Keys to understanding ectopic pregnancies

What is an ectopic pregnancy?

From fertilization to delivery, pregnancy requires several steps in a woman’s body. One of these steps is when a fertilized egg travels to the uterus to attach. In the case of an ectopic pregnancy, the fertilized egg does not adhere to the uterus. Instead, it can join the fallopian tube, abdominal cavity, or cervix.

While a pregnancy test can reveal that a woman is pregnant, a fertilized egg cannot grow properly anywhere other than the uterus. On average, ectopic pregnancies occur in about 1 in 50 pregnancies.

An untreated ectopic pregnancy can be a medical emergency. Immediate treatment reduces the risk of complications from ectopic pregnancy, increases the chances of future and healthy pregnancies, and reduces future health complications.

What causes an ectopic pregnancy?

The cause of an ectopic pregnancy is not always clear. In some cases, the following conditions have been linked to an ectopic pregnancy:

Inflammation and scarring of the fallopian tubes due to a previous medical condition, infection, or surgery.
hormonal factors
genetic abnormalities
birth defects
medical conditions affecting the shape and condition of the fallopian tubes and reproductive organs

Who is at risk for an ectopic pregnancy?

All sexually active women have some risk of ectopic pregnancy. Risk factors increase with any of the following:

woman 35 years or older
a history of pelvic surgery, abdominal surgery, or multiple abortions
a history of pelvic inflammatory disease (PID)
history of endometriosis
Conception occurred despite tubal ligation or intrauterine device (IUD)
conception aided by medications or fertility procedures
smoking patient
ectopic pregnancy history
a history of sexually transmitted diseases (STDs), such as gonorrhea or chlamydia
Having structural abnormalities in the fallopian tubes that make it difficult for the egg to travel.

If you have any of the above risk factors, talk to your doctor. You can consult your doctor or a fertility specialist to minimize the risks of future ectopic pregnancies.

What are the symptoms of an ectopic pregnancy?

Nausea and breast pain are common symptoms in ectopic and uterine pregnancies. The following symptoms are more common in an ectopic pregnancy and may indicate a medical emergency:

sharp waves of pain in the abdomen, pelvis, shoulder or neck
severe pain that occurs on one side of the abdomen
light to heavy vaginal spotting or bleeding
dizziness or fainting
rectal pressure

Diagnosing an ectopic pregnancy

If you suspect that you may have an ectopic pregnancy, see your doctor immediately. Ectopic pregnancies cannot be diagnosed by physical examination. However, your doctor may still perform one to rule out other factors.

Another step in diagnosis is a transvaginal ultrasound to check for a gestational sac in the uterus. Your doctor may also use a blood test to determine your hCG and progesterone levels. These are hormones that are present during pregnancy. If these hormone levels start to drop or stay the same over the course of a few days and there is no gestational sac on ultrasound, the pregnancy is likely ectopic.

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