Ectopic Pregnancy
What is an ectopic pregnancy?
This is when a fertilised egg (embryo) implants outside the uterus. Approximately 1-2% of pregnancies are ectopic.
This can be a dangerous condition for you, so it’s important to recognize the early signs and get treatment as soon as possible.
How does it happen?
After conception, the embryo travels down one of your fallopian tubes towards your uterus. If the tube is damaged or blocked and does not propel the embryo toward your womb, it may implant in the tube and continue to develop there. (Most ectopic pregnancies occur in a fallopian tube, so they are often called “tubal” pregnancies.)
Rarely, can also implant in an ovary, in the cervix, directly in your abdomen, or even in a caesarean section scar.
An ectopic pregnancy that is not diagnosed and treated quickly could result in a ruptured fallopian tube, causing severe abdominal pain and bleeding. This can lead to permanent tube damage or loss, or even death if very heavy internal bleeding is not treated right away.
What are the risk factors for ectopic pregnancy?
The risk factors that make this condition more likely are:
- Surgery
- A previous ectopic pregnancy
- Pelvic inflammatory disease (PID)
- Endometriosis
- Fertility issues
- Being age 35 or older
- Smoking
- Having a mother who took the drug DES during pregnancy
- Getting pregnant with an intrauterine device (IUD) in place
- Taking progestin-only hormonal contraceptives
What are the symptoms of an ectopic pregnancy?
Signs and symptoms may vary from woman to woman, but the most common indicators are a missed period, abdominal pain, and vaginal bleeding. However, many women have no symptoms at all until the ectopic pregnancy ruptures.
How is an ectopic pregnancy diagnosed?
This can be difficult to diagnose. If you have symptoms that suggest an ectopic pregnancy, your doctor will need you to have an ultrasound.
During the ultrasound, our sonographer will examine your tubes and uterus very closely. If your blood test reveals that you have the pregnancy hormone hCG at a certain level but the sonographer can’t find the embryo in your uterus, you may have an ectopic pregnancy.
However, it is also possible that you have miscarried or that you have a uterine pregnancy that is still in the very early stages.
If our sonographer can see an embryo in the fallopian tube, you definitely have an ectopic pregnancy. However, in many cases the embryo dies soon after it has been implanted and is too small for the sonographer to find. They may see that your fallopian tube is swollen or see blood clots as well as tissue left from the embryo.
If you are not in pain and there is still some question about the diagnosis, you will have another ultrasound and blood test in two days’ time. Your doctor will likely continue to monitor your condition very closely with blood tests and ultrasounds until they can confirm the diagnosis and management options will be discussed with you.