woman holding stomach in pain

Ectopic pregnancy: what you need to know

An ectopic pregnancy happens when the fertilized egg implants itself somewhere besides the uterine wall. Because of the tremendous and nearly unavoidable health complications involved in carrying a non-uterine baby, only in incredibly rare circumstances will an ectopically implanted embryo make it to birth, and only then when doctors fail to diagnose the situation earlier. Maintaining an ectopic pregnancy can lead to life-threatening, massive internal hemorrhaging as the embryo grows and ruptures the fallopian tube.

How does an ectopic pregnancy happen?

Normally, an egg fertilized in the fallopian tubes will make its way down, and implant itself into the wall of your uterus, where it will reside for the next nine months. However, some embryos implant into tissue besides the uterine wall, most commonly a fallopian tube itself (known as a tubular pregnancy), ovary, or the abdomen.

Are there symptoms of an ectopic pregnancy?

Early symptoms of an ectopic pregnancy are the same as those for a normal pregnancy, perhaps with some morning sickness, and of course the elevated hCG (human chorionic gonadotropin) that your pregnancy test has detected. If you have severe pelvic or abdominal pain, especially when accompanied by bleeding, this may be an indication of an ectopic pregnancy, and a reason to call your doctor, who can run further tests to determine whether or not your pregnancy is ectopic.

Severe abdominal pain during pregnancy requires an emergency evaluation so if your doctor is not available, seek alternate medical attention. An ectopic pregnancy in the fallopian tube may also be deleterious to the functionality of the tube itself, and require its removal if the pregnancy is not caught early enough and terminated with methotrexate before the tube ruptures.

What happens when they detect an ectopic pregnancy?

Once an ectopic pregnancy is detected, usually around or before 8 weeks, doctors have no choice but to end the pregnancy. Doctors may try using a shot of methotrexate if it’s earlier than 5 or 6 weeks gestation, and if the pregnancy has not ruptured. Methotrexate is supposed to rid the body of the ectopically implanted cells. Your doctor will be able to determine if the injection worked by monitoring your hCG levels for a drop.

If the methotrexate injection was not successful, doctors will end up having to perform laparoscopic surgery, in which they will insert a camera-containing tube through the abdomen, allowing them to navigate the fallopian tube and remove the abnormal pregnancy. Doctors may have to remove the ruptured fallopian tube, although ithey’ll try to save the tube if possible.

Getting pregnant again?

Having a previous ectopic pregnancy can make conceiving again more difficult, but it is certainly possible, so long as the doctors did not remove both fallopian tubes. Additionally, women who experience an ectopic pregnancy are at an increased risk for another in the future. Your healthcare provider will be the best person to give you a fertility prognosis following an ectopic pregnancy.

Reviewed by Dr. Jamie Lo
Read more
  • “Ectopic Pregnancy: FAQ 155.” ACOG. American College of Obstetricians and Gynecologists, 8/11/2015. Web.
  • “Ectopic Pregnancy.” U.S National Library of Medicine. MedlinePlus, 2/24/2014. Web.
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