Ectopic pregnancies occur in 1 of 100 pregnancies. And while fairly uncommon, they can be dangerous for the pregnant person and emotionally devastating for an expecting family. Here’s what to know about ectopic pregnancies, including how to recognize the signs and symptoms of a possible ectopic pregnancy.
What Is an Ectopic Pregnancy?
An ectopic pregnancy happens when a fertilized egg grows outside of the uterus, rather than implanting in the uterine lining. In over 90 percent of cases ectopic pregnancies occur in the fallopian tubes, and may also referred to as tubal pregnancies.
Are Ectopic Pregnancies Dangerous?
They definitely can be if they remain undetected. As the embryo continues to grow larger, it can cause the fallopian tube to rupture, or burst. If this happens, major internal bleeding can occur—and emergency surgery is almost always necessary.
If you discover you’re pregnant while using an intrauterine device (IUD) as birth control, it’s important to inform your doctor right away. While it’s rare to get pregnant when using an IUD, the chances of an ectopic pregnancy are higher as they prevent a pregnancy from occurring in the uterus.
What Are the Signs and Symptoms of an Ectopic Pregnancy?
It’s important to know the signs and symptoms of an ectopic pregnancy, especially if you have one of the risk factors (see below). Early signs are similar to any pregnancy in its early stages, including tender breasts, an upset stomach, and a missed period. Other more unique signs include:
- Abnormal bleeding
- Lower back pain
- Mild pain or cramping on one side of the pelvis
If you’re experiencing any vaginal bleeding or pelvic pain during your pregnancy, you should always contact your provider to discuss your symptoms. If they suspect you may have an ectopic pregnancy, they will likely perform a pelvic exam, do an ultrasound to examine the pregnancy, and possibly test your blood for the pregnancy hormone, called human chorionic gonadotropin (hCG).
More serious symptoms that indicate a fallopian tube rupture include:
- Sudden severe pain in the pelvis or abdomen
- Weakness, dizziness or fainting
- Shoulder pain
If any of these symptoms occur, go to the nearest emergency department for evaluation and treatment immediately.
What Are the Risk Factors for an Ectopic Pregnancy?
Half of all women who have experienced an ectopic pregnancy don’t have any known risk factors. Those considered more at-risk for an ectopic pregnancy include women who:
- Have had a previous ectopic pregnancy
- Have had fallopian tube, pelvic, or abdominal surgery
- Have had certain sexually transmitted infections (STIs)
- Have endometriosis
- Smoke cigarettes
- Are older than 35 years of age
- Have a history of infertility
- Have used assisted reproductive technology, such as in vitro fertilization (IVF) or intrauterine insemination (IUI)
How Are Ectopic Pregnancies Treated?
Unfortunately ectopic pregnancies aren’t able to be moved to the uterus. This means the pregnancy simply can’t continue without putting your own health—and life—at risk. In order to treat an ectopic pregnancy, and depending on your health and medical situation, your provider will recommend medication or surgery.
Medication to treat an ectopic pregnancy
Medication (typically methotrexate) is often used when an ectopic pregnancy hasn’t ruptured a fallopian tube. This drug stops cells from growing, which will end the pregnancy. After taking this medication, the pregnancy will be absorbed back into the body over four to six weeks, and the fallopian tube typically can remain in-tact. Methotrexate is usually given by injection, and can cause abdominal pain, nausea, vomiting, diarrhea or dizziness. Bleeding or spotting may also occur.
When treating an ectopic pregnancy with medication, it’s crucial that you follow up with blood tests to ensure your hCG levels continue to decline the whole way to zero. If your hCG levels haven’t decreased enough after the first dose, another may be recommended. The risk of fallopian rupture doesn’t pass until treatment is complete.
Surgery to treat an ectopic pregnancy
In certain cases, including if a fallopian tube ruptures, a surgery may be necessary to treat an ectopic pregnancy. If the fallopian tube ruptures, the entire tube containing the pregnancy will be removed. If it hasn’t ruptured, it may be possible to remove the ectopic pregnancy itself without harming the fallopian tube. This surgery is typically performed with a slender, lighted camera inserted through small incisions in the abdomen, known as a laparoscopy. This procedure is done in the hospital with general anesthesia. After treatment, you can expect some pain, fatigue, and possible bleeding.
What Can I Expect after an Ectopic Pregnancy?
You may feel a lot of different physical symptoms, not to mention tough emotions, after an ectopic pregnancy. You’ll likely feel tired for several weeks as your body recovers from treatment, and potentially some abdominal discomfort or pain. Since it can take some time for your hCG levels to drop to zero, you may also continue to experience some pregnancy symptoms.
Emotionally, ectopic pregnancies can be traumatic—and just as with a miscarriage, you may experience feelings of loss, devastation, and even guilt. But know this: no pregnancy loss or complication is ever a woman’s fault. And if you’ve had an ectopic pregnancy, we’re so sorry for your loss. It may feel helpful to talk to others who have experience an ectopic pregnancy or pregnancy loss. For support groups in the local community, visit Share of Lancaster.