Ectopic Pregnancy

Overview

What is an ectopic pregnancy?

In a normal pregnancy, a fertilized egg implants in the uterus (also called the womb). In an ectopic (say: "ek-top-ik") 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.

It is important to find the ectopic pregnancy in its early stages. An ectopic pregnancy can rupture or damage the pelvic organ that it is implanted in. This can be very dangerous for the mother.

Symptoms

What are the symptoms of an ectopic pregnancy?

The early signs of an ectopic pregnancy are like those of a normal pregnancy. You may have missed periods, sore breasts and nausea (also called "morning sickness"). A home pregnancy test may be positive.

More serious signs of ectopic pregnancy are pain and vaginal bleeding. You also may feel a sharp or stabbing pain in your stomach or on one side of your pelvis. You may feel dizzy or faint. If you experience any of these symptoms, you should see your doctor immediately.

Causes & Risk Factors

Who is at risk for an ectopic pregnancy?

Anyone who can get pregnant can have an ectopic pregnancy, but you are more likely to have an ectopic pregnancy 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 fertizilation (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 one or more ectopic pregnancies before

Diagnosis & Tests

How will my doctor know if I have an ectopic pregnancy?

Your doctor will likely perform a pelvic exam to check the size and shape of your uterus. He or she may also 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. Your doctor may also want to perform a sonogram. A sonogram uses sound waves to make "pictures" of organs in the body. This will allow your doctor to see where the ectopic pregnancy is.

Treatment

How is an ectopic pregnancy treated?

If a pregnancy is ectopic, the egg cannot develop, so the ectopic tissue must be removed. If an ectopic pregnancy is discovered early, your doctor can give you a shot of medicine called methotrexate. This medicine dissolves the egg, and your body will reabsorb it.

Ectopic pregnancies that are not discovered early enough, or that cause a pelvic organ to rupture, require surgery.

Will I have an ectopic pregnancy if I get pregnant again?

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.

Questions to Ask Your Doctor

  • Could vaginal bleeding in early pregnancy be a sign of ectopic pregnancy?

  • Where is the ectopic pregnancy located?

  • What treatment do you recommend?

  • Will I need surgery?

  • I’m having a hard time dealing with my feelings. Is there someone I could talk to? A support group?

  • I’d like to get pregnant again. Am I at risk for another ectopic pregnancy? Is there anything I can do to minimize my risk?

Citations

  • Diagnosis and Management of Ectopic Pregnancy by AM Lozeau, MD, MS, and B Potter, MD( 11/01/05, http://www.aafp.org/afp/20051101/1707.html)