What is an ectopic pregnancy?

An ectopic pregnancy is a pregnancy that develops outside the uterus. This almost always happens in a fallopian tube. That’s why we often talk about tubal pregnancy. In rare cases, an ectopic pregnancy occurs in an ovary, in the cervix, or in the uterus.

What are the causes of an ectopic pregnancy?

A fertilized egg normally travels through the fallopian tubes to the uterus. But the egg can get stuck in the tube if it is blocked. This can be due to an infection or scar tissue. If the fertilized egg cannot reach the uterus, it starts to grow in the tube.

Who is at risk of having an ectopic pregnancy?

Ectopic pregnancy is more common in women who:

• Have had difficulty getting pregnant (infertility)
• Suffer from endometriosis. This is the growth of uterine tissue in other areas of the pelvis.
• Have a sexually transmitted disease. This disease can cause infection and scarring in the pelvis.
• Have had surgery on their fallopian tubes.
• Use an IUD
• Have had an ectopic pregnancy in the past.
• Have multiple sexual partners
• Smoke
• Are older

What are the symptoms of an ectopic pregnancy?

Women with an ectopic pregnancy may have irregular bleeding and pelvic or abdominal pain. The pain is usually on one side. Symptoms often appear between 6 and 8 weeks after the last normal period. If the ectopic pregnancy does not occur in the fallopian tubes, symptoms may appear later. Classic symptoms of an ectopic pregnancy include:

• Abdominal pain
• Absence of recent periods
• Vaginal bleeding unrelated to periods

How is an ectopic pregnancy diagnosed?

Your doctor will measure the level of the hormone hCG (human chorionic gonadotropin) in your blood. They will use an ultrasound to check for the presence of a fetus or other pregnancy tissue in the uterus. In some cases, your doctor will use laparoscopy to diagnose and treat an ectopic pregnancy. This is a surgical procedure that uses a light tube inserted into the abdomen to examine the inside of the pelvis. It often provides the most accurate diagnosis.

How is an ectopic pregnancy treated?

Ectopic pregnancy can be treated in several ways. This depends on how open (ruptured) the fallopian tube is, how advanced the pregnancy is, and your hormone levels. 

Treatments may include:

• Allowing the ectopic pregnancy to heal and for the body to absorb it on its own. This is only possible in certain cases.
• Using a medication, Methotrexate, to prevent the pregnancy from developing further.

A surgical procedure (usually laparoscopy) to make a small opening in the fallopian tube. The surgeon removes the pregnancy and sometimes the tube.

In rare cases, healthcare professionals must make a larger incision in the abdomen to remove the ectopic pregnancy or the damaged fallopian tube.

What are the complications of an ectopic pregnancy?

When the embryo implants in the fallopian tube, it does not have enough space to grow or enough blood flow to stay healthy, and it dies.

The tube may begin to lose tissue or bleed. Some embryos continue to develop and can become large enough to rupture the fallopian tube. This can cause severe bleeding and shock.

Ectopic pregnancy is the leading cause of pregnancy-related deaths during the first three months of pregnancy in the United States.

When should I call the doctor?

Do not ignore the symptoms of an ectopic pregnancy. Call your healthcare provider if you have bleeding or pain during pregnancy.

Key points about ectopic pregnancy

• A pregnancy that develops outside the uterus is called an ectopic pregnancy.
• Women with an ectopic pregnancy may have irregular bleeding and pelvic or abdominal pain, often on one side.
• Symptoms most frequently appear between 6 and 8 weeks after the last normal period.
• Ectopic pregnancy can be treated in different ways, depending on whether the fallopian tube has ruptured or not.
• Do not ignore the symptoms of an ectopic pregnancy. Call your healthcare provider if you have bleeding or pain during pregnancy.

Next steps. Tips to help you make the most of a visit to your doctor:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down the questions you want answered.
• Have someone with you to help ask questions and remember what your doctor tells you.
• During the visit, note the name of any new diagnosis and any new medications, treatments, or tests. Also, keep track of any new instructions given by your doctor.
• Ask why you are being prescribed a new medication or treatment and how it will help you. Also, know what the side effects are.
• Ask if your condition can be treated in another way.
• Ask why a test or procedure is recommended and what the results may mean.
• Ask yourself what you expect if you do not take the medication or do not undergo the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose of this visit.
• Ask how to contact your doctor if you have questions.

For comprehensive details about IVF In Vitro Fertilization, please refer to the treatments section.