What Is an Ectopic Pregnancy?
An ectopic pregnancy is a pregnancy that occurs outside of your uterus. This happens when a fertilized egg implants in a location that cannot support its growth. An ectopic pregnancy often occurs in the fallopian tube (a structure that connects your ovaries and uterus). An ectopic pregnancy can rarely occur in the ovary, abdominal cavity, or cervix. If the pregnancy is ectopic, it cannot continue because only your uterus is meant to carry a pregnancy.
An ectopic pregnancy can be life-threatening, especially if your fallopian tube ruptures. This is a ruptured ectopic pregnancy and can cause severe bleeding, infection, and sometimes death. This is a medical emergency. Doctors must treat ectopic pregnancies quickly.
Where Does an Ectopic Pregnancy Occur?
An ectopic pregnancy occurs when a fertilized egg implants outside of your uterus. The egg is meant to travel down your fallopian tubes and embed itself into the wall of your uterus, where it can develop. In an ectopic pregnancy, the egg is implanted in one of the structures along the way. The most common place this can happen is inside your fallopian tubes. Most ectopic pregnancies occur here – about 90%.
What Are the Symptoms of an Ectopic Pregnancy?
The early symptoms of an ectopic pregnancy can be very similar to those of a normal pregnancy. However, you may experience other symptoms during an ectopic pregnancy, including:
. Pain in your lower abdomen, pelvis and lower back.
. Vaginal bleeding.
. Dizziness or weakness.
If your fallopian tube ruptures, the pain and bleeding could be severe enough to cause additional symptoms. These can include:
. Low blood pressure (hypotension).
. Shoulder pain.
. Fainting.
. Rectal pressure or bowel problems.
When a tube bursts, you may feel a sudden, sharp pain in your lower abdomen. This is a medical emergency. You should contact your doctor or go to the emergency room immediately.
What Causes an Ectopic Pregnancy?
In most cases, conditions that slow down or block the movement of the egg down your fallopian tube cause ectopic pregnancy. This could happen because:
. Your fallopian tubes have been damaged, such as from a sexually transmitted infection (STI).
. You have scar tissue, adhesions, or inflammation from previous pelvic surgery.
. You have a growth blocking your fallopian tube.
. You were born with an irregularly shaped fallopian tube.
Risk Factors for Ectopic Pregnancy
There are several risk factors that could increase your chance of developing an ectopic pregnancy. You may be at higher risk for an ectopic pregnancy if you have:
. A history of pelvic inflammatory disease (PID), an infection that can cause scar tissue to form in your fallopian tubes, uterus, ovaries and cervix.
. A previous ectopic pregnancy.
. A history of infertility.
. Surgery on your fallopian tubes (including tubal ligation) or on the other organs of your pelvic area.
. Treatment for infertility with in vitro fertilization (IVF).
. Sexually transmitted infections (STIs).
. Endometriosis.
. A history of smoking tobacco.
. An IUD in place at the time of conception.
If you find out you are pregnant and have an IUD (intrauterine device) in place, or if you have a history of a tubal ligation, call your doctor right away. Ectopic pregnancy is more common in these situations.
Your risk can also increase with age. People over 35 are more at risk than people under 35.
Up to 50% of people who experience an ectopic pregnancy do not have any of the above risk factors.
How Is an Ectopic Pregnancy Diagnosed?
Most people don’t know that their pregnancy is ectopic until they visit their doctor for a prenatal appointment, blood test, or ultrasound. Your doctor may suspect an ectopic pregnancy based on what happens at this appointment.
To diagnose an ectopic pregnancy, your doctor will perform several tests. This may include a pelvic exam and pregnancy confirmation. These tests include:
. A urine test: This test involves urinating on a test strip or into a cup at the doctor’s office and then having a test strip dipped into the urine sample.
. A blood test: Your doctor may test your blood to see how much of the hormone human chorionic gonadotropin (HCG) you have in your body. Your body only makes HCG during pregnancy. A low level may indicate an ectopic pregnancy because HCG levels rise dramatically when a fertilized egg implants in your uterus.
. An ultrasound exam: An ultrasound uses sound waves to picture your body’s internal structures. Your doctor will use this test to see where the fertilized egg has implanted.
If your doctor suspects that an ectopic pregnancy has ruptured, they can also perform culdocentesis, but this is rarely used.
