What is an Ectopic Pregnancy?
Normally, a fertilised egg implants in the lining of the uterus. However, in an ectopic pregnancy (also called an extrauterine pregnancy), the fertilised egg grows outside the uterus. This can occur in other areas, such as the fallopian tubes, the ovaries, the abdomen, or the lower part of the cervix (the neck of the uterus), which is located above the vagina. In more than 90% of belongings, the egg implants in a fallopian tube; this is called a tubal pregnancy.
How Common Are Ectopic Pregnancies?
Rates are difficult to determine, but one study suggests that approximately 1 in 50 pregnancies in the United States is ectopic. As the fertilised egg grows, it can rupture and cause life-threatening bleeding. If this happens, you will need instant medical attention. If left untreated, it can be fatal. In fact, ectopic pregnancies are the top cause of pregnancy-related deaths during the first trimester.
Can a Baby Survive an Ectopic Pregnancy?
No. There are very rare cases in which an abdominal ectopic pregnancy is discovered too late, and following an emergency delivery, the baby survives. However, it is important to note that the fertilised egg in an ectopic pregnancy is not considered “viable.” Most often, ectopic pregnancies lead to the rupture of blood vessels and cause uncontrollable bleeding in the mother, resulting in her death.
Ectopic Pregnancy vs. Miscarriage
A miscarriage is the damage of a pregnancy that was located in the correct place—inside the uterus—before 20 weeks. There are many different causes for miscarriages. An ectopic pregnancy is too a pregnancy that tops in loss because it produces in an improper location. This is mentioned to as an ectopic pregnancy loss.
Symptoms of an Ectopic Pregnancy
Initially, you may not experience any symptoms of an early ectopic pregnancy. The symptoms can closely look like those of a normal pregnancy: you may miss a period and feel abdominal discomfort, as well as breast tenderness.
Only about half of women with an ectopic pregnancy will experience the three main symptoms: a missed period, vaginal bleeding, and abdominal pain
Early signs of an ectopic pregnancy include:
- Stomach pain and vomiting
- Severe abdominal pain
- Pain on one side of the body
- Dizziness or weakness
- Pain in the shoulder, neck, or rectum
Signs of a Ruptured Ectopic Pregnancy
An ectopic pregnancy can reason the fallopian tube to rupture or tear. Emergency symptoms include severe pain, with or deprived of heavy bleeding. Call your doctor immediately if you knowledge heavy vaginal bleeding accompanied by dizziness, fainting, or shoulder pain, or if you experience severe abdominal pain, especially on one side.
You may need to call 911 or go to the nearest hospital to receive immediate treatment.
When Do Ectopic Pregnancy Symptoms Start?
Ectopic pregnancy symptoms typically appear early in the pregnancy: between the 4th and 12th week.
Ectopic Pregnancy Locations
Although most ectopic pregnancies occur in a fallopian tube, an egg can also attach to other locations outside the uterus. Other types of ectopic pregnancy include:
Ovarian ectopic pregnancy (OEP)
This type of ectopic pregnancy occurs when a fertilised egg implants outside the ovary. OEP may result from issues with the body’s egg release during the menstrual cycle. An egg can be fertilised while it is still inside a follicle (a structure within the ovary); OEP can then occur as the egg travels from the fallopian tube toward the ovary.
Abdominal ectopic pregnancy
In rare cases, the pregnancy occurs amongst the abdominal barrier and the spine (the abdominal cavity). In this type of ectopic pregnancy, fluid movement within the abdomen may carry the egg back toward the uterus, where a sperm fertilises it. Alternatively, an embryo may travel from the reproductive tract into the abdominal cavity via the lymphatic channels.
Cervical Ectopic Pregnancy
This type of ectopic pregnancy occurs when an egg implants in the cervical canal; it may be caused by damage to the interior space of the uterus (uterine cavity).
Cesarean Scar Ectopic Pregnancy (CSEP)
CSEP occurs when a fertilised egg attaches to the scar tissue resulting from a cesarean section. Since scar tissue is weaker than the uterine lining, it can tear and lead to heavy bleeding.
The symptoms of these ectopic pregnancies—such as vaginal bleeding and lower abdominal pain—are similar to those seen in ectopic pregnancies that occur in the fallopian tube.
Ectopic Pregnancy Treatment
You may not know why you are experiencing an ectopic pregnancy. One possible cause is a blockage in a fallopian tube. This can prevent a fertilised egg from reaching the uterus.
Ectopic Pregnancy Risk Factors
You are more likely to have an ectopic pregnancy if:
- You are a smoker
- You are over 35 years old
- You have a sexually transmitted infection
- You have scarring resulting from pelvic surgery
- You have had a previous ectopic pregnancy
- You have undergone tubal ligation (or a reversal of it)
- You have used fertility treatments, such as in vitro fertilisation (IVF)
It can also occur if you become pregnant though using an intrauterine device (IUD) as a method of contraception.
