Ectopic pregnancies occur when a fertilized egg fails to attach to the uterus. In most ectopic pregnancies, the egg will attach to the fallopian tubes.
Less common, it may also attach to the abdominal cavity or cervix. Ectopic pregnancies occur in one out of every 50 pregnancies.
Outside the uterus, a fertilized egg has virtually no chance of survival. This condition may cause serious health complications if not treated.
As such, immediate treatment is highly recommended. Early treatment may prevent fertility problems as well as future health complications.
What Causes Ectopic Pregnancy?
The cause of an ectopic pregnancy is not clear in all cases. In some cases, the following conditions have been linked with the abnormal pregnancy:
- inflammation and scarring of the fallopian tubes from a previous medical condition or surgery
- hormonal factors
- genetic abnormalities
- birth defects
- medical conditions that affect the shape and condition of the fallopian tubes and reproductive organs
Is Ectopic Pregnancy Dangerous?
Yes. Ectopic pregnancy is life threatening. It is a leading cause of pregnancy-related death during the first trimester in the U.S. A growing embryo can rupture — burst — a fallopian tube.
That can lead to internal bleeding and infection. The good news is that effective treatment is available.
Who Is at Risk for Ectopic Pregnancy?
Women have an increased risk for ectopic pregnancy if they
- have a history of pelvic inflammatory disease or endometriosis
- are 30 years old or older
- have had a previous ectopic pregnancy
- have had abdominal, fallopian tube, or pelvic surgery
- have had a fertilized egg placed in a fallopian tube during an infertility procedure (It usually implants in the uterus, but in rare cases may implant in the tube.)
It’s rare for a woman to get pregnant after she has had a sterilization procedure or while she’s using an IUD. But if she does, she has an increased risk of ectopic pregnancy.
What Are the Symptoms of Ectopic Pregnancy?
Nausea and sore breasts, which are also common in a normal pregnancy, are common in ectopic pregnancies.
Other symptoms more clearly point to an abnormal pregnancy. The following symptoms should be discussed with your doctor:
- sharp waves of pain in the abdomen, pelvis, shoulder, or neck
- light to heavy vaginal spotting or bleeding
- dizziness or fainting
- rectal pressure
If you have severe pain or bleeding, go to the emergency room right away. If you have any other symptoms of ectopic pregnancy, contact your health care provider right away.
The earlier an ectopic pregnancy is diagnosed and treated, the better.
How Can I Know If I Have an Ectopic Pregnancy?
A health care provider can diagnose an ectopic pregnancy. Usually, a provider does a pelvic exam and uses ultrasound.
Your provider may also use blood tests or a laparoscope — a thin instrument inserted into the abdomen.
Diagnosing Ectopic Pregnancy
If you suspect an ectopic pregnancy, see your healthcare provider as soon as possible. Ectopic pregnancies cannot be diagnosed from the outside.
Your doctor may perform a physical exam to rule out other factors.
If an ectopic pregnancy is suspected, a blood test can assess hCG and progesterone levels. If hormone levels are not typical, additional tests will be required.
If blood tests point to a problem, your doctor will perform a transvaginal ultrasound. This will locate the fertilized egg and confirm an ectopic pregnancy diagnosis.
In extreme cases, the fallopian tube may rupture and bleed. A surgeon may then perform an emergency laparotomy by making an incision in the abdomen.
This procedure is used not only to diagnose an ectopic pregnancy, but to provide immediate treatment.
How Is Ectopic Pregnancy Treated?
Ectopic pregnancy is treated with medicine or surgery. Talk with your health care provider about what treatment is best for you.
The medicine methotrexate can be used to end a tubal pregnancy.
Surgery can remove the pregnancy. Sometimes it is necessary to remove the tube with the pregnancy. This is called a salpingectomy.
The tube may be removed through an opening in the abdomen. This is called an open procedure. It can also be removed through a small incision near the navel, using a laparoscope.
If I Had an Ectopic Pregnancy, Can I Get Pregnant Again?
It depends on what treatment you had and on the condition of your fallopian tubes. If a tube was removed or your tubes are scarred, it may be more difficult to get pregnant.
But many women are able to have normal pregnancies after having an ectopic pregnancy. From 5–8 out of 10 women are able to. But about 1 out of 10 women who have an ectopic pregnancy will have another one.
There are many treatments available to help women have healthy pregnancies after an ectopic pregnancy. Talk with your health care provider about finding the best treatment for you.
Prognosis: What Is to Be Expected in the Long Term
The prognosis is determined by the damage caused by the ectopic pregnancy. If both fallopian tubes are still intact, there is a 60 percent chance of having a normal pregnancy in the future.
Fertility may be affected if an existing reproductive problem triggered the ectopic pregnancy.
Surgery may scar the fallopian tubes. This scarring may make future ectopic pregnancies more likely.
Fertility treatments may be required if one or both fallopian tubes had to be removed. Ectopic pregnancies may also create problems that make natural conception impossible.
A ruptured fallopian tube may cause death, although this is rare. Successful treatment is common with surgery and medication.
The mortality rate associated with a ruptured fallopian tube is less than 0.1 percent.
Prediction and prevention are not possible in every case. You can, however, lower your risk of inflamed fallopian tubes, which is often the root cause of ectopic pregnancies.
Prevention begins with good reproductive health maintenance. Maintenance includes regular gynecological exams, regular STD screenings, and quitting smoking.