Ectopic pregnancy

The causes, risk factors, symptoms, signs and treatment of an ectopic pregnancy explained.
In the majority of pregnancies once an egg has been fertilised by a sperm it travels along the fallopian tube into the uterus where it implants in the fertile lining and begins to develop. However, occasionally the fertilised egg will implant outside the womb - this is known as an ectopic pregnancy.

Most ectopic pregnancies (over 95%) implant in a fallopian tube although they do also occur in the ovaries, cervix or abdomen. Unfortunately, embryos are unable to survive anywhere outside the womb as they do not have the space or nourishment to develop and grow. Sadly this means that ectopic pregnancies have to be removed as they pose such a great health risk to the mother.

Why do ectopic pregnancies occur?

There is no way to predict who will conceive an ectopic pregnancy as there is no one condition or reproductive problem that is known to cause implantation outside the womb. However, any condition that causes a blockage of the fallopian tubes or a delay in the movement of a fertilised egg towards the womb may increase the likelihood of a pregnancy being ectopic.

Factors known to increase the likelihood of an ectopic pregnancy include Pelvic Inflammatory Disease (e.g. chlamydia or gonorrhoea), abdominal surgery (including sterilisation reversal), increased age and having 3 or more terminations. Previous ectopic pregnancy and conception by IVF are also known to increase the risk, however individuals who fall in this category do tend to be very closely monitored by their health care professional during the early stages of pregnancy and so are detected early.

Symptoms

Initially the symptoms of an ectopic pregnancy are very similar to those signifying miscarriage. These include pregnancy symptoms such as tender breasts, fatigue and testing positive on a pregnancy test coupled with dizziness, (non-menstrual) vaginal bleeding and abdominal pain on one side.

If an ectopic pregnancy proceeds without treatment then the encasing fallopian tube may rupture and cause severe internal bleeding. Symptoms of this include sudden, severe abdominal pain, shoulder pain (this is caused by blood leaking into the abdominal cavity), dizziness and fainting. Eventually the individual is likely to go into shock - this is a potentially fatal condition where there is insufficient blood circulating around the body.

Treatment

Although in a number of instances implantation of the ectopic embryo is rejected by the body and naturally removed, medical attention is often required.

If an ectopic pregnancy is suspected then an ultrasound will usually be carried out to detect the status and location of the pregnancy. However, in the earlier stages of pregnancy the tiny embryo may not be detected by this method and so in this case the levels of the pregnancy hormone HCG will be regularly monitored. This will indicate whether the pregnancy is implanted in the womb or elsewhere as HCG levels will continue to increase during a normal pregnancy but level off if the pregnancy is ectopic.

Once an ectopic pregnancy has been identified there are really two options for treatment. The first is only suitable for some early, unruptured ectopic pregnancies and is in the form of an injection of the drug Methotrexate. This avoids the need for surgical intervention by stopping the division of cells causing the pregnancy to halt and be removed by the body. After administration levels of HCG are monitored to ensure termination has been successful.

If treatment using Methotrexate is not deemed suitable then surgery will be needed. Many can be treated via a laparoscopy (keyhole surgery) that removes the pregnancy. However, if this is not possible or if the fallopian tube has ruptured or needs to be removed then a laparotomy may be carried out. This will involve open surgery carried out through a small incision made in the abdominal area.

Outcome

If you experience an ectopic pregnancy there is a 10-20% chance that further pregnancies will also be ectopic. However, for the majority of women it is possible to go on to have further pregnancies that are successfully carried to term, even if the encasing fallopian tube has to be removed. You should always talk to your doctor if you have any questions about possible effects on your fertility or if you are planning to start trying to conceive again.

The loss of a pregnancy whether ectopic or otherwise is a very distressing event. After treatment for an ectopic pregnancy it is important to grieve for your loss - talking to your partner and close friends will help you through this difficult time and help you prepare yourself mentally and physically for another pregnancy if that is what you wish.

