A healthy pregnancy starts when the fertilized egg implants, or attaches, itself to the lining of the mother’s uterus. Ectopic pregnancies occur when the fertilized egg implants somewhere outside of the uterus. This could occur in or on the fallopian tube, the cervix, either ovary, an old abdominal scar, or the abdominal cavity. The fallopian tube is the most common site for an ectopic pregnancy, occurring in roughly 98% of the cases. Pregnancies where the fertilized egg attaches to the fallopian tube are sometimes called ‘tubal pregnancies’.
Causes of ectopic pregnancy
There are a lot of different factors that can contribute to an ectopic pregnancy, and many women who have an ectopic pregnancy don’t have any risk factors. However, there are some factors that may make it more likely for a woman to experience an ectopic pregnancy.
- Fallopian tube abnormalities: These are one of the more common risk factors for ectopic pregnancies.
- Medical history: Women with a history of pelvic inflammatory disease, STDs, or recent pelvic surgery are also at higher risk of having an ectopic pregnancy, due to possible damage to their fallopian tubes.
- Previous ectopic pregnancy: Women who have had a previous ectopic pregnancy are at a higher risk of it occurring again in future pregnancies.
- Lifestyle: Smoking may also increase a woman’s risk of ectopic pregnancy.
Early on, ectopic pregnancies can feel similar to normal pregnancies. They may cause symptoms such as vaginal bleeding, lower abdominal or pelvic pain, weakness, dizziness, fainting, a missed period, or shoulder pain. In some ectopic pregnancies, the woman doesn’t know that she’s pregnant until the diagnosis.
To diagnose an ectopic pregnancy, a doctor will perform blood tests and a transvaginal ultrasound. He or she will also observe a woman’s symptoms. An important blood test to monitor is the level of hCG (human chorionic gonadotropin, an important pregnancy hormone) in the woman’s body. If the levels of hCG are lower than normal, this could indicate an ectopic pregnancy.
Transvaginal ultrasound is performed to locate where the ectopic pregnancy is implanted within a woman’s abdominal cavity or reproductive tract. There is a small chance that the ectopic pregnancy is too small to detect on ultrasound, and if so your provider may want a few weeks to perform this test until the pregnancy is slightly more progressed.
Ectopic pregnancies can be treated with medication, surgery, or (less commonly) expectant waiting if a miscarriage is likely. Medication therapy is used in approximately one-third of the cases, and is more effective if the pregnancy is detected early-on. Surgical therapy is used in roughly two-thirds of cases, especially if the ectopic pregnancy is further along or there is concerns of rupture. The earlier the treatment, the better, because untreated ectopic pregnancies can have serious health risks.
Many women who have ectopic pregnancies go on to have completely normal pregnancies in the future. However, it is important to know that women with a history of ectopic pregnancy are at higher risk of recurrence in future pregnancies. When it comes to ectopic pregnancy, early diagnosis and treatment are the keys to getting back into good health.
- Josie L. Tenore. “Ectopic pregnancy.” American Family Physician. 61(4):1080-1088. Feb 2000. Web.
- Mayo Clinic Staff. “Ectopic Pregnancy.” MayoClinic. Mayo Foundation for Medical Education and Research, Jan 20 2015. Web.
- “Ectopic Pregnancy.” ACOG. FAQ155 from American College of Obstetricians and Gynecologists, Aug 2011. Web.
- Togas Tulandi. “Ectopic pregnancy: Choosing a treatment and methotrexate therapy.” UptoDate. Up to Date Inc., Apr 13 2016. Web.