What is an ectopic pregnancy?

Any pregnancy that develops outside of the uterus is called an ectopic pregnancy. This takes place when an egg that has been fertilized implants in an area that cannot sustain its growth. Most ectopic pregnancies occur in the fallopian tube (a structure that connects the ovaries and the uterus).

Seldom, ectopic pregnancies can develop in the cervix, abdominal cavity, or ovary. Since only the uterus is designed to sustain a pregnancy, ectopic pregnancies cannot be carried to term. Moreover, they can be dangerous, particularly if the fallopian tube ruptures. This can result in serious bleeding, infection, and in some cases, it can even result in death. This represents a medical emergency. Ectopic pregnancies require prompt medical attention.

How common are ectopic pregnancies?

About 1 in every 50 pregnancies end up being ectopic pregnancies (20 out of 1,000) or about 2%.

What are the possible causes of ectopic pregnancy?

It's not always obvious what causes an ectopic pregnancy. Several different conditions are often connected to an ectopic pregnancy: 

· the fallopian tubes are inflamed and scarred as a result of past illnesses, infections, or surgeries

· hormonal factors

· genetic anomalies

· congenital defects

· medical conditions that have an impact on the reproductive organs' and fallopian tubes' shape and condition

More detailed information about a particular situation may be provided by a medical professional.

Who is at risk for developing an ectopic pregnancy?

All sexually active women face a certain risk of developing an ectopic pregnancy. Any of the following factors can increase the risk of an ectopic pregnancy occurring:

· maternal age of 35 years or older

· history of pelvic surgery, abdominal surgery, or multiple abortions

· history of pelvic inflammatory disease (PID), an infection that can form scar tissue on the fallopian tubes, uterus, ovaries and cervix

· history of endometriosis

· surgery on the fallopian tubes (including tubal ligation) or on the other organs of the pelvic area · an intrauterine device (IUD) in place at the time of conception

· history of infertility

· conception helped by fertility medications or procedures

· smoking

· a previous ectopic pregnancy

· history of sexually transmitted diseases (STDs), such as gonorrhea or chlamydia

· having structural abnormalities in the fallopian tubes that make it hard for the egg to travel

However, it is relevant to note that close to 50% of people who experience an ectopic pregnancy do not present any of the above-mentioned risk factors.

What are the symptoms of an ectopic pregnancy?

Early signs of an ectopic pregnancy can resemble usual pregnancy symptoms quite closely. However, women can also encounter the following signs and symptoms of ectopic pregnancy:

· vaginal bleeding

· pain in the lower abdomen, pelvis and lower back

· dizziness or weakness

The pain and bleeding that result from a fallopian tube rupture may be so intense that they contribute to other symptoms.

These may consist of:

· fainting

· low blood pressure (hypotension)

· shoulder pain

· rectal pressure or bowel problems If a tube ruptures, it is likely to experience a sharp, severe pain in the lower abdomen. In this case, it is strongly recommended to contact a medical professional.

How is an ectopic pregnancy diagnosed?

The physician will run a number of tests to determine whether the pregnancy is ectopic. A pelvic examination and pregnancy confirmation may be part of this procedure. These tests consist of:

A urine test – it entails either urinating on a test strip or into a cup, followed by dipping a test strip into the urine sample in the doctor's office. 

A blood test - a healthcare provider may perform a blood test to determine how much of the hormone human chorionic gonadotropin (HCG) can be found in the body. Only during pregnancy does the organism produce HCG. Since there is a rapid rise in HCG levels when a fertilized egg implants in the uterus, low levels of HCG may signify an ectopic pregnancy. 

An ultrasound examination – it creates an image of the body's interior structure utilizing sound waves. This test will be used by the physician to determine the location where the fertilized egg has implanted.

How is an ectopic pregnancy treated?

Depending on the location of the ectopic pregnancy and how it develops, different treatment options are available. 

Medication

In some circumstances, a physician could advise taking a drug called methotrexate to prevent the fertilized egg from developing and terminating the pregnancy. The fallopian tubes should not be harmed by the medicine. If the fallopian tube has already ruptured, this drug cannot be administered. 

Surgery

If the fallopian tube has already ruptured or is in danger of doing so, a physician will want to perform surgery to remove the ectopic pregnancy. This is an emergency procedure and a life-saving treatment. The surgery is often carried out laparoscopically (via a number of small abdominal incisions) under anesthesia.

Is it possible to prevent an ectopic pregnancy?

Ectopic pregnancy is not possible to prevent. However, the risks can be lowered by adopting a healthy lifestyle. This includes not smoking, achieving and maintaining a healthy weight, and preventing any sexually transmitted infections (STIs).

Can the pregnancy continue after an ectopic pregnancy?

Unfortunately, an ectopic pregnancy results in the death of the fetus, ending the pregnancy. An egg cannot be transferred into the uterus once it has implanted outside of it. It is crucial to treat ectopic pregnancies right away. There may be serious internal bleeding if the fallopian tube ruptures after the egg has implanted there.

Note from UNICA: An ectopic pregnancy can be unexpected and frightening. You are most likely experiencing a roller-coaster of emotions including grief, shock, and anxiety. Such an event may cause significant trauma, therefore, if you are experiencing an ectopic pregnancy, our team of medical professionals at UNICA is ready to assist you medically and emotionally.

We acknowledge that this is an extremely difficult time, but in time, with much patience, you can heal.