Ectopic Pregnancy

In a normal pregnancy, the fertilized egg travels through the fallopian tube into the uterus and implants itself. An ectopic pregnancy occurs when the fertilized egg doesn't make it to the uterus but becomes implanted somewhere along the route, most often in the fallopian tube.

Ectopic pregnancies occur when the passage to the uterus is blocked, such as when the fallopian tube is twisted or narrowed.

Because the egg is outside the uterus, an ectopic pregnancy cannot grow as it should and must be treated. It can also cause the fallopian tube to burst, which can cause a dangerous loss of blood. A ruptured fallopian tube must be treated by surgery.

Who Is At Risk

Any woman can be at risk for an ectopic pregnancy; however, if you have abnormal fallopian tubes you are at a higher risk. Abnormal fallopian tubes may be present in women who have had:

• Pelvic inflammatory disease
• Previous ectopic pregnancy
Although an ectopic pregnancy can threaten your health and well-being, prompt treatment and follow-up care can help prevent complications.
• Infertility
• Pelvic or abdominal surgery
• Endometriosis
• Sexually transmitted disease (STD)
• Prior tubal surgery, such as tubal ligation.

Other factors that can increase a woman's risk of an ectopic pregnancy include:

• Cigarette smoking
• Exposure to DES during your mother's pregnancy
• Increased age.

Symptoms

Early symptoms of an ectopic pregnancy sometimes are similar to the symptoms of pregnancy, such as tender breasts or an upset stomach. However, you may have no symptoms in the early stages of this type of pregnancy.

As an ectopic pregnancy progresses, you may have:

• Abnormal vaginal bleeding
• Abdominal or pelvic pain
• Shoulder pain
• Weakness, dizziness, or fainting.

If you have any of these symptoms, call your doctor, even if you do not think you are pregnant.

Diagnosis

An ectopic pregnancy can be difficult to diagnose in its early stages. To determine if you have an ectopic pregnancy, your doctor may:

• Perform a pelvic exam
• Check your blood pressure and pulse
• Perform an ultrasound exam
• Test your blood for increased hormone levels.

Treatment

If your ectopic pregnancy is in its early stages and your fallopian tube has not ruptured, medication can be used to stop the growth of the pregnancy. The medication allows your body to absorb the pregnancy over time and, in most cases, no surgery is needed. It takes your body about four to six weeks to completely absorb the pregnancy.

If your doctor suspects that you have an ectopic pregnancy that has ruptured, emergency surgery will be needed. Depending on the stage of your ectopic pregnancy, surgery may be performed either through a small cut made in the fallopian tube during a laparoscopy or through a larger incision in your abdomen. In either case, some or all of your fallopian tube may need to be removed.

After An Ectopic Pregnancy

If medication was used to treat your ectopic pregnancy and there was little or no damage to your fallopian tube, there is a good chance for a normal pregnancy in the future. If your ectopic pregnancy was treated with surgery in which your fallopian tube was repaired, there is also a good chance for a future normal pregnancy. If your fallopian tube was removed during surgery, you will have to rely on your remaining fallopian tube for any future pregnancies.