An ectopic pregnancy occurs when the fertilized egg attaches itself in a place other than inside the uterus. Almost all ectopic pregnancies occur in a fallopian tube, and are thus sometimes called tubal pregnancies. The fallopian tubes are not designed to hold a growing embryo; the fertilized egg in a tubal pregnancy cannot develop normally and must be treated. An ectopic pregnancy happens in 1 out of 60 pregnancies.
Ectopic pregnancies are caused by one or more of the following:
Women who are more at risk for having an ectopic pregnancy include the following:
The following symptoms may be used to help recognize a potential ectopic pregnancy:
It is important for you to seek emergency care if you are experiencing sharp pain or have bleeding.
Ectopic pregnancies are diagnosed by your physician who will probably first perform a pelvic exam to locate pain, tenderness or a mass in the abdomen. Your physician will also use an ultrasound to determine whether the uterus contains a developing fetus.
The measurement of hCG levels is also important. An hCG level that is lower than what would be expected is one reason to suspect an ectopic pregnancy. Low levels of progesterone may also indicate that a pregnancy is abnormal.
Your physician may do a Culdocentesis, which is a procedure that involves inserting a needle into the space at the very top of the vagina, behind the uterus and in front of the rectum. The presence of blood in this area may indicate bleeding from a ruptured fallopian tube.
An ectopic pregnancy may be treated in any of the following ways:
If the ectopic cannot be removed by a laparoscope procedure, then another surgical procedure called a laparotomy may be done.
Your hCG level will need to be rechecked on a regular basis until it reaches zero if you did not have your entire fallopian tube removed. An hCG level that remains high could indicate that the ectopic tissue was not entirely removed, which would require surgery or medical management with methotrexate.
The chances of having a successful pregnancy after an ectopic pregnancy may be lower than normal, but this will depend on why the pregnancy was ectopic and your medical history. If the fallopian tubes have been left in place, you have approximately a 60% chance of having a successful pregnancy in the future.