Ectopic Pregnancy

Ectopic Pregnancy at a Glance

• An uncommon but serious pregnancy complication

• Happens when a fertilized egg implants outside of the uterus

• Symptoms include abdominal and shoulder pain, cramps, vaginal bleeding, nausea, and dizziness

• Women need treatment right away

Many women are concerned about having a pregnancy complication. Ectopic pregnancy is a very serious one. Whether you think that you may have an ectopic pregnancy, are a concerned partner or friend, or are just curious, you may have many questions. Here are some of the most common questions we hear women ask about ectopic pregnancy.

What Is Ectopic Pregnancy?

Normal pregnancies develop inside a woman's uterus.  "Ectopic" means out of place. In an ectopic pregnancy, a fertilized egg attaches to the wrong place in a woman's body. In most ectopic pregnancies, the egg attaches to the woman's fallopian tube. That is why ectopic pregnancies are often called "tubal pregnancies." Rarely, ectopic pregnancies can take place in other parts of a woman's body — like on the cervix, ovary, or somewhere else in a woman's abdomen.

Ectopic pregnancies are serious. They can cause internal bleeding, infection, and death.

Ectopic pregnancies are not very common. They happen in about 2 out of every 100 pregnancies. However, they have become much more common in the past 30 years. Experts think the increase may be due to

• an increase in sexually transmitted infections that can scar the fallopian tubes

• infertility treatments

Is Ectopic Pregnancy Dangerous?

Yes. Ectopic pregnancy is life threatening. It is a leading cause of pregnancy-related death during the first trimester in the U.S. A growing embryo can rupture — burst — a fallopian tube. That can lead to internal bleeding and infection. The good news is that effective treatment is available.

Who Is at Risk for Ectopic Pregnancy?

Women have an increased risk for ectopic pregnancy if they

• have a history of pelvic inflammatory disease or endometriosis

• are 30 years old or older

• have had a previous ectopic pregnancy

• have had abdominal, fallopian tube, or pelvic surgery

• smoke

• have had a fertilized egg placed in a fallopian tube during an infertility procedure (It usually implants in the uterus, but in rare cases may implant in the tube.)

It's rare for a woman to get pregnant after she has had a sterilization procedure or while she's using an IUD. But if she does, she has an increased risk of ectopic pregnancy.

What Are the Symptoms of Ectopic Pregnancy?

Very early in pregnancy, ectopic pregnancies seem like normal pregnancies. A woman may have a missed period, breast tenderness, fatigue, and nausea.
Symptoms of ectopic pregnancy include

• severe abdominal pain on one side of the body

• cramps and spotting

• vaginal bleeding

• shoulder pain

• nausea and vomiting

• fainting spells or dizziness

If you have severe pain or bleeding, go to the emergency room right away. If you have any other symptoms of ectopic pregnancy, contact your health care provider right away. The earlier an ectopic pregnancy is diagnosed and treated, the better.

How Can I Know If I Have an Ectopic Pregnancy?

A health care provider can diagnose an ectopic pregnancy. Usually, a provider does a pelvic exam and uses ultrasound. Your provider may also use blood tests or a laparoscope — a thin instrument inserted into the abdomen.

How Is Ectopic Pregnancy Treated?

Ectopic pregnancy is treated with medicine or surgery. Talk with your health care provider about what treatment is best for you.

• The medicine methotrexate can be used to end a tubal pregnancy.

• Surgery can remove the pregnancy. Sometimes it is necessary to remove the tube with the pregnancy. This is called a salpingectomy. The tube may be removed through an opening in the abdomen. This is called an open procedure. It can also be removed through a small incision near the navel, using a laparoscope.

If I Had an Ectopic Pregnancy, Can I Get Pregnant Again?

It depends on what treatment you had and on the condition of your fallopian tubes. If a tube was removed or your tubes are scarred, it may be more difficult to get pregnant. But many women are able to have normal pregnancies after having an ectopic pregnancy. From 5–8 out of 10 women are able to. But about 1 out of 10 women who have an ectopic pregnancy will have another one.

There are many treatments available to help women have healthy pregnancies after an ectopic pregnancy. Talk with your health care provider about finding the best treatment for you
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