1What is an ectopic pregnancy?
An ectopic pregnancy occurs when a fertilised egg implants itself outside of the womb – most commonly in one of the fallopian tubes, but it can be in another area of the body such as the abdomen or internal scar tissue.
In the US, around 2% of pregnancies are ectopic; the figures are slightly lower in the UK, affecting approximately one in 85 expectant women.
Sometimes an ectopic pregnancy is only detected as part of a routine scan. With others, symptoms are sudden and serious, and you should seek medical advice as soon as possible.
2What causes an ectopic pregnancy?
It’s not possible to pinpoint a specific reason. The fallopian tubes may be blocked or simply too narrow for the fertilised egg to travel to the womb. Other higher risk factors are:
- Previous surgery on the fallopian tubes, for example an unsuccessful sterilisation
- Pelvic inflammatory disease (PID) – an inflammation of the female reproductive system
- Being a smoker
- Age – women aged between 35 and 40 are more likely to experience an ectopic pregnancy
- Medication taken during fertility treatment to stimulate ovulation
- Becoming pregnant while using an intrauterine contraceptive device or system
- Endometriosis – a condition where cells like those in the womb grow elsewhere in the body and react to the monthly menstrual cycle.
3What are the symptoms?
The signs of an ectopic pregnancy vary and generally appear between the fourth and 12th weeks of pregnancy. They can include:
- General signs of pregnancy, including missed periods
- Pain low down on one side of your stomach
- A brown watery discharge or bleeding from the vagina
- Discomfort when going to the toilet
- Pain in the tip of the shoulder, which may intensify when you lie down – internal bleeding into the abdomen puts pressure on the diaphragm, which in turn affects nerves to the shoulder.
Even if you haven’t taken a test, if there is any chance you could be pregnant and you experience any combination of these symptoms then it’s important to obtain medical advice.
You should also seek emergency treatment if you have sudden and intense stomach pain, feel dizzy or faint, feel sick or look very pale. This could mean your fallopian tube has ruptured, which is dangerous and means you need urgent surgery.
4What happens when an ectopic pregnancy is confirmed?
An ultrasound scan and blood tests will usually confirm the diagnosis.
Many early ectopic pregnancies resolve themselves, with the fertilised egg dissolving, so you may be monitored – called ‘expectant management’.
If intervention is needed, you might be injected with methotrexate, a powerful drug, to stop the pregnancy developing.
The third option is keyhole surgery under general anaesthetic to remove the fertilised egg; this usually also means taking out the affected fallopian tube.
Your doctor will discuss the options with you to determine which is the most suitable for you.
5Is there any chance saving the baby?
While there have been one or two high-profile cases when an ectopic pregnancy has resulted in a baby, experts agree it’s not a viable possibility – in the UK, only three such cases were recorded in 20 years.
The risks to the mother-to-be are incredibly high, and no medical technology currently exists to transfer an ectopic pregnancy to the uterus to allow it to develop normally.
6Is it possible to conceive and give birth normally after an ectopic pregnancy?
Most women are advised to wait for around three months after an ectopic pregnancy before trying to conceive again. As well as physical recovery, couples need time to grieve so it may be a while before they feel ready; it may also help to seek outside support such as a local counselling group or charity.
The chance of a subsequent pregnancy also being ectopic rises to around 10%, but this is still very low – in the UK, figures recorded show that around 65% of women experience a healthy pregnancy within 18 months of an ectopic, rising to around 85% over two years.
Even if one fallopian tube has been removed, if the other is healthy there is every chance of a successful pregnancy in future. In some cases, fertility treatment may be necessary – you can discuss this with your doctor.
It’s also a good idea to arrange a scan as soon as possible after a subsequent pregnancy is confirmed to check everything is developing normally.
Read also: I Survived An Ectopic Pregnancy