Ectopic Pregnancy

Woman with her hands over her abdomen
If you have severe abdominal cramps during early pregnancy, contact your doctor immediately. Marcela Barsse / Getty Images

An ectopic pregnancy is an abnormal pregnancy, where the embryo implants itself outside the uterus, typically in the fallopian tube.

An ectopic pregnancy can be life-threatening and must be treated by a doctor as soon as possible. An ectopic pregnancy, also known as a tubal pregnancy, may be treated with medication or with laparoscopic surgery.

Symptoms

An ectopic pregnancy foes not always initially cause any symptoms.

But sometimes, early symptoms might be the same as those of any pregnancy — a missed period, breast tenderness and nausea.

If you take a pregnancy test, the result will be positive. Still, an ectopic pregnancy can't continue as normal.

Light vaginal bleeding with abdominal or pelvic pain is often the first warning sign of an ectopic pregnancy. If the fallopian tube ruptures, heavy bleeding inside the abdomen is likely — followed by lightheadedness, fainting and shock.

Causes

An ectopic pregnancy happens when a fertilized egg gets stuck on its way to the uterus, often because the fallopian tube is damaged by inflammation or is misshapen. Hormonal imbalances or abnormal development of the fertilized egg also might play a role.

Risk Factors

Various factors are associated with ectopic pregnancy, including:

  • Previous ectopic pregnancy. 
  • Inflammation or infection. Inflammation of the fallopian tube or an infection of the uterus, fallopian tubes or ovaries (pelvic inflammatory disease) increases the risk of ectopic pregnancy.
  • Fertility issues. Some research suggests an association between difficulties with fertility and ectopic pregnancy.
  • Structural concerns. An ectopic pregnancy is more likely if you have an unusually shaped fallopian tube or the fallopian tube was damaged.
  • Contraceptive choice. Pregnancy when using an intrauterine device (IUD) is rare. If pregnancy occurs, however, it's more likely to be ectopic. 
  • Smoking. Cigarette smoking just before you get pregnant can increase the risk of an ectopic pregnancy. And the more you smoke, the greater the risk.

Treatment

A fertilized egg can't develop normally outside the uterus so to keep life-threatening complications from occurring, the ectopic tissue needs to be removed.

If the ectopic pregnancy is detected early, an injection of the drug methotrexate can be used to stop cell growth and dissolve existing cells. 

In other cases, ectopic pregnancy is usually treated with laparoscopic (minimally invasive)surgery. In this procedure, a small incision is made in the abdomen and your doctor uses a thin tube equipped with a camera lens and light to see the area.

Other instruments can be inserted into the area to remove the ectopic tissue and repair the fallopian tube. If the fallopian tube is significantly damaged, it might need to be removed.

If the ectopic pregnancy is causing heavy bleeding or the fallopian tube has ruptured, you might need emergency surgery through a more invasive abdominal incision, called a laparotomy.

In some cases, the fallopian tube can be repaired. Typically, however, a ruptured tube must be removed.

More on Struggling to Get Pregnant

Source:

Mayo Clinic. Ectopic Pregnancy. http://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/basics/definition/con-20024262

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