Ectopic Pregnancy and Endometriosis
Endometriosis is a painful condition in which tissue—similar to the tissue that lines the inside of the uterus—grows outside of it. It typically develops in the ovaries, the fallopian tubes, and the tissue lining the pelvis. The scarring caused by this condition can prevent the fertilised egg from reaching the uterus, leading to an ectopic pregnancy.
Ectopic Pregnancy Complications
During an ectopic pregnancy, the fertilised egg becomes lodged in a structure that may continue to grow outside the uterus for several weeks. However, this structure typically ruptures between the sixth and sixteenth week. The rupture of an ectopic pregnancy can cause severe bleeding. If the bleeding does not stop, the body may begin to go into shock due to blood loss (hemorrhagic shock), which increases the risk of death. If treated before a rupture occurs, it is rarely fatal.
If the structure ruptures, it can damage the fallopian tube to which it is attached. Your doctor may need to remove that tube during surgery. However, you have two fallopian tubes; if the other tube is healthy, you should be able to become pregnant again. Nevertheless, if the other fallopian tube is damaged or absent, you could experience fertility issues. In such a case, consult your doctor regarding other options for achieving pregnancy, such as IVF (in vitro fertilisation).
Ectopic Pregnancy Diagnosis
Your doctor will likely perform tests, including a pregnancy test and a pelvic examination. They may also perform an ultrasound to examine your uterus and fallopian tubes.
An ultrasound for an ectopic pregnancy is a non-invasive test that uses complete waves to create images of the inside of the uterus. An ultrasonographer performs the test, which can be carried out either transvaginally or transabdominally. Through the ultrasound, the doctor will look for the attendance of a gestational sac, determine its location, and check for a fetal heartbeat. The test is painless and typically lasts 15-20 minutes.
An abdominal ultrasound—performed by gliding a transducer over the abdomen—may be used to confirm the pregnancy or to detect internal bleeding.
Ectopic Pregnancy Treatment
Since a fertilised egg cannot survive outside the uterus, your doctor must remove it to prevent you from suffering serious health complications. To do this, they will use one of two methods: medication or surgery.
Methotrexate for Ectopic Pregnancy
If your fallopian tube has not been damaged and the pregnancy is not far advanced, your doctor may administer an injection of methotrexate (Trexall). You may require only one injection, although a second dose is sometimes recommended. Your body will reabsorb the egg within approximately 4 to 6 weeks. With this treatment, it is not necessary to remove the fallopian tube.
Before you can receive methotrexate, your doctor must perform blood tests to measure your hCG (human chorionic gonadotropin) levels. This is the hormone the body produces when it detects a pregnancy. You cannot receive methotrexate if you are breastfeeding or if you have certain health conditions.
Once the injection has been administered, your doctor will monitor your hCG levels during follow-up appointments. If the levels do not decrease after the first dose, you may require a second dose of the same medication. You must continue under medical supervision until your blood is free of hCG. It is important to note that the use of methotrexate is not equivalent to undergoing a medical abortion, as would be the case in a “viable” pregnancy where the fertilised egg implants within the uterus. To perform a medical abortion, a combination of two prescription medications is required: mifepristone and misoprostol.
Methotrexate administered during an ectopic pregnancy—before the egg ruptures—is medically necessary. It can reduce the risk of death or other serious complications.
Surgery for Ectopic Pregnancy
In some cases, surgical intervention will be compulsory. The most common procedure is laparoscopy. Your doctor will make a very minor cut in your lower abdomen and supplement a thin, supple tube—called a laparoscope—to remove the ectopic pregnancy. If the fallopian tube is damaged, it may also need to be removed. If you experience heavy bleeding or if your doctor defendants that the fallopian tube has ruptured, you may require emergency surgery involving a larger incision. This procedure is called a laparotomy.
Side effects of surgery may include:
- Pain
- Bleeding
- Infection
Whether you receive treatment with methotrexate or undergo surgery, you may feel tired for a few weeks and experience some abdominal discomfort. You may continue to experience pregnancy-like symptoms for a while. It could take several menstrual cycles before you feel back to normal.
After an Ectopic Pregnancy
You may find it difficult to achieve a typical pregnancy afterwards. Consider consulting a fertility specialist, especially if a fallopian tube has been removed.
Additionally, talk to your doctor about how long you should wait before trying to conceive again. Some experts suggest waiting at least 3 months to give your body time to recover.
An ectopic pregnancy increases the risk of consuming another one in the future. If you suspect you might be pregnant again, pay close attention to changes in your c. Consult your doctor, who can confirm the pregnancy and take the necessary steps.
An ectopic pregnancy can also affect your mental health. Do not vacillate to seek support from mental health professionals, such as a licensed counsellor or therapist.
How to Avoid an Ectopic Pregnancy
There is no way to prevent an ectopic pregnancy completely. However, you can reduce the odds through certain lifestyle choices.
You can do the following:
- Use condoms during sexual intercourse. This can reduce the risk of developing pelvic inflammatory disease and sexually transmitted infections.
- Avoid douching. Various studies indicate that douching could increase the risk of having an ectopic pregnancy.