An ectopic pregnancy typically occurs in one of the tubes that carry eggs from the ovaries to the uterus (fallopian tubes). This type of ectopic pregnancy is known as a tubal pregnancy. In some cases, however, an ectopic pregnancy occurs in the abdominal cavity, ovary or neck of the uterus (cervix).
An ectopic pregnancy can’t proceed normally. The fertilized egg can’t survive, and the growing tissue might destroy various maternal structures. Left untreated, life-threatening blood loss is possible. Early treatment of an ectopic pregnancy can help preserve the chance for future healthy pregnancies.
At first, an ectopic pregnancy might not cause any signs or symptoms. In other cases, early signs and symptoms of an ectopic pregnancy might be the same as those of any pregnancy — a missed period, breast tenderness and nausea. If you take a pregnancy test, the result will be positive. Still, an ectopic pregnancy can’t continue as normal.
Abdominal or pelvic pain and light vaginal bleeding are often the first warning signs of an ectopic pregnancy. If blood leaks from the fallopian tube, it’s also possible to feel shoulder pain or an urge to have a bowel movement — depending on where the blood pools or which nerves are irritated. Heavy vaginal bleeding is unlikely, unless the ectopic pregnancy occurs in the cervix.
If the fallopian tube ruptures, heavy bleeding inside the abdomen is likely — followed by lightheadedness, fainting and shock.
When to see a doctor
Seek emergency medical help if you experience any signs or symptoms of an ectopic pregnancy, including:
1. Severe abdominal or pelvic pain accompanied by vaginal bleeding
2. Extreme lightheadedness or fainting
A tubal pregnancy — the most common type of ectopic pregnancy — happens when a fertilized egg gets stuck on its way to the uterus, often because the fallopian tube is inflamed, damaged or misshapen. Hormonal imbalances or abnormal fetal development might also play a role. Sometimes, the specific cause of an ectopic pregnancy remains a mystery.
When you have an ectopic pregnancy, the stakes are high. Without treatment, a ruptured fallopian tube could lead to life-threatening bleeding.
Treatments and drugs
A fertilized egg can’t develop normally outside the uterus. To prevent life threatening complications, the ectopic tissue must be removed.
If the ectopic pregnancy is detected early, an injection of the drug methotrexate is sometimes used to stop cell growth and dissolve existing cells. After the injection, your doctor will monitor your blood for the pregnancy hormone human chorionic gonadotropin (HCG). If the HCG level remains high, you might need another injection of methotrexate.
In other cases, ectopic pregnancy is treated with laparoscopic surgery. In this procedure, a small incision is made in the abdomen, near or in the navel. Then your doctor uses a thin tube equipped with a camera lens and light (laparoscope) to view the area. Other instruments can be inserted into the tube or through other small incisions to remove the ectopic tissue and repair the fallopian tube. If the fallopian tube is significantly damaged, it might need to be removed.
If the ectopic pregnancy is causing heavy bleeding or the fallopian tube has ruptured, you might need emergency surgery through an abdominal incision (laparotomy). In some cases, the fallopian tube can be repaired. Typically, however, a ruptured tube must be removed.
In a few cases, an injection of methotrexate is needed after surgery.
You can’t prevent an ectopic pregnancy, but you can 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 infections and reduce the risk of pelvic inflammatory disease.
If you’ve had an ectopic pregnancy, talk to your doctor before conceiving again. When you become pregnant, your doctor will carefully monitor your condition. Early blood tests and ultrasound imaging can offer the earliest detection of another ectopic pregnancy — or reassurance that the pregnancy is developing normally.