Ectopic Pregnancy

Ectopic pregnancy at a glance

  • In normal conception, an egg is fertilized in the fallopian tube by sperm. Three to four days later, the resulting embryo travels to the uterus, where it can implant and grow. An ectopic pregnancy results from an embryos implanting anywhere outside of the uterus.
  • Ectopic pregnancy occurs when the fallopian tube is blocked or damaged, preventing the embryo from traveling to the uterus.
  • Although ectopic pregnancies can occur in the ovary, cervix or even the abdomen, 95 percent of ectopic pregnancies implant in the fallopian tube, where the lining cannot support the growing embryo.
  • After several weeks of growth, the tube may rupture and bleed, creating an emergency medical situation.
  • Ectopic pregnancies only account for one or two percent of pregnancies, and are discovered by blood test and ultrasound.

Who is at Risk for Ectopic Pregnancy?

Many ectopic pregnancies occur in women with no obvious risk factor. However, potential risk arises from:

  • Pelvic (lower belly) surgery
  • Endometriosis (a condition that causes uterus lining tissue to grow outside of the uterus), which can cause scar tissue (adhesions)
  • History of a sexually transmitted infection
  • Cigarette smoking
  • Undergoing fertility treatment

How Ectopic Pregnancies Are Treated

Ectopic pregnancies are treated immediately, using one of the following techniques:

  1. Injecting Methotrexate: Methotrexate is a drug that stops development of an ectopic pregnancy, confirmed through a series of blood test. Roughly 90 percent of ectopic pregnancies can be treated using this method if detected early enough.
  2. Laparoscopy: A doctor makes several small incisions in the lower belly, inserting a small telescope attached to a camera and using tools to remove the pregnancy through these small openings. This is a minimally invasive surgery, but if the fallopian tube is damaged, it may need to be removed.
  3. Laparotomy: A laparotomy is usually performed for ectopic pregnancies in emergency situations, often when the pregnancy has caused excessive internal bleeding. An abdominal incision is made to perform the procedure. Laparotomy rarely needs to be performed thanks to early detection of ectopic pregnancy.

When discovered, ectopic pregnancies must be terminated. Unfortunately, today’s medical sciences cannot yet save the pregnancy by removing it from the fallopian tube and transplanting it into the uterus. However, in rare cases of abdominal pregnancies that can progress late into the pregnancy, viable fetuses have been delivered via surgery.

Possible Ectopic Pregnancy Complications

Even if an ectopic pregnancy is treated by methotrexate, the fallopian tube may still subsequently tear. This can be a life-threatening situation that requires emergency surgery. A tear can cause blood to begin filling the abdomen, resulting in pelvic, abdominal, or shoulder pain.

Fertility After an Ectopic Pregnancy

Experiencing an ectopic pregnancy makes future pregnancies more difficult. However, if treated correctly, the fallopian tube often remains open and there is a 60 percent chance of a future birth, according to the American Society of Reproductive Medicine. In addition, fertility treatment can improve chances of a healthy pregnancy, although there is a 10 to 15 percent chance another ectopic pregnancy could occur.