Pregnancy begins with a fertilized egg that normally sticks to the uterine lining. Ectopic pregnancy or tubal pregnancy occurs when a fertilized egg implants somewhere other than the main uterine cavity.
The ectopic pregnancy occurs most often in one of the tubes that carry the eggs from the ovary to the uterus (fallopian tube). This type of ectopic pregnancy is known as tubal pregnancy. In some cases, an ectopic pregnancy may occur in the abdominal cavity, ovary, or cervix.
The ectopic pregnancy will not be completed normally. The fertilized egg will not survive, and the growing tissues may cause life-threatening bleeding if not treated.
The most common combination of symptoms is feeling pain in the abdomen or pelvis, the expected delay of menstrual bleeding, as well as a positive pregnancy test result.
Other symptoms may develop later, such as:
- Mild irregular vaginal bleeding
- Abdominal and pelvic pain
- Abdominal bloating
- Heavy bleeding in the abdominal cavity
- Shoulders pain
If the fertilized egg continued to grow inside the fallopian tube, it can cause the tube to tear and severe stomach bleeding may occur. Symptoms of this life-threatening condition include severe dizziness, fainting and shock.
Tubal pregnancy – the most common type of ectopic pregnancy – occurs when a fertilized egg is wedged on its way to the uterus, often due to damage to the fallopian tubes caused by inflammation or deformation. Hormone imbalance or abnormal growth of the fertilized egg may also play a role in ectopic pregnancy.
The following risk factors are likely to cause pregnancy outside of the uterus:
- Previous ectopic pregnancy. You are more likely to have an ectopic pregnancy if you have had it before.
- Inflammation or infection. Sexually transmitted infections, such as gonorrhea or chlamydia, can cause inflammation of the tubes and other nearby organs, and increase the risk of an ectopic pregnancy.
- Fertilization treatments. Some research indicates that women who undergo IVF or similar treatments are more likely to have an ectopic pregnancy. Infertility may increase your risk of this type of pregnancy as well.
- Tubal surgery. Surgery repairing a closed or damaged fallopian tube can increase the risk of an ectopic pregnancy.
- Contraceptive methods. The chance of pregnancy is rare while using the IUD. However, if you become pregnant while the IUD is in place, this pregnancy is more likely to happen outside the uterus. Moreover, tubal ligation, which is a permanent method of contraception increases the risk of ectopic pregnancy if you become pregnant after undergoing this procedure.
- Smoking. Smoking cigarettes before pregnancy can increase the risk of ectopic pregnancy. The more you smoke, the higher the risk.
Pelvic exams can help your doctor locate the areas of pain and masses in the ovary or fallopian tube. However, your doctor cannot diagnose an ectopic pregnancy only by examination; you will also need blood tests and ultrasound screening.
Your doctor will order a Human Chorionic Gonadotropin (HCG) test in the blood to confirm pregnancy. Levels of this hormone increase during pregnancy. This blood test can be repeated every few days until the ultrasound test can confirm an ectopic pregnancy or exclude it, and this usually occurs after a period of five to six weeks of pregnancy
Ultrasound examination allows the doctor to know the exact position of the pregnancy. To do this test, a special device is inserted into the vagina. This device uses ultrasound to create an image of the uterus, ovaries, and fallopian tubes, and then sends these images to a display screen.
A complete blood count is done to check for anemia or other signs of blood loss. If you are diagnosed with an ectopic pregnancy, your doctor may also order tests to check your blood type in case you need a blood transfusion.
A fertilized egg cannot grow normally outside the uterus. To prevent life-threatening complications, ectopic tissue should be removed. Depending on your symptoms and when your ectopic pregnancy has been detected, this can be done with medication, laparoscopic surgery, or abdominal surgery.
Coping and support
Losing a pregnancy is devastating, even if you only knew about it for a short time. Accept this loss and give yourself a chance to mourn. Talk about your feelings and allow yourself to completely pass these feelings.
Rely on your life partner, your loved ones, and your friends for support. You can also seek help from a support group or consult a grief counselor or other mental health provider.
Women who have had an ectopic pregnancy can still have a normal healthy pregnancy in the future. The female body usually contains two fallopian tubes. If either of them is damaged or removed, the egg will be attached to the sperm in the other tube and then move to the uterus.