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  1. What is an Ectopic Pregnancy?

What is an Ectopic Pregnancy?

Ectopic pregnancy is a serious medical condition that affects about 100,000 women in the US every year. Learn more about why it happens and how it is treated.

Jul. 7, 2022 • 7   min read

What is an ectopic pregnancy?

A pregnancy that happens outside of the uterus is called an ectopic pregnancy. The uterus is the pear-shaped, hollow organ in a woman’s pelvis where a fetus (unborn baby) grows and develops. The uterus is also commonly called the womb, and its main function is to nourish developing fetuses before they’re born.

Pregnancy begins with a fertilized egg, which usually attaches to the lining of the uterus. When a fertilized egg implants and grows outside of the uterus (often in a fallopian tube, but sometimes in an ovary or the abdominal cavity), the pregnancy is ectopic.

Unfortunately, an ectopic pregnancy cannot proceed normally, and the fetus will not develop fully. Ectopic pregnancies can be dangerous for the mother if not immediately treated, and never result in the birth of a baby.

Are ectopic pregnancies serious?

Ectopic pregnancies are medical emergencies. The uterus is designed to nourish and expand as the fetus grows. No other organ in the body can perform this function, including the fallopian tube or ovary. As the fertilized egg develops in the tube or ovaries, it can burst, which can cause large amounts of internal bleeding. This internal bleeding is life-threatening and needs immediate treatment to avoid injury to the fallopian tube, other nearby organs, and possible death.

“Ectopic pregnancies are one of the leading causes of death among women in the first trimester," said Olivia Higgins, MD, a minimally invasive gynecologic surgeon at the Center of Excellence in Minimally Invasive Gynecology at Rochester General Hospital. "If it is not caught early and managed appropriately, it can be catastrophic.”

How are ectopic pregnancies diagnosed?

Most ectopic pregnancies are discovered early in pregnancy–typically within the first trimester, or by the eighth week. Health care providers will perform several tests to confirm the pregnancy and then look for any signs of ectopic pregnancy. Tests may include:

  • A urine test
  • A blood test
  • An ultrasound

Once a pregnancy is confirmed and it has been determined where the egg has been implanted, a personalized treatment plan will be created. Ectopic pregnancies are a medical emergency and treatment is key.

Is it possible for an ectopic pregnancy to go to full-term?

No, it is not. Unfortunately, an ectopic pregnancy is fatal for the fetus, as it cannot survive outside of the uterus. Quick treatment for an ectopic pregnancy is necessary to protect the mother’s life, and the fetus cannot be re-implanted in the uterus or elsewhere to continue growing.

What are the symptoms of an ectopic pregnancy?

Early symptoms tend to mimic the symptoms of pregnancy. The first warning signs are usually pelvic pain and light vaginal bleeding.

If blood is leaking from your fallopian tube or if it ruptures, you may experience additional symptoms including:

  • Dizziness, weakness, and fainting due to low blood pressure
  • Pain in your lower back and/or abdomen
  • Rectal pressure (including the urge to make a bowel movement)
  • Shoulder pain

If you experience any of these symptoms with a positive pregnancy test, you should head to the nearest emergency room and reach out to your women’s health provider immediately, as this could indicate a medical emergency.

How is an ectopic pregnancy treated?

Treating an ectopic pregnancy ends your pregnancy. Sometimes, ectopic pregnancy treatments are confused with elective abortions, but with or without medical intervention, an ectopic pregnancy cannot progress past the first few months. If they continue, they risk rupturing a tube and causing catastrophic internal bleeding. A healthy birth is not possible with an ectopic pregnancy.

“The diagnosis of an ectopic pregnancy can be confusing and devastating for patients," Dr. Higgins said. "It is very important to treat this diagnosis with compassion and sympathy, making every attempt to understand the patient’s perspective. Then we must educate our patients on the seriousness of treatment and the need for continued follow up until complete resolution. This will help provide safety for the mother and any other future fertility.”

There are several ways to treat an ectopic pregnancy. They include medication or surgery.

Methotrexate

Your provider will inject this medication to stop the growth of your pregnancy, ending it. This is a less invasive option than surgery but will require follow-up appointments to monitor your hCG levels to ensure you’re safe and healthy.

Laparoscopic Surgery

Laparoscopic surgery can be used to treat ectopic pregnancies. The two procedures used are salpingostomy or salpingectomy. In both, a small incision will be made near or in your navel. Your surgeon will use a thin tube capped with camera light and lens (called a laparoscope) to view your fallopian tubes.

If you are undergoing salpingostomy, the ectopic pregnancy will be removed, and the fallopian tube will be left to heal on its own.

If you are undergoing salpingectomy, both the tube and the ectopic pregnancy will be removed.

Your provider will determine which is right for you based on the damage to your tube, the amount (if any) of bleeding and whether your fallopian tube shows signs of previous damage.

Learn more about our Women’s Specialty Surgery Program

Emergency Surgery

If your fallopian tube has ruptured or if you are at risk of a rupture, surgery will be necessary. Medication is not the best option at this time. This life-saving and emergency treatment will involve removing the ectopic pregnancy from its incorrect implantation site, which sometimes involves removal of your fallopian tube.

Frequently Asked Questions

  • For most, conditions that slow down or block the movement of the egg down the fallopian tube and into the uterus (womb) cause an ectopic pregnancy.

    There are risk factors that may increase your chance of developing an ectopic pregnancy, including:

    • A previous ectopic pregnancy
    • Endometriosis
    • Fallopian tube surgery
    • Fertility treatments
    • Having an IUD in place at the time of conception (but it is still very unlikely to get pregnant in the first place with an IUD)
    • History of PID (pelvic inflammatory disease)
    • Smoking
    • STIs

    Your risk may also increase as you age. Women over the age of 37 are at a higher risk of ectopic pregnancy than younger women. Many women who are diagnosed with an ectopic pregnancy have no risk factors.

    You can try to reduce your risk factors and talk about them with your provider before you try to become pregnant.

  • Yes, most women who have had an ectopic pregnancy do have successful pregnancies in the future. There is a higher risk of experiencing another ectopic pregnancy after you’ve had one, though. Mention any ectopic pregnancies to your women’s health provider so you can discuss any risk factors and healthy lifestyle changes before you try for your next pregnancy.

  • This tends to vary person by person and it is something you should talk about with your women’s health provider. The most important thing is to ensure complete resolution of the ectopic pregnancy before getting pregnant again. You do this by continuing close follow up with your health care provider until your pregnancy tests are negative.

  • Yes, most people can still get pregnant if they’ve had one fallopian tube removed (you have two). If it cannot happen naturally for you, in vitro fertilization may be an option, as a doctor will extract your egg from your ovary, fertilize it, and then place it in your uterus for implantation, removing the need for the fallopian tube to carry the egg to the womb.

NEXT STEPS Supportive Women’s Health Care, Every Step of the Way

An unexpected medical diagnosis can come out of the blue, leaving you with any number of feelings. Our women’s health team is experienced in providing compassionate, understanding care that goes beyond just diagnosing and treating – we’re here to offer you help and support when you need it most.

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Olivia M. Higgins, MD
Gynecology
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