and testing, an ectopic baby will usually be diagnosed by your healthcare provider. An ectopic pregnancy can usually be detected within eight weeks. The following tests are common:
- Pregnancy test such as a urine test strip
- Pelvic examination
- Use transvaginal ultrasound to locate fertilized eggs
- A blood test that checks for levels of human chorionic Gonadotropin (hCG).
It may take more than one ultrasound to diagnose an ectopic pregnancy.
Treatment
Your healthcare provider will create a treatment plan once you have been diagnosed with an ectopic baby. You will most likely be admitted to the emergency room without an appointment. Your health and the decision of your healthcare provider will determine what treatment you receive.
Methotrexate
Methotrexate can stop pregnancy progression. As an alternative to surgery, it is administered by injection. It is necessary to keep the hCG levels in check after the injection.
Warning: Prenatal Vitamins and Methotrexate
Stop taking folate or prenatal vitamins while you take methotrexate.
Methotrexate can be given in a single, double, or multiple-dose form, depending on the circumstances.
Surgery
When necessary, surgery is performed. Laparoscopy is the most common type for ectopic pregnancy. It involves multiple small incisions rather than one large.
The surgeon inserts a small camera equipped with a light to see the area in need of treatment. The surgeon may decide to remove the entire fallopian tube or just the fertilized egg depending on its condition.
For life-saving reasons, emergency surgery is performed for ectopic pregnancies. You can either perform it via laparoscopy (described above) or by incision to the abdomen.
Risk Factors
A life-threatening condition, ectopic pregnancy is not recommended. However, it can be treated with great success.
Talking to your healthcare provider is a good idea if you are considering having another pregnancy. While most people will experience an ectopic birth, it is possible to have a normal pregnancy. However, your healthcare provider might recommend that you wait a few months. The chances of having another ectopic baby can be reduced by waiting.
You can still have normal pregnancy even if you had your fallopian tube surgically removed.
Multiple Ectopic Pregnancies
There is a 5 to 25% chance of another ectopic birth. Pregnancy is not a factor.1
A fertilized egg can travel through both the affected and unaffected fallopian tubes to reach the uterus. If you are having difficulty getting pregnant following an ectopic pregnancy, IVF (in vitro fertilization) may be an option.
Coping
Even if you weren’t expecting it, losing a pregnancy can be devastating. If you feel depressed, reach out to friends and family for support.
Pregnancy Loss Support
Support groups to help with pregnancy loss are:
- Ectopic Pregnancy Trust
- Support Pregnancy and Infant Loss Share
- March of Dimes
- MISS Foundation
- The Compassionate Friend
A Word From Verywell
Although it might seem scary to try again for a pregnancy, many women have successful pregnancies following an ectopic pregnancy. To ensure that your pregnancy is normal, your healthcare provider will closely monitor you if you become pregnant following an ectopic pregnancy.