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Hi, I had a healthy pregnancy and labour with my son in 2006 and ive had two ectopics in six months this year had operation both times, 1st one i was 10wks+ and my right fallopian tube was removed.
the 2nd one i was 5wks and even though i had been to the doctors and the walk in at the hospital before to tell them i had had a positive test and was bleeding the test they done where negative. i collapsed at home and was taken to the hospital where i was told it was on the remnant of right tube and had ruptured. im not trying for a baby but we have decided that if it happens it happens, im just so scared ill have to go through all the heartache again and add to the six little scars and constant reminders that i already have. if it happens again the surgeon has said they would just take it all away im only 26! its made me scared and when i watched out of interest under-age and pregnant i have to turn it over it makes me so angry. everywhere i look there's pregnant women and tiny babies, Why not me?
by jellybean09 21st Oct 2010, 9:08am
Hey. I'm just having a bit of a panic. I've been having shooting pains in my left lower side. I was just wondering...are they unbearable to the point you have to sit down or does it feel like it's kind of a throb??I'm so scared of losing our baby :-(
by Starsdb 14th May 2010, 4:56pm
Hi I am new at this. I just went through an ectopic pregnancy. I just now went back to work after being for three weeks. My tubes were tied with my second child with a c-section. This really scared me and my husband for one we were totally in shock. Now we r scared to have the tubal reversal bc we are not sure if we will have to go through this emotional rollercoster again. I really want to give my husband a child, considering my other two are from a previous marriage and he has none of his own. We are just really scared of the surgery and not for sure if this will happen again. This was a very painful, emotional and physically, time for us. I want to do know if there is any other way of doing this or if I should just give up on this. My husband has done told me that he has all he needs and that this really scared him bc he almost lost me. I am very confussed and I am not sure on what to do from here. I am scared that if I dont do something though I will have another ectopic pg and we just caught this one in time. We are scared that if this done happen again then we will not catch in time. Please someone please let me know what they suggest me to do. Please if anyone has any suggestions at all please email me alambert029@yahoo.com
by alambert 21st Jan 2010, 9:21am
i just experienced an ectopic pregnancy in July... the doctor advised me to wait a few months before conceiving and OOps, im prego again... i havent had any of the symptoms like before and i have set a doctors appointment for next week... im praying everything will be fine
by DMVDiva 7th Oct 2009, 10:27am
Hi.I am 30 years old woman.i have 3 years old daughter.now we try for another child.1 year back i got ectopic pregnancy when i had IUD.after that doctor gave injection.so problem solve.removed IUD also.14thday of menstrual cycle is correct time for fertility so we tried for pregnancy. last period is 18th sep,2009.my que is will i get ectopic again?.i scar about it?
by praveena 6th Oct 2009, 12:46pm
Lillyboxer, your post stood out to me as this is exactly what I have been through. We were told that most likely this was all just bad luck and to keep on trying. I've had my ups and downs but the only way to move forward was holding on to the hope that it is all just crappy 'bad luck'. Of course I am terrified but the thought of not having a family scares me even more. I just wanted you to know that you are not alone in how you are feeling and if you want to chat / vent some more then let me know!!!
by maybebay76 10th Aug 2009, 9:27am
i have had an ectopic pregnancy where the outcome my left tube was removed i had the injection which the doctor advised me to he told me it was 99.9 per cent accurate which i left the hospital just excpecting a period which happened then a week later i collapsed went straight to the hospital which sent me home and said it was normal 2 days later i started havin fits and couldnt breath tidy got rushed bk dwn 2 the hospital where i died they had 2 rush me into theatre in the mornin the consultant said ur lucky 2 be alive. i then fell pregnant again a few weeks later but my body wasnt ready i now hav a stunnin 2 year old so never give up tryin i couldnt b happier i love him so much.if any1 wants to chat about simila situation my email address is sarajones2599@yahoo.co.uk
by sexykittensara 6th Aug 2009, 10:03am
HI I HAVE 2 MISCARRIAGE AND A FEW WEEKS AGO AN ECTOPIC TALK ABOUT BAD LOOK I HAD TO HAVE MY LEFT TUBE TOOK AWAYI NOW I FEEL LIKE I NEVER BECOME A MAM IM SCARED OF EVEN TRYING FOR A BABY AGAIN .
by LILLYBOXER 28th Jul 2009, 1:10pm
I am currently 8 weeks pregnant. I have a healthy 10 year old, but I had an unexplained miscarriage in September 2008 at 12 weeks. Now, I am spotting, with back ache and pain on my right side of my abdoman. I don't want to think that this may be ectopic, but what are the chances?
by Scaredwitless 22nd Jul 2009, 9:39am
Hi,My name is JD.i could love to share with you our exprience.last year Aug,my darling felt unwell and we went to see our doctor. the Doctor advised her to do Pregnancy test since she had missed her periods which turned positive.We were so happy but our happiness didnt last! One night afer four days while preparing dinner, she just collasped and fainted, i called for help and we rushed her to the hospital. With a quick test,it turned positive(Ectopic). I got shocked when i was told she had to be operated for it had raptured.All went successful with all her tubes remaining.We have been visting our Doctor for advise,check ups and Luck enough she conceived April this year.So our Doctor requested for scanning but unluck it tunned to be Ectopic again! What a pain again God? Anyway she had to be operated through Laparoscopic surgery and they had to remove the left Tube since it had produced two ectopic pregnancies.So we are left with God's blessings but we hope all will be fine.I love my darling and I believe she will be ok.cheers.

