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What is an ectopic pregnancy?
An ectopic pregnancy happens when a fertilized egg grows outside the uterus.
In a normal pregnancy, a fertilized egg implants in the uterus (also called the womb). In an ectopic pregnancy, the fertilized egg does not make it to the uterus and implants somewhere else. An ectopic pregnancy most often occurs in the fallopian tube, causing a “tubal pregnancy.” It can also occur in the ovary, cervix or abdomen.
An ectopic pregnancy can be dangerous for the mother. As the pregnancy grows, it could cause the organ it is implanted in to rupture (burst). This can cause major internal bleeding. That’s why it is important to find an ectopic pregnancy in its early stages.
Symptoms of an ectopic pregnancy
The early signs of an ectopic pregnancy are like those of a normal pregnancy.
- Missed periods
- Tender breasts
- Frequent urination
- A positive home pregnancy test
The first warning signs of ectopic pregnancy may include:
- Abnormal vaginal bleeding
- Low back pain
- Mild pain in the abdomen or pelvis
- Mild cramping on one side of the pelvis
If you have any of these symptoms, you should contact your healthcare provider.
As an ectopic pregnancy grows, it may rupture. Then you may experience more serious symptoms. These could include:
- Sudden, severe pain in the abdomen or pelvis
- Shoulder pain
- Feeling weak, faint, or dizzy
If you experience these symptoms, get medical help right away.
CAUSES & RISK FACTORS
What causes an ectopic pregnancy?
Usually, an ectopic pregnancy happens because the fertilized egg wasn’t able to move down the fallopian tube quickly enough. An infection or inflammation in the tube can cause it to be partially or completely blocked. This is commonly caused by pelvic inflammatory disease (PID).
Another common reason tubes get blocked is endometriosis. This is when cells from the lining of the uterus grow outside the uterus. The cells can grow inside the fallopian tube and cause blockages. Scar tissue from previous abdominal surgery or fallopian tube surgery can also block the tube.
Any pregnancy can be an ectopic pregnancy, but you are more likely to have one if:
- You are older than 35 years of age
- You have had infections (such as pelvic inflammatory disease) or operations in the pelvic area
- You have endometriosis and are using assisted reproductive methods to become pregnant, such as in vitro fertilization (IVF)
- You smoke
- You have a history of inflammation of the fallopian tubes or abnormally shaped fallopian tubes
- You have had trouble getting pregnant or have had fertility treatment
You have had an ectopic pregnancy in the past DIAGNOSIS & TESTS
How is an ectopic pregnancy diagnosed?
Ectopic pregnancies can be hard to diagnose because the first symptoms are the same as those of a normal pregnancy. If your healthcare provider thinks you may have an ectopic pregnancy, they may do the following:
- Perform a pelvic exam to check the size and shape of your uterus.
- Order a urine test and a blood test to check your levels of human chorionic gonadotropin (hCG). hCG is a hormone that is produced by the placenta. If you have an ectopic pregnancy, you may have a low hCG level.
- Perform a transvaginal ultrasound. During this procedure, a wand is inserted into your vagina. Sound waves from the wand make “pictures” of organs in the body. This will allow your healthcare provider to see where the pregnancy is growing.
Can an ectopic pregnancy be prevented or avoided?
You can’t prevent an ectopic pregnancy, but you can try to control your risk factors. Don’t smoke. If you do smoke, plan on quitting before you get pregnant. Before getting pregnant, use a condom when having sex. This can help prevent sexually transmitted infections, such as chlamydia and gonorrhea, which can cause PID.
If you’re at higher risk of having an ectopic pregnancy, talk to your healthcare provider. They may take extra steps to detect an ectopic pregnancy early. This could include checking your hormone levels or scheduling an early sonogram
Ectopic pregnancy treatment
If a pregnancy is ectopic, the egg cannot develop, so the ectopic tissue must be removed. This can be done with medicine or surgery.
If an ectopic pregnancy is discovered early, your healthcare provider can give you a medicine called methotrexate. This medicine stops cells from growing and ends the pregnancy. Your body then absorbs the ectopic tissue. Some ectopic pregnancies require surgery. These include those that aren’t discovered early enough, or that cause a pelvic organ to rupture. Surgery is usually done with laparoscopy. This procedure uses a tiny camera that is inserted into your body through small cuts in your abdomen. Special tools are used to remove the pregnancy. If your fallopian tube or another organ has burst, your healthcare provider may remove that, as well.
Whether you’re treated with medicine or surgery, your healthcare provider may want to see you regularly afterward. They may monitor your hCG levels to make sure they go back to normal. This can take several weeks.
Living with an ectopic pregnancy
Whether you’re treated with medicine or surgery, your recovery may take several weeks. You may feel tired and have abdominal pain or discomfort. You also might still feel pregnant for a while. It takes a while for the hCG levels in your body to drop. It will probably take a few cycles before your periods go back to normal.
If you have had an ectopic pregnancy, you are more likely to have another one. You also may have trouble getting pregnant again. You should give yourself time to heal before you try to get pregnant after having an ectopic pregnancy.
Having an ectopic pregnancy can be emotionally hard. You may feel sad, angry, and confused. Talk about your feelings with your partner, a trusted family member, or friend. Allow yourself to grieve the loss of a pregnancy.
FOR MORE INFORMATION
Nova Scotia Health Authority Patient Information Pamphlet