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Ectopic Pregnancy

What is an ectopic pregnancy?

An ectopic pregnancy happens when a baby starts growing outside the uterus. Most often it happens in one of the fallopian tubes that lead from the ovaries to the uterus. This is called a tubal pregnancy. Sometimes the pregnancy happens on the ovary. Rarely, an ectopic pregnancy can happen in the abdominal cavity or on the cervix.

An ectopic pregnancy can threaten the life of the mother. It must be treated as soon as possible.

How does it occur?

An ectopic pregnancy may happen when something stops a fertilized egg from passing into the uterus. Things that may cause this are:

  • a previous infection that caused scar tissue to form in or around the fallopian tubes
  • scarring from surgery on the tubes or ovaries
  • a ruptured appendix
  • a defect in the fallopian tube that you have had since you were born
  • endometriosis, which is a growth of tissue from the lining of the uterus outside the uterus
  • a tumor
  • a previous ectopic pregnancy

If you know you have any of these conditions, you should see your healthcare provider as soon as you think you might be pregnant.

Also, you have a greater chance of having an ectopic pregnancy if:

  • Your mother was exposed to DES.
  • You smoke.
  • You have had problems getting pregnant.
  • You are pregnant after having infertility treatments.
  • You are older than 35.

What are the symptoms?

Ectopic pregnancies are usually diagnosed within the first 2 months of pregnancy, sometimes before a woman knows she is pregnant. The symptoms may be mild or they may be severe and dangerous. They can be the same as the symptoms of early pregnancy or other less serious conditions. Possible symptoms of an ectopic pregnancy are:

  • missed period or abnormal bleeding
  • pain in the lower belly or pelvis
  • symptoms of pregnancy, such as breast tenderness or morning sickness

The ectopic pregnancy can damage your pelvic organs. Sometimes the pregnancy sac breaks open and starts to bleed, or the pregnancy grows into the surrounding tissues and causes bleeding. This is called a ruptured ectopic pregnancy. It can cause severe internal bleeding and is life threatening. The symptoms of a rupture include:

  • sudden increase in severe pain
  • symptoms of oncoming shock: pale skin, fast heart rate, and dizziness
  • fainting from low blood pressure caused by bleeding
  • shoulder pain

Many times a tubal pregnancy will rupture and cause severe pain while you are having a bowel movement, especially if you are straining.

How is it diagnosed?

Blood tests can detect a pregnancy before symptoms develop. The following procedures may also be done to find an ectopic pregnancy:

  • Ultrasound scan to see where the fertilized egg is.
  • Culdocentesis, which is the insertion of a needle through the vagina behind the uterus. This is a way to look for blood in the pelvis. Blood could be a sign of a rupture.
  • Laparoscopy, which is the insertion of a lighted tool into the belly through a cut in the bellybutton. Your healthcare provider uses the scope to look at the pelvis and tubes. An ectopic pregnancy can be seen even before it ruptures. The pregnancy may be removed with this procedure.

How is it treated?

If an ectopic pregnancy is diagnosed very early in pregnancy (within the first 6 weeks), the pregnancy can be ended with medicine (methotrexate). Otherwise, you will need surgery to remove the pregnancy. In some cases the surgery can be done through a laparoscope. Abdominal surgery may be needed if there is a lot of bleeding into the abdomen and if the fallopian tube has ruptured and needs repair. Any damaged tissue, such as all or part of a fallopian tube, will be repaired or removed.

If you are in shock and very sick, you must have surgery right away to stop too much bleeding. If you lose a lot of blood, you may need blood transfusions.

You may need to stay in the hospital for 1 to 2 days after surgery, depending on the type of surgery you have had and if you have lost a lot of blood.

How long will the effects last?

If the ectopic pregnancy is not removed, it can cause serious problems, including death.

How can I take care of myself?

The best way to take care of yourself is to pay close attention to your health. Pay attention to changes related to your menstrual cycle. Tell your healthcare provider about any abnormal bleeding or unusual pain between menstrual periods. Call your provider as soon as you think you are pregnant, especially if you have an increased risk for ectopic pregnancy.

If you have had surgery for an ectopic pregnancy, follow your healthcare provider's instructions after you go home from the hospital. Have someone stay with you until you are able to take care of yourself. Get plenty of rest, drink a lot of fluids, and eat a healthy diet. Take your pain and other medicine as prescribed.

How can I prevent an ectopic pregnancy?

Pelvic inflammatory disease (PID) is the most common and preventable cause of ectopic pregnancy. Sexually transmitted diseases (STDs), such as gonorrhea and chlamydia, can cause PID. Always practice safe sex by using a latex or polyurethane condom to lower your chances of infection. Have only one sexual partner who also has just you as their sex partner.

Not all ectopic pregnancies can be prevented, but reporting any suspicious symptoms right away to your provider can help prevent serious problems.

Developed by Phyllis G. Cooper, RN, MN, and RelayHealth.
Published by RelayHealth.
Last modified: 2011-04-28
Last reviewed: 2010-12-26
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2011 RelayHealth and/or its affiliates. All rights reserved.
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