In the early stages of pregnancy, a fertilized egg implants itself in the protective lining of the uterus and begins the growth process until birth. However, in about 2% of pregnancies, an ectopic pregnancy occurs when a fertilized egg implants anywhere but the uterus.
“Ectopic pregnancy occurs when implantation does not make it into the uterine cavity,” said Pooja Shah, MD, an OBGYN with Banner Health Center in Chandler, AZ. “About 90% of ectopic pregnancies are in the fallopian tubes, but they can also be found in the abdominal cavity, ovaries, cervix, or scars from a prior C-section. When an ectopic pregnancy is in the fallopian tube, it is also known as a tubal pregnancy.”
When the ectopic pregnancy goes unnoticed and continues to grow, it can be life-threatening for the mother. In fact, ectopic pregnancies are the leading cause of pregnancy-related death during the first trimester. That’s why it’s important to catch it in its early stages.
Dr. Shah answered some questions about ectopic pregnancies, including your options if it happens to you.
How can I tell if I have an ectopic pregnancy?
Symptoms of an ectopic pregnancy can often resemble symptoms you experience early on with a normal pregnancy or miscarriage. “Some of the first signs of an ectopic pregnancy that women report include vaginal bleeding, nausea, and abdominal or pelvic pain,” Dr. Shah said.
In extreme cases, as the fertilized egg continues to grow, it can cause the fallopian tube to rupture or burst, which can cause life-threatening internal bleeding. If this occurs, you may experience:
- Heavier bleeding
- Sudden, severe pain in the abdomen or pelvis
- Shoulder pain
- Low blood pressure and weakness due to blood loss
- Extreme dizziness or fainting
What can I do to prevent an ectopic pregnancy?
Having an ectopic pregnancy isn’t your fault. “Unfortunately, there is no way to predict or prevent an ectopic pregnancy from happening,” Dr. Shah said.
Although it can happen to any woman, the following can increase your risk of ectopic pregnancy:
- History of prior ectopic pregnancy
- Prior surgery of the fallopian tubes or in the pelvis, including tubal ligation (having your tubes tied).
- Smoking
- Endometriosis
- Sexually transmitted infections that travel to the pelvis, such as gonorrhea, chlamydia or pelvic inflammatory disease
Treatment for an ectopic pregnancy
If your health care provider thinks you may have an ectopic pregnancy, they may use a pelvic exam, ultrasound, blood tests and clinical symptoms to make the diagnosis. However, emergency medical care is needed for any pregnancy that has excessive vaginal bleeding or sudden severe abdominal or pelvic pain. Fortunately, most ectopic pregnancies that are detected early can be treated successfully.
If a pregnancy is ectopic, this means it can’t continue to develop and the tissue must be removed. Your provider will use some of the following treatment options:
- Close monitoring to evaluate your human chorionic gonadotropin (hCG) levels, the hormones that are produced by the placenta, to make sure they go back to normal. This is called expectant management and can take several weeks. This is done when the ectopic pregnancy is expected to resolve naturally.
- Medication to stop pregnancy growth called methotrexate
- Surgery, typically laparoscopically, to remove the ectopic pregnancy
“The decision to proceed along a specific treatment path has to be done in conjunction with the health care provider,” Dr. Shah said. “It should consider factors like severity of the symptoms, level of pregnancy hormone in the blood, appearance of the ectopic pregnancy on ultrasound, underlying health conditions, your desire for current pregnancy, your ability to follow up for ongoing monitoring and your personal preference.”
What does recovery look like after an ectopic pregnancy?
Pregnancy can bring many hopes and plans for the future and can be very traumatic when you realize it’s suddenly not possible. That’s why recovery needs to involve both physical healing and emotional support—whether the pregnancy was planned or not.
“Support from family, friends and your health care partners may need to be considered,” Dr. Shah said. “Allow yourself the chance to talk about your feelings and grieve the loss.”
As far as physical healing, it can take several weeks to months to heal completely, “especially if expectant management and medication are used for treatment,” Dr. Shah said. “It’s important to follow your provider’s recommendations to ensure the ectopic pregnancy is fully resolved prior to considering a future pregnancy.”
Can I get pregnant again after an ectopic pregnancy?
While your chances for having another ectopic pregnancy are increased, you can still successfully carry a baby to term after a previous ectopic pregnancy.
Talk to your doctor before becoming pregnant again. They can work with you to decrease any other risk factors you may have and monitor new pregnancies closely to make sure it gets you and your baby off to a healthy start.
To find a Banner OBGYN near you, visit bannerhealth.com.
