An ectopic pregnancy is any pregnancy that implants in a site other than the uterine cavity. During a normal pregnancy, an egg becomes fertilized by a sperm inside the Fallopian tube. The fertilized egg travels down through the Fallopian tube and into the uterus, where it implants on the inside wall. An ectopic pregnancy occurs when the embryo implants outside the uterus. In most cases, ectopic pregnancy occurs in a Fallopian tube—a fertilized egg becomes trapped there and implants. Although more rare, ectopic pregnancy can also occur in other places such as on an ovary, within the cervix, or in the abdomen.
SYMPTOMS OF ECTOPIC PREGNANCY
Symptoms of ectopic pregnancy may include irregular bleeding after a missed period, lower abdominal pain, and lower back pain. If you have these symptoms, call your doctor right away—an ectopic pregnancy can become a serious, life-threatening medical emergency if it is not diagnosed and treated early. Your Fallopian tube can rupture from the growing embryo, resulting in severe pain, uncontrolled internal bleeding, and shock.
CAUSES OF ECTOPIC PREGNANCY
The cause is often unknown. However, ectopic pregnancy tends to occur when the Fallopian tube has become damaged in some way—from a previous infection, endometriosis, tubal surgery, or even a previous ectopic pregnancy. Scar tissue that is partially blocking the inside of the Fallopian tube can trap the fertilized egg, resulting in an ectopic pregnancy. An ectopic pregnancy may also be a very rare complication of in vitro fertilization (IVF).
DIAGNOSTIC TESTS FOR ECTOPIC PREGNANCY
Your medical history and a pelvic exam are helpful in diagnosing ectopic pregnancy. However, other tests are needed to confirm the diagnosis. You may need one or more of the following tests:
hCG (human chorionic gonadotropin)
A blood test that confirms pregnancy by measuring the amount of hCG (a hormone produced by pregnancy) in your blood; often, we repeat this test every 2 days
A scan that uses high-frequency sound waves to visually confirm a pregnancy
TREATMENT FOR ECTOPIC PREGNANCY
Your treatment will depend on how early we are able to discover the ectopic pregnancy. If you are in a lot of pain and have heavy internal bleeding, you will likely need emergency surgery to stop the bleeding. The surgery may involve either removing the embryo from your tube or removing the segment of the tube containing the embryo. If a physician discovers the ectopic pregnancy early, before the embryo has grown large enough to rupture your Fallopian tube, an injection of a medication called methotrexate may be an option. Methotrexate prevents the rapid division of cells in early pregnancy, thereby ending the pregnancy.
How will an ectopic pregnancy affect my chances for a successful pregnancy in the future?
An ectopic pregnancy can damage your Fallopian tube, which may reduce your chances for future normal pregnancies. In addition, women who have had an ectopic pregnancy are at increased risk for a future ectopic pregnancy. Your doctor will discuss treatment options with you that can often increase your chance for a healthy pregnancy.