Jared,NAIROBI Kenya.
by motush 11th May 2009, 11:42am
Update: I actually did conceive during the month of February. The home pregnancy test did not show a positive result until the 1st day of my missed period. I am now 5 weeks pregnant :-)
by Gmama 4th Mar 2009, 9:18am
Hi, i once had ectopic pregnancy which was ruptured b4 it was confirmed .The baby was removed with one of the tubes partially.An operation was done and the scan did after the opeeration says everything is o.k have been ttc since then.A yr plus after that i went to the hospital to see the Doctor 4 ttc but i had 2 go 4 hsg which the result says blocked tubes and pelvic adhesion. The gynaecologist now told me i ve to go thru Laparascopy to know why the other tube was also blocked. and maybe thru another operation. i was scared and did not go for any out of the operations. Is there anyone with this past experience but has been able toconeive now. what do i do next.
by click 17th Nov 2008, 8:54am
i am 29 yrs old have 5 beautiful children ....on 3rd nov 08 i found i was preg an was happy an hr later i was rust 2 hosp an learnd that i was havin an eptopic preg wiv a bleed i was very upset wen i got rushed 2 surgery an had 2 have my bby an tube removed ...i havnt got the heart 2 explain 2 my other children why mommy wasnt home 4 a few days an y i am so upset an y i am in so much pain ...i am scared ov it happenin again as i do want another child...
by bbyb 10th Nov 2008, 9:51am
Hi my name is dean. me and my partener went to the doctors yesterday because my partener was experiencing pain in the front lower part of her abdomen. we have had a pregnancy test which tested posative(buzzin).the doctor said we could be having an eptopic pregnancy, we are both very worried. we have had to wait two days for the scan to tell us iether way. i am not very happy as i thought any doctor that thought that we were having an eptopic would have had us in that day for tests. anyway the test is tommorow and all we can do is hope for the best. my partener has not had any bleeding or the pain isnt there all the time. in fact if has gone away today . i am very upset at the doctors diagnosis because we could be worrying over nothing but if we are not why wernt we sent straight away for tests. what i have read about eptopic pregnancys are if the tubes burst it requires an operation i just hope if it is an eptopic that it doesnt burst between now and tommorow. thankyou for reading my E/,ail. Dean
by hindmarsh 1st Oct 2008, 9:14am
I had an eptopic pregnancy last June, and it did rupture and I had massive internal bleeding, I went into shock but luckily I was with my husband who rushed me to the hospital.

The scary thing was I had no real signs I thought I was having a period, but then I started having stabbing pains on the Sunday and then 6am on the Monday morning I passed out when getting out of bed!

I have been trying to concieve since but with no luck as yet, we had been trying for 3 years before the eptopic pregnancy :-(
by ladykb 7th Aug 2008, 8:54am

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