Feb. 14, 2019 | In a normal pregnancy, a woman’s egg is fertilized by a man’s sperm in one of her fallopian tubes. The fertilized egg then moves through the tube to the lining of the uterus, where it implants and starts to grow. An ectopic pregnancy occurs when a fertilized egg grows in an abnormal location. Ectopic means “out of place.” The egg settles in the fallopian tubes in more than 95 percent of ectopic pregnancies, which is why they are commonly called “tubal pregnancies.” The egg can also implant in the ovary, abdomen, or the cervix, so you may see these referred to as cervical or abdominal pregnancies. None of these areas has as much space or nurturing tissue as a uterus for a pregnancy to develop. As the fetus grows, it will eventually burst the organ that contains it. Left untreated, this can cause severe bleeding and endanger the mother’s life. Early treatment of an ectopic pregnancy can help preserve the chance for future healthy pregnancies.

Feb. 14, 2019 | Women who are older than 35 years of age, who smoke or who have a history of inflammation of the fallopian tubes or assisted fertility are considered to be high risks for an ectopic pregnancy. In many cases, a woman with a developing ectopic pregnancy may not have any indication that she is pregnant. Early signs and symptoms, if they occur, may be the same as those of any pregnancy, a missed period, breast tenderness, nausea and fatigue. If you suspect that you are pregnant and take a test, it will be positive. But an ectopic pregnancy can’t continue as normal. The first warning signs of an ectopic pregnancy often include vaginal bleeding, lower abdominal pain and cramping on one side of the pelvis. If the fallopian tube ruptures, the woman will likely experience a sharp pain in the pelvis, abdomen, shoulder or neck as well as dizziness and lightheadedness. A woman who experiences any of these symptoms should see a doctor immediately.

Feb. 14, 2019 | If a physician suspects a woman has an ectopic pregnancy, he or she may do a pelvic exam to check for pain, tenderness, or a mass in the fallopian tube or ovary. A physical exam alone isn’t enough to diagnose an ectopic pregnancy, however. The diagnosis is typically confirmed with blood tests and imaging studies, such as an ultrasound. With a standard ultrasound, high-frequency sound waves are directed at the tissues in the abdominal area. During early pregnancy, however, the uterus and fallopian tubes are closer to the vagina than to the abdominal surface. The ultrasound will likely be done through a wand-like device placed in the vagina. Sometimes it’s too soon to detect a pregnancy through ultrasound. If the diagnosis is in question, the physician may monitor the woman’s condition with blood tests until the pregnancy can be confirmed or ruled out through ultrasound, usually by four to five weeks after conception.

Feb. 14, 2019 | Treatment of an ectopic pregnancy varies, depending on how medically stable the woman is and the size and location of the pregnancy. An early ectopic pregnancy can sometimes be treated with an injection of methotrexate, which stops the growth of the embryo. If the pregnancy is further along or if there is a problem in using methotrexate, it’s likely surgery will be needed. In the past, this was a major operation, requiring a large incision across the pelvic area. While this might still be necessary in cases of internal injury, the pregnancy may sometimes be removed using laparoscopy, a less invasive surgical procedure. In this procedure, the doctor makes a small incision in the abdomen, near or in the navel. Then he or she uses a thin tube equipped with a camera lens to view the area. Other instruments can be inserted into the tube or through other small incisions to remove the ectopic tissue. If the fallopian tube is damaged, it may need to be removed.

Feb. 14, 2019 | While there is nothing a woman can do to prevent an ectopic pregnancy, there are things she can do to decrease certain risk factors. For example, limit your number of sexual partners and use a condom when you have sex to help prevent sexually transmitted diseases and reduce the risk of pelvic inflammatory disease. If you’ve had an ectopic pregnancy, talk to your health care provider before conceiving again. When you become pregnant, your physician will carefully monitor your condition. Losing a pregnancy is devastating, even if you’ve only known about it for a few days. Recognize the loss, and give yourself time to grieve. You should talk about your feelings and allow yourself to experience them fully. Many women who have ectopic pregnancies go on to have other, healthy pregnancies. If you choose to conceive again, seek your physician’s advice. Early ultrasound imaging can offer reassurance that the pregnancy is developing normally.