Ectopic Pregnancy

In a normal pregnancy, the egg is fertilized, travels through the fallopian tube, and then attaches – or implants – into the uterine lining. In an ectopic pregnancy, the egg never makes it into the uterus. An ectopic pregnancy occurs in approximately 1 in 40 to 1 in 100 pregnancies. It is a very serious condition because it can permanently damage a woman’s reproductive system and can even lead to lethal hemorrhaging without treatment.

In most cases, it attaches inside the fallopian tube, which is why ectopic pregnancies are often referred to as “tubal pregnancies.” However, fertilized eggs can also implant in other locations, such as the cervix, ovary, or the belly.

Here are five things you should know about ectopic pregnancies.

1. Who is at risk? The most common cause of an ectopic pregnancy is a damaged fallopian tube. An abnormality or scar tissue can prevent the fertilized egg from exiting into the uterus. There are several factors that put women at risk such as:

◦ Smoking: Smoking puts you at higher risk for innumerable health complications and diseases. If you currently smoke, please talk to your healthcare provider about cessation therapies.

◦ Pelvic Inflammatory Disease (PID). PID is most commonly caused by sexually transmitted diseases, most notable chlamydia and gonorrhea. If you have sex with more than one partner, or have sex with someone who you suspect has been promiscuous, get tested for STDs on a regular basis.

◦ Endometriosis. This common condition can cause scar tissue in and around the fallopian tubes.

◦ Pelvic surgery/treatments. Certain treatments and surgical procedures can cause scarring in the fallopian tubes.

2. Additional risk factors. There are other risk factors that make you susceptible to ectopic pregnancies. Women over 35 are at higher risk, as are women who have IVF treatments. Surprisingly, women who have had their tubes tied can also experience an ectopic pregnancy, often two or more years after their surgery.

3. The symptoms. The first symptom may be the normal cessation of a period, which accompanies pregnancy. Women with ectopic pregnancies may experience subsequently abnormal vaginal bleeding. You may also have a relatively sharp pain on one side that eventually spreads to the abdomen and/or lower back. If you are pregnant, or suspect you are pregnant, and have any of the above symptoms, contact your healthcare provider immediately.

4. How is it diagnosed? While a urine test can show that you are pregnant, only a doctor can tell if the pregnancy is ectopic. First, we run a blood test to verify your pregnancy. We will also do a pelvic exam to feel for abnormal swellings or growths, and perform gentle palpations to determine the localized pain site. Finally, we will do an ultrasound to get a visual. In most cases, we can identify an ectopic pregnancy anytime from about 6-weeks on.

5. How is it treated? As mentioned above, there is no way for ectopic pregnancies to develop normally. The embryo will eventually grow too large, causing permanent damage to the fallopian tube. If left untreated, the tube will burst and a woman can bleed to death. When ectopic pregnancies are diagnosed within the first few weeks, a shot of methotrexate will be given, one or more times, to terminate the pregnancy. If it is diagnosed beyond this point, a laparoscopy is done to remove the embryo and repair existing damage if possible.

Always let your OB/GYN know if you have had an ectopic pregnancy in the past. It is never easy to lose a pregnancy, but in most cases, women who have had ectopic pregnancies will be able to conceive a healthy baby down the road, but make sure to carefully monitor your reproductive health.