Ectopic Pregnancy

Ectopic Pregnancy

What is an ectopic pregnancy? — This is the term doctors use for a pregnancy that is not located in the uterus, where a pregnancy usually is. It is located somewhere else in the body. An ectopic pregnancy is a serious condition and can even be life-threatening.
Pregnancy begins when a woman's egg joins together with a man's sperm. These cells grow into a bigger group of cells, called an "embryo." In a normal pregnancy, the embryo attaches to the lining of the uterus (figure 1). Then, it can grow into a baby (figure 2).
In an ectopic pregnancy, a woman's egg joins with a man's sperm and forms an embryo. But the embryo does not attach to the lining of the uterus. Instead, it attaches to a place in the body that it should not attach to and starts to grow. Even though the embryo gets bigger, it cannot grow into a baby. As the embryo gets bigger, it can cause pain and bleeding and lead to other problems. Some of these problems can be life-threatening.
In most ectopic pregnancies, the embryo attaches to the lining of 1 of the fallopian tubes (the tubes that connect the ovaries to the uterus). When this happens, doctors also call it a "tubal pregnancy." In rare cases, the embryo can also attach to the cervix, ovary, or the inside of the belly.
Some women have a higher chance than other women of having an ectopic pregnancy. A woman can have a higher chance of having an ectopic pregnancy if she:
Has abnormal or damaged fallopian tubes, such as from past infections or surgeries
Had an ectopic pregnancy before
Is getting certain treatments to help her get pregnant
Smokes cigarettes
Women who use a type of birth control called an "intrauterine device" or "IUD" have a very low chance of getting pregnant at all. But, if a woman using an IUD does get pregnant, she is at higher risk of ectopic pregnancy and should have her doctor to check for ectopic pregnancy.
What are the symptoms of an ectopic pregnancy? — Women who have an ectopic pregnancy don't always have symptoms early on. If a woman does have symptoms early on, she can have:
Lower belly pain
Bleeding from the vagina (the bleeding can be heavy or light, or it can even be just spots of blood or brown staining)
Some women don't have any symptoms until the ectopic pregnancy causes more serious problems. For example, an embryo growing in a fallopian tube can cause the fallopian tube to burst open. When this happens, symptoms can include:
Severe lower belly pain
Heavy bleeding from the vagina
Fainting or passing out, or feeling like you might faint or pass out
If you are pregnant and have any of the symptoms listed above, go to an emergency room as soon as possible.
Is there a test for an ectopic pregnancy? — To check if you have an ectopic pregnancy, your doctor or nurse can do:
A blood test to measure a hormone called hCG – This test checks if you are pregnant and how much hCG the pregnancy is making.
An imaging test called an ultrasound to see where the embryo is in your body – Imaging tests create pictures of the inside of the body.
Sometimes, test results show an ectopic pregnancy right away. But most of the time, doctors need to repeat the tests every few days to know for sure if a woman has an ectopic pregnancy.
How is an ectopic pregnancy treated? — Doctors can treat an ectopic pregnancy in 2 ways, depending on the size of the embryo, the woman's symptoms, and other factors. Both treatments involve removing the embryo. A woman can be treated with:
Medicine – Your doctor can give you a shot of medicine. The medicine stops the embryo's growth and causes it to dissolve. Women who are treated with medicine need follow-up blood tests for a few weeks to make sure that the treatment worked.
Surgery – A doctor can do surgery to remove the embryo. Your doctor might or might not need to remove your fallopian tube.
Can an ectopic pregnancy be prevented? — Most ectopic pregnancies cannot be prevented. But women have a higher chance of having an ectopic pregnancy if they get a lot of infections that you catch during sex. To reduce your chance of getting a disease from sex, you can use a condom.
Can I get pregnant in the future? — Most women are able to have a normal pregnancy after having an ectopic pregnancy. But let your doctor or nurse know if you are trying to get pregnant. That way, he or she can follow your pregnancy to make sure everything is normal.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15856 Version 8.0
Release: 28.2.2 - C28.105
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