Can an Ectopic Pregnancy be Saved?

While fetal survival is unlikely, there have been exceptions

Sonogram showing an ectopic pregnancy. The embryo sac, in dark pink, is located outside the uterus in orange
Sonogram showing an ectopic pregnancy. The embryo sac, in dark pink, is located outside the uterus in orange. Getty Images/BSIP/UIG

An ectopic pregnancy (also known as a tubal pregnancy) is one in which the fertilized egg implants somewhere other than in the uterus, most often in the fallopian tubes. As the pregnancy advances, the developing fetus will cause the tube to stretch and sometimes rupture, leading potentially life-threatening internal bleeding.

While there have been rare, well-publicized cases where an ectopic pregnancy has been brought to term—including British woman who, in 2011, delivered a healthy baby at 30 weeks—pregnancies of this sort are almost universally considered nonviable.

Understanding Ectopic Pregnancy

Ectopic pregnancies affect about one to two percent of all pregnancies. These are most commonly seen in women who have pelvic inflammatory disease (PID) due to a chlamydial infection. Smoking, tubal surgery, a history of infertility, and assisted reproduction are also known to contribute to the risk.

Up to 30 percent of ectopic pregnancies have no medical signs or symptoms in the early stages. When present, most will typically appear before the eighth week and may include:

  • Vaginal bleeding
  • The sudden onset of lower abdominal pain
  • Pelvic pain
  • A tender cervix

In cases of heavy bleeding, the pregnancy may initially be diagnosed as a miscarriage. It is typically at this stage that an ultrasound will reveal the problem to be an ectopic pregnancy. Elevated hCG levels in the blood can further support the diagnosis (since miscarriage usually results in a drop in hCG). 

Almost as a rule, once an ectopic pregnancy is diagnosed, termination is recommended.

Why Ectopic Pregnancies Are Terminated

The vast majority of ectopic pregnancies implant in the fallopian tubes. If left unchecked, the fetal growth will involve larger amounts of tissue and vascular structures. It is at this point that the pregnancy can become dangerous with any rupture likely to cause a massive bleed.

Since fetal death is all but certain and the risk to the mother is high, termination will be recommended, either through surgery or abortive medications.

Sadly, no medical technology currently exists to move an ectopic pregnancy from the fallopian tubes to the uterus.

Rare Cases of Successful Ectopic Pregnancies

While there have been cases where an ectopic pregnancy has been brought to term, the conditions by which these occurred were extremely unusual. In fact, they are so rare that the odds of successful ectopic pregnancy are around one in three million.

Most successful deliveries have involved the implantation of the egg somewhere in the abdomen rather than the fallopian tubes. Referred to as an abdominal pregnancy, these anomalies are usually situated near the liver or other organs where there the blood supply is rich. Even then, the chances of survival are slim. Delivery can also be tricky depending on where major blood vessels or organs are located.

The British case, in which the abdominal pregnancy was diagnosed at 20 weeks, was only one of three such pregnancies documented in the United Kingdom in over 20 years.

Others have occurred in parts of the world where prenatal care is lacking.

Such cases are considered flukes since they would most likely have been terminated in the developed world. It is this absence of care that accounts for the high rate of deaths in women with abdominal pregnancies. Some studies, in fact, suggest that the rate may be as much as seven times greater than that of tubal pregnancies.

Sources:

Baffau, P.; Fofie, C.; and Gandau, B. "Term Abdominal Pregnancy with Healthy Newborn: A Case Report." Ghana Med J. 2011; 45(2): 81-83.

Barash, J.; Buchanan, E.; and Hillson, C. "Diagnosis and management of ectopic pregnancy." Am Fam Physician. 2014; 90(1):34-40.

LifeSite News. "Woman with ectopic pregnancy risks life and defies the odds – gives birth to healthy baby." June 30, 2011.

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