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Ectopic Pregnancy

What is an ectopic pregnancy?

A pregnancy that develops outside the uterus is called an ectopic pregnancy. This nearly always happens in a fallopian tube. So it’s often called a tubal pregnancy. In rare cases, an ectopic pregnancy will happen in an ovary, in the cervix, or the belly (abdomen).

What causes an ectopic pregnancy?

A fertilized egg normally moves down a fallopian tube and into the uterus. But the egg can get stuck in the tube if the tube is blocked. This might be from an infection or scar tissue. If the fertilized egg can't reach the uterus, it begins to develop in the tube.

Who is at risk for an ectopic pregnancy?

Ectopic pregnancy is more common in women who:

  • Have had trouble getting pregnant (infertility)
  • Have endometriosis. This is when uterine tissue grows in other areas of the pelvis.
  • Have a sexually transmitted disease. This can cause infection and scarring in the pelvis.
  • Have had tubal surgery
  • Use an IUD
  • Had an ectopic pregnancy in the past
  • Have multiple sex partners
  • Smoke
  • Are older

What are the symptoms of an ectopic pregnancy?

Women with an ectopic pregnancy may have irregular bleeding and pelvic or belly (abdominal) pain. The pain is often just on one side. Symptoms often appear 6 to 8 weeks after the last normal menstrual period. If the ectopic pregnancy is not in the fallopian tube, symptoms may happen later. The classic symptoms of an ectopic pregnancy are:

  • Belly (abdominal) pain
  • No recent period
  • Vaginal bleeding not related to a period

How is an ectopic pregnancy diagnosed?

Your healthcare provider will measure the level of the hormone hCG (human chorionic gonadotropin) in your blood. He or she will use ultrasound to check the uterus for a fetus or other pregnancy tissue. In some cases, your healthcare provider will use laparoscopy to diagnose and treat an ectopic pregnancy. This is surgery that uses a lighted tube inserted into your abdomen to check inside the pelvis. It often gives the most accurate diagnosis.

How is an ectopic pregnancy treated?

Ectopic pregnancy may be treated in several ways. This depends on whether the fallopian tube has broken open (ruptured), how far along the pregnancy is, and your hormone levels. Treatments may include:

  • Letting the ectopic pregnancy heal and the body absorb it on its own. This is only for certain cases.
  • Using the medicine methotrexate to stop the pregnancy from growing further
  • Using surgery (usually laparoscopy) to make a small opening in the fallopian tube. The surgeon removes the pregnancy and sometimes the tube.

In rare cases, healthcare providers must make a larger incision in the abdomen to remove the ectopic pregnancy or damaged fallopian tube.

What are the complications of an ectopic pregnancy?

When the embryo implants in the fallopian tube, it does not have enough room to grow or enough blood flow to keep it healthy, so it dies.

The tube may start to let out some of the tissues or bleed. Some embryos do keep growing and may become large enough to burst the fallopian tube. This can cause severe bleeding and shock.

Ectopic pregnancy is the leading cause of pregnancy-related deaths during the first 3 months of pregnancy in the U.S.

When should I call the healthcare provider?

Don’t ignore symptoms of ectopic pregnancy. Call your healthcare provider if you have any bleeding or pain in pregnancy.

Key points about ectopic pregnancy

  • Pregnancy that develops outside the uterus is called ectopic pregnancy.
  • Women with an ectopic pregnancy may have irregular bleeding and pelvic or abdominal pain, often on one side.
  • Symptoms most often appear 6 to 8 weeks after the last normal menstrual period.
  • Ectopic pregnancy may be treated in several ways, depending on whether the fallopian tube has burst.
  • Don’t ignore symptoms of ectopic pregnancy. Call your healthcare provider if you have any bleeding or pain in pregnancy.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Medical Reviewers:

  • Burd, Irina, MD, PhD
  • Goode, Paula, RN, BSN, MSN