What Is Ectopic Pregnancy?
Normally, a fertilized egg implants in the uterus. But if the fertilized egg implants somewhere other than the uterus, the pregnancy is said to be "ectopic." Ectopic simply means "located in an abnormal position."
When an ectopic pregnancy occurs, in most cases, the fertilized egg implants in one of the fallopian tubes. Because the fallopian tube is narrow and its walls are thin, the fetus only has to be about the size of a jellybean before the fallopian tube bursts, causing major bleeding.
Occasionally, an ectopic pregnancy will occur in places other than the fallopian tube. For example, the fertilized egg may implant on an ovary, in the abdominal cavity, or in the cervix.
An ectopic pregnancy is also known as a tubal pregnancy because most
ectopic pregnancies occur in the fallopian tube.
Ectopic pregnancies are rare; they occur in about 1 out of every 60 pregnancies.
Certain risk factors can make an ectopic pregnancy more likely:
- A history of pelvic inflammatory disease (PID)
- Women whose mothers took diethylstilbestrol (DES) while pregnant
- Sexually transmitted diseases, such as chlamydia or gonorrhea
- A previous ectopic pregnancy
- A previous tubal surgery for infertility
- Tubal sterilization procedure, such as laparoscopic tubal ligation or postpartum tubal ligation, within the past 1 to 2 years
- History of IUD (intrauterine device) use
- Pregnancy with an IUD in place
- Prolonged infertility
- Multiple sex partners
- Vaginal douching.
Symptoms
Symptoms of ectopic pregnancy are similar to those of a normal early pregnancy. Classic
early ectopic pregnancy symptoms include:
- Lower abdominal or pelvic pain (present in more than 90 percent of cases)
- Late menstrual period (present in up to 90 percent of cases)
- Vaginal bleeding or spotting (present in up to 80 percent of cases).
(Click Ectopic Pregnancy Symptoms to learn about other symptoms and signs of ectopic pregnancy.)
Diagnosing an Ectopic Pregnancy
In order to diagnose an ectopic pregnancy, the doctor generally begins by asking a number of questions and performing a physical exam, looking for signs or symptoms of an ectopic pregnancy. If the doctor suspects an ectopic pregnancy, he or she may recommend certain tests, such as:
- Blood tests, such as checking blood hCG (human chorionic gonadotropin) and progesterone levels
- Ultrasound
- Culdocentesis (a procedure that checks for abnormal fluid in the space just behind the vagina)
- Laparoscopy (see Laparoscopy for an Ectopic Pregnancy).
Treating an Ectopic Pregnancy
When an ectopic pregnancy occurs, medical or surgical treatment is necessary to prevent serious or even life-threatening complications. In most cases,
ectopic pregnancies are now treated medically with a drug known as methotrexate. Methotrexate stops the growth of the embryo and is successful in treating ectopic pregnancies in up to 94 percent of women.
If methotrexate is not an option, the ectopic pregnancy can be treated with surgery. During surgery, a fallopian tube may have to be removed along with the embryo. If only one fallopian tube is removed, the woman should still be able to become pregnant in the future if her other tube and ovary are normal. However, she will be at increased risk (about 10 to 20 percent) of having another ectopic pregnancy.