Once your doctor has confirmed an ectopic pregnancy and determined where the fertilized egg has implanted, they’ll discuss a treatment plan with you. An ectopic pregnancy is an emergency and treatment is very important.
How Soon Would You Know If You Have an Ectopic Pregnancy?
Ectopic pregnancy is usually discovered early in pregnancy. Doctors usually diagnose an ectopic pregnancy in the first trimester of pregnancy (up to 12 weeks of pregnancy). However, most people find out that they have an ectopic pregnancy around the eighth week of pregnancy.
What Are the Complications of an Ectopic Pregnancy?
An ectopic pregnancy is a medical emergency. Your uterus is the only organ that can hold a growing fetus. It can stretch and expand as the fetus grows. Your fallopian tubes are not that flexible. They can burst as the fertilized egg develops. If this happens, it can cause severe, life-threatening internal bleeding. This is dangerous. An ectopic pregnancy must be treated immediately to prevent damage to the fallopian tubes and other organs, internal bleeding, and possibly death.
How Is an Ectopic Pregnancy Treated?
Doctors treat ectopic pregnancies with medication or surgery.
. Methotrexate for ectopic pregnancy
In some cases, the doctor may suggest the use of a medication called methotrexate to prevent the development of the fertilized egg and end the pregnancy. The medication should not damage your fallopian tubes. You cannot use this medication if your fallopian tube has already ruptured.
Your doctor gives you methotrexate as a single injection. This option is less invasive than surgery but requires follow-up appointments so your doctor can monitor your HCG levels. It is important to have consistent follow-up in these cases. In rare cases, a second methotrexate injection is necessary if HCG levels don’t decrease enough with one dose. Talk to your doctor about the possible risks and side effects of methotrexate so you know what to expect.
. Surgery for ectopic pregnancy
If your fallopian tube has ruptured or is at risk of rupture, your doctor may want to surgically remove the ectopic pregnancy. This is an emergency surgery and a life-saving treatment. This procedure is usually done laparoscopically (through several small incisions in your abdomen) while you are asleep under anesthesia. The surgeon may remove your entire fallopian tube with the egg still inside, or remove the egg from the tube (while preserving your fallopian tube).
Can I Prevent an Ectopic Pregnancy?
You cannot prevent an ectopic pregnancy. However, you can reduce this risk by following good lifestyle habits. These can include not smoking, reaching and maintaining a healthy weight and preventing any sexually transmitted infections (STIs). Before trying to get pregnant, talk to your doctor about any risk factors you may have.
FAQ:
- Can I Get Pregnant Again After an Ectopic Pregnancy?
Most people who have had an ectopic pregnancy in the past can have a successful pregnancy in the future. There is a higher risk of having ectopic pregnancies after you have had one. It is important to talk to your doctor about the causes of your ectopic pregnancy and the risk factors that may cause an ectopic pregnancy in the future.
- How Long Should I Wait Before Becoming Pregnant Again After an Ectopic Pregnancy?
After treating an ectopic pregnancy, you should talk to your doctor about future pregnancies. Although pregnancy may occur quickly after treatment, it is often best to wait about three months. This gives your fallopian tubes time to heal and reduces the risk of another ectopic pregnancy.
- Can My Pregnancy Continue After an Ectopic Pregnancy?
Unfortunately, an ectopic pregnancy is fatal for the fetus and your pregnancy cannot continue. Once an egg implants outside your uterus, you cannot move it to your uterus. Prompt treatment for an ectopic pregnancy is important. If the egg is implanted in your fallopian tube and the tube ruptures, you may experience heavy internal bleeding.
- Can I Still Have a Baby If My Fallopian Tube Was Removed?
In most cases, you can still get pregnant if you have one of your fallopian tubes removed. Most people are born with two fallopian tubes. Only one fallopian tube is necessary for a pregnancy. Eggs can still travel down your remaining fallopian tube. There are also assisted reproduction methods such as IVF that do not involve your fallopian tubes.
- How Common Are Ectopic Pregnancies?
Ectopic pregnancies occur in about 2% of all pregnancies.
Read more about: Ectopic pregnancy approach
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Sources:
. https://my.clevelandclinic.org/health/diseases/9687-ectopic-pregnancy
. https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088