In a normal pregnancy, your ovary releases an egg into your fallopian tube. If the egg meets with a sperm, the fertilized egg moves into your uterus to attach to its lining and continues to grow for the next 9 months.
But in up to 1 of every 50 pregnancies, the fertilized egg stays in your fallopian tube. In that case, it's called an ectopic pregnancy or a tubal pregnancy. In rare cases, the fertilized egg attaches to one of your ovaries, another organ in your abdomen, the cornua (or horn) of the uterus or even the cervix. In any case, instead of celebrating your pregnancy, you find your life is in danger. Ectopic pregnancies require emergency treatment.
Most often, ectopic pregnancy happens within the first few weeks of pregnancy. You might not even know you're pregnant yet, so it can be a big shock. Doctors usually discover it by the 8th week of pregnancy.
Ectopic pregnancies can be scary and sad. The baby probably can't survive -- though in extremely rare cases he or she might. (This is not possible in a tubal pregnancy, cornual or cervical ) So it's a loss that may take some time to get over. It may comfort you to know that if you have an ectopic pregnancy, you'll likely be able to have a healthy pregnancy in the future.
Symptoms of an Ectopic Pregnancy
- Light vaginal bleeding
- Nausea and vomiting with pain
- Lower abdominal pain
- Sharp abdominal cramps
- Pain on one side of your body
- Dizziness or weakness
- Pain in your shoulder, neck, or rectum
- If the fallopian tube ruptures, the pain and bleeding could be severe enough to cause fainting.
If you are experiencing the symptoms listed above, contact your health care provider immediately and go to the emergency room. Getting to the hospital quickly is important to reduce the risk of hemorrhaging (severe bleeding) and to preserve your fertility.
Causes of an Ectopic Pregnancy
One cause of an ectopic pregnancy is a damaged fallopian tube that doesn't let a fertilized egg into your uterus, so it implants in the fallopian tube or somewhere else.
You might not ever know what caused an ectopic pregnancy. But you are higher risk if you have:
- Current use of an intrauterine device (IUD), a form of birth control.
- History of pelvic inflammatory disease (PID)
- Sexually-transmitted diseases such as chlamydia and gonorrhea
- Congenital abnormality (problem present at birth) of the fallopian tube
- History of pelvic surgery (because scarring may block the fertilized egg from leaving the fallopian tube)
- History of ectopic pregnancy
- Unsuccessful tubal ligation (surgical sterilization) or tubal ligation reversal
- Use of fertility drugs
- Infertility treatments such as in vitro fertilization (IVF)
Diagnosing an Ectopic Pregnancy
If an ectopic pregnancy has been confirmed, the health care provider will decide on the best treatment based on your medical condition and your future plans for pregnancy.
Treating an Ectopic Pregnancy
If the doctor suspects that the fallopian tube has ruptured, emergency surgery is necessary to stop the bleeding. In some cases, the fallopian tube and ovary may be damaged and will have to be removed.
If the fallopian tube has not ruptured and the pregnancy has not progressed very far, laparoscopic surgery may be all that is needed to remove the embryo and repair the damage. A laparoscope is a thin, flexible instrument inserted through small incisions in the abdomen. During this surgery, a tiny incision is made in the fallopian tube and the embryo is removed, preserving the fallopian tube’s integrity.
In some cases, medication may be used to stop the growth of pregnancy tissue. This treatment option may be appropriate if the tube is not ruptured and the pregnancy has not progressed very far.
After medical treatment for an ectopic pregnancy, you will usually have to have additional blood tests to make sure that the entire tubal pregnancy was removed. The blood tests detect the hCG level, the hormone that is produced during pregnancy.
Getting Pregnant After an Ectopic Pregnancy
Most women who have an ectopic pregnancy have normal pregnancies and births in the future, even if a fallopian tube was removed. As long as you have one normally working fallopian tube, you can get pregnant. If the ectopic pregnancy was caused by a treatable illness, such as a sexually transmitted disease, getting treated for it can improve your chances of a successful pregnancy. The infection is not what caused the ectopic – it is the scarring that occurs due to the infection. Treatment of the infection does not get rid of the damage already done.
Talk with your doctor about how long to wait after an ectopic pregnancy before trying to conceive again. Some doctors suggest waiting 3 to 6 months.
After an ectopic pregnancy, take the time you need to heal your body and mind. Above all, don't blame yourself. Counseling or pregnancy loss support groups can help you and your partner cope. Ask your doctor about groups near you.