An ectopic pregnancy is a pregnancy that happens outside of your uterus. This occurs when a fertilized egg implants in a location that can’t support its growth. An ectopic pregnancy most often happens in your fallopian tube (a structure that connects your ovaries and uterus). Ectopic pregnancies more rarely can occur in your ovary, abdominal cavity or cervix. Pregnancies can’t continue if they’re ectopic because only your uterus is meant to carry a pregnancy.
Ectopic pregnancies can become life-threatening, especially if your fallopian tube breaks (ruptures). This is a ruptured ectopic pregnancy, and it can cause severe bleeding, infection and sometimes, death. This is a medical emergency. Healthcare providers must treat ectopic pregnancies quickly.
What are the symptoms of an ectopic pregnancy?
The early symptoms of an ectopic pregnancy can be very similar to typical pregnancy symptoms. However, you may experience additional symptoms during an ectopic pregnancy, including:
When a tube bursts, you may feel sudden, sharp lower abdominal pain. This is a medical emergency. You should contact your healthcare provider or go to the emergency room immediately.
In some cases, your provider may suggest using a medication called methotrexate to stop the fertilized egg from growing, ending the pregnancy. The medication shouldn’t damage your fallopian tubes. You can’t use this medication if your fallopian tube has already ruptured.
Your healthcare provider gives you methotrexate as a single injection. This option is less invasive than surgery, but it does require follow-up appointments so your provider can monitor your HCG levels. It’s important to have consistent follow-up in these cases. In rare cases, a second injection of methotrexate is necessary if HCG levels don’t decrease enough with one dose. Talk to your healthcare provider about the possible side effects and risks of methotrexate so you know what to expect.
Surgery for ectopic pregnancy
Your provider will want to remove the ectopic pregnancy with surgery if your fallopian tube has ruptured or if you’re at risk of rupture. This is an emergency surgery and a life-saving treatment. The procedure is typically done laparoscopically (through several small incisions in your abdomen) while you’re asleep under anesthesia. The surgeon may remove your entire fallopian tube with the egg still inside it or remove the egg from the tube (preserving your fallopian tube).
How is an ectopic pregnancy diagnosed?
Most people don’t know that their pregnancy is ectopic until they visit their pregnancy care provider for a prenatal appointment, bloodwork or ultrasound. Your provider may suspect an ectopic pregnancy based on what happens at this appointment.
To diagnose an ectopic pregnancy, your provider will perform several tests. This may include a pelvic exam and confirmation of pregnancy. These tests include:
A urine test: This test involves either peeing on a test strip or into a cup in your provider’s office and then having a test strip dipped into the urine sample.
A blood test: You provider may test your blood to see how much of the hormone human chorionic gonadotropin (HCG) you have in your body. Your body only makes HCG during pregnancy. A low amount may indicate an ectopic pregnancy because HCG levels increase dramatically when a fertilized egg implants in your uterus.
An ultrasound exam: An ultrasound uses sound waves to create a picture of your body’s internal structures. Your provider will use this test to see where the fertilized egg has implanted.
If your provider suspects the ectopic pregnancy has ruptured, they can also perform culdocentesis, but this is rarely used.
Once your provider has confirmed an ectopic pregnancy and determined where the fertilized egg has implanted, they’ll discuss a treatment plan with you. An ectopic pregnancy is an emergency and treatment is very important.
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