Ectopic Pregnancy

An ectopic pregnancy occurs when a fertilized egg implants in an area of the female body outside of the uterus, most commonly in one of the two fallopian tubes. However, an embryo may also fertilize in unexpected areas such as the abdominal cavity (abdominal pregnancy), cervical canal or even an ovary. A tubal pregnancy is a serious health condition not only for the unborn child, but also because it can rupture the mother’s fallopian tube, causing uncontrolled bleeding. This extensive loss of blood is an urgent medical emergency that, if left untreated, can lead to shock, and even death.

Causes of Ectopic Pregnancy

The majority of ectopic pregnancies are caused by a blockage in one or both of the fallopian tubes. This blockage is usually scar tissue left over from surgery, infection, or a past ectopic pregnancy. It is not uncommon for the fallopian tubes to become blocked after infection with Pelvic Inflammatory Disease (PID), which can be a result of sexually transmitted infections (STIs) like chlamydia and gonorrhea. According to a website dedicated to women’s health and fitness, the “rate of ectopic pregnancy in women with previous known PID is increased 6-10 times higher than in women with no previous history of PID” (Womenfitness.net). Females who have had surgery to have their "tubes tied" (tubal sterilization) are at increased risk for ectopic pregnancy, as are women who have had surgery to reverse tubal sterilization (a process known as tubal ligation reversal). Also, women who are over the age of 35, smoke cigarettes, or have had a previous ectopic pregnancy are at an even higher risk of acquiring another.

Symptoms of Ectopic Pregnancy

Symptoms tend to occur 6 to 8 weeks after the woman's last menstrual period, and may include:

  • Severe, sharp, and sudden abdominal pain (in the lower abdominal area)
  • Cramping on one side of the pelvis
  • Nausea
  • Lower back pain
  • Low blood pressure
  • Breast tenderness
  • Bleeding or Spotting
  • Feeling dizzy or faint, or actually fainting
  • Pain in the shoulder area (this alone may not be a sign of ectopic pregnancy, but should be monitored)
  • Full-Body Shock (occurs if the fallopian tube ruptures)

Diagnosing Ectopic Pregnancy

To recognize and diagnose an ectopic pregnancy, a doctor (usually your gynecologist) will first administer a pelvic exam to test for any pain in the pelvic region. The doctor may then conduct other tests to measure white blood cell count and the level of progesterone in the blood. There may also be a blood or urine test to reaffirm pregnancy and an ultrasound to check if the uterus is in fact empty.

Treatment of Ectopic Pregnancy

In the case of an ectopic pregnancy, the embryo cannot simply be left to continue growing¾therefore the developing cells must be removed as soon as possible. The most common treatment involves making a small incision in the lower abdomen (just below the belly-button) in order to surgically remove the developing cells from wherever it is that they are multiplying.

If the embryo or fetus has already developed to a stage where it has ruptured the fallopian tube, the woman must undergo immediate and emergency medical care in order to prevent further blood loss. If the doctor determines that the ectopic pregnancy will not rupture, the woman can be administered a drug called methotrexate, which terminates any existing pregnancy, and carefully monitored thereafter. According to the United States National Library of Medicine, “The rate of death due to an ectopic pregnancy in the United States has dropped in the last 30 years to less than 0.1%.”

Most ectopic pregnancies occur due to conditions that cannot be prevented. However, one can take certain measures to prevent some cases of tubal fertilization by avoiding risky behaviors. These activities include engaging in sexual acts with multiple partners (to avoid contracting infections that could lead to PID), having sex without a condom, and neglecting to get tested regularly for STIs.

Alternative names for "Ectopic Pregnancy"

  • Tubal pregnancy
  • Cervical pregnancy
  • Abdominal pregnancy

 

Last Updated 20 February 2013.