Ectopic Pregnancy

An ectopic pregnancy is when a fertilized egg grows outside of the uterus, whereas in a normal pregnancy, the fertilized egg attaches to the uterine lining. An ectopic pregnancy most commonly develops in the fallopian tube (tubal pregnancy), but on some occasion, can occur in the ovary or cervix. Regardless of the location, an ectopic pregnancy is a non-viable pregnancy that can be life-threatening, if not treated. Although it’s heartbreaking, an ectopic pregnancy cannot proceed safely.

SYMPTOMS

Women with an ectopic pregnancy usually experience the typical signs of pregnancy (missed period, nausea, and breast tenderness) at first, but more severe symptoms will occur as the fertilized egg starts to grow in the fallopian tube. Early symptoms of an ectopic pregnancy include:

• Light vaginal bleeding
• Pelvic pain
• Shoulder pain (indicates blood leaking from the fallopian tube)
• Urge to have a bowel movement

Life-threatening signs can develop if the fallopian tube ruptures, which can cause bleeding in the abdomen. It’s extremely important to seek medical attention immediately if you experience these signs. Emergency symptoms of an ectopic pregnancy include:

• Extreme lightheadedness
• Fainting

• Shock

CAUSES / RISK FACTORS

Because an ectopic pregnancy mostly occurs in the fallopian tube, inflammation or damage to the tube is the most common cause of an ectopic pregnancy. Other causes of an ectopic pregnancy point towards abnormalities in the fertilized egg or hormonal imbalances. Risk factors for having an ectopic pregnancy include:

• Previous ectopic pregnancy
• Inflammation and infections (sexually transmitted)
• Previous tubal surgery (including reversal)
• Infertility
• Choice of birth control (IUDs or tubal ligation)
• Smoking

DIAGNOSIS

After confirming pregnancy by testing the blood for the pregnancy hormone (hCG), a pelvic exam may be done to locate areas of sensitivity or pain. Testing that can confirm a diagnosis of an ectopic pregnancy includes:

• Ultrasound: a transvaginal probe is used to detect the presence and location of an ectopic pregnancy, by capturing images of the fallopian tubes and uterine cavity.
• Blood tests: other than an hCG, additional testing can include a blood count (to check for any signs of blood loss).

TREATMENT

Treatment options vary, depending on the severity of an ectopic pregnancy. For an early ectopic pregnancy, medication can be used, if bleeding is stable. An ectopic pregnancy with excessive, unstable bleeding and/or damage to the tube (rupture) can be treated surgically. Treatment options for an ectopic pregnancy include:

• Medication: methotrexate is used to stop cell growth in the fertilized egg and dissolve remaining existing cells.
• Salpingostomy: procedure where the ectopic pregnancy is removed and the affected fallopian tube is left to heal.

• Salpingectomy: procedure where the ectopic pregnancy and the affected fallopian tube are removed.

Ectopic Pregnancy

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