What to Know About an Ectopic or Tubal Pregnancy

Ectopic pregnancy, sometimes known as a "tubal" pregnancy, is the number one cause of death of women in the first trimester of pregnancy. With the numbers of ectopic pregnancies on the rise, it is important to understand the causes and symptoms of ectopic pregnancies.

What Is an Ectopic Pregnancy?

The term ectopic pregnancy frequently refers to a pregnancy that has occurred in one of the fallopian tubes, instead of the uterus.

This is the case about 95 percent of the time, but ectopic pregnancies can also be abdominal, ovarian, cornual, or cervical. Ectopic pregnancies are never viable.

While we don't always know the cause of an ectopic pregnancy, there are certain risk factors, including a history of pelvic inflammatory disease (PID) or Salpingitis, infertility, endometriosis, a previous tubal ligation surgery, or having an intrauterine device (IUD) in place. If a patient has had an ectopic pregnancy or previous pelvic of abdominal surgery, she's at a higher risk of an ectopic pregnancy.

Symptoms and Diagnosis of Ectopic Pregnancies

There are several symptoms of an ectopic pregnancy, including vaginal bleeding, shoulder pain, abdominal pain, and weakness or dizziness. Though many of these symptoms can also occur in a normal, healthy pregnancy, if you suspect that you are pregnant and have any of these symptoms, call your doctor.

An ectopic pregnancy is a life-threatening condition that requires immediate treatment.

Testing for ectopic pregnancy is actually difficult, because the answers are not always clear cut, nor are they always available right away. Your hCG levels may be tested to check the rate of rise as they normally double about every two days in a normal pregnancy, but this alone is not an indicator of an ectopic pregnancy.

Ultrasound is frequently used to diagnose tubal pregnancies, along with vaginal ultrasound to try to visualize the pregnancy. If a uterine pregnancy is confirmed then the chance of ectopic pregnancy is rare. Sometimes it is too early to diagnose an ectopic via ultrasound, and the exam will have to be repeated later on.

Sometimes in urgent situations, a laparoscopy procedure will be done to provide diagnosis and treatment. This is done in an operating room as surgery. If you do have an ectopic pregnancy, most likely you will have the surgical treatment done at this time.

The Two Main Treatment Options

There are two main types of treatment for ectopic pregnancies: chemical and surgical.

Chemical treatment is done with a drug called methotrexate. It is used in non-urgent cases to dissolve the pregnancy without harming the tubes and other organs. Testing to measure hCG levels in the patient's blood, which is a hormone found only in pregnancy will ensure that further treatment is not needed.

Surgery is usually done if a pregnancy is further along, or there is another medical reason to not use the chemical process. It may be necessary, especially when the tube ruptures or there is other damage.

Sometimes the woman will lose her tube and possibly her uterus if the bleeding can't be stopped.

Facing Pregnancy Again

Once your recovery is physically underway, you may question your ability to have a successful pregnancy. If your fallopian tubes were not damaged, you have excellent chances of getting pregnant again, although a higher than average risk of having another ectopic pregnancy. If your tubes were damaged or removed, you still have pregnancy options, so consult your doctor.