How Serious Is An Ectopic Pregnancy
An ectopic pregnancy is a medical emergency. The uterus is uniquely suited to hold a growing fetus. Its an organ that can stretch and expand as the fetus grows. Your fallopian tubes arent as flexible. They can burst as the fertilized egg develops. When this happens, you can experience large amounts of internal bleeding. This is life threatening. An ectopic pregnancy needs to be treated right away to avoid injury to the fallopian tube, other organs in the abdominal cavity, internal bleeding and death.
Where Does An Ectopic Pregnancy Happen
Its considered an ectopic pregnancy whenever the fertilized egg implants outside of your uterus. The egg is meant to travel down the fallopian tubes and imbed itself into the wall of your uterus, where it can begin to develop. In an ectopic pregnancy, the egg implants in one of the structures along the way. The most common place this can happen is within the fallopian tubes. The majority of ectopic pregnancies happen herecalled a tubal ectopic pregnancy. A fertilized egg can also implant on other organs in your abdominal cavity. This is a rarer form of ectopic pregnancy than one that happens in a fallopian tube.
Getting Pregnant Again After Ectopic Pregnancy
Having an ectopic pregnancy should have little bearing on your future fertility. Even if you lost a fallopian tube, the other tube should take over.
Some research has shown that about two-thirds of women treated for ectopic pregnancy conceive and have a normal pregnancy within two years. On average, about 85 percent of couples who haven’t experienced ectopic pregnancy conceive within one year of trying.
Be aware that having one ectopic pregnancy does increase your risk of having another, and the same factors that led to it in the first place may be still at work.
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.
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Signs Of Ectopic Pregnancy
For further information: signs of ectopic pregnancy
Unfortunately , for the phenomenon of ectopic pregnancy, it is impossible to outline an objective and standard symptom picture, as the body of every woman reacts in an absolutely subjective way to the anomaly consequently, the symptoms of ectopic pregnancy appear very general, so much so that they are sometimes confused with those of other disorders affecting the female genital system .
It should also be noted that various factors contribute to the characteristics of the signs of ectopic pregnancy, such as the stage of progress of the ectopic pregnancy itself, the age of the patient, and the complications present. According to some statistics, 10% of ectopic pregnancy cases are asymptomatic, without symptoms.
Frequently Asked Questionsexpand All
- What is ectopic pregnancy?
An ectopic pregnancy occurs when a fertilized egg grows outside of the uterus. Almost all ectopic pregnanciesmore than 90%occur in a fallopian tube. As the pregnancy grows, it can cause the tube to burst . A rupture can cause major internal bleeding. This can be a life-threatening emergency that needs immediate surgery.
- What are the risk factors for ectopic pregnancy?
The risk factors for ectopic pregnancy include the following:
Previous ectopic pregnancy
Other factors that may increase a womans risk of ectopic pregnancy include:
Age older than 35 years
History of infertility
About one half of all women who have an ectopic pregnancy do not have known risk factors. Sexually active women should be alert to changes in their bodies, especially if they experience symptoms of an ectopic pregnancy.
At first, an ectopic pregnancy may feel like a typical pregnancy with some of the same signs, such as a missed menstrual period, tender breasts, or an upset stomach. Other signs may include:
Abnormal vaginal bleeding
Mild pain in the abdomen or pelvis
Mild cramping on one side of the pelvis
At this stage, it may be hard to know if you are experiencing a typical pregnancy or an ectopic pregnancy. Abnormal bleeding and pelvic pain should be reported to your obstetriciangynecologist or other health care professional.
Perform a pelvic exam
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What Are The Consequences Of Signs Of Ectopic Pregnancy
An ectopic pregnancy can in no way give rise to the birth of the child. The fetus cannot develop!
The uterus is the best and eligible region for the implantation. Like every other organ, it has its own function. The uterus walls provide nutrition and support the fetal growth. How can a fetus grow on any other organ? It wont be able to get proper nourishment. Even if it seeks nourishment through other methods, it will grow in size.
Neither the fallopian tube, nor the ovary is capable to hold the growing fetus. You must keep an eye on the signs of ectopic pregnancy as discussed above as the consequences of ectopic pregnancy may be severe in many cases.
At the end, all the efforts go in vain! There is not successful child birth. Ectopic pregnancies are a curse to womanhood.
If you have an ectopic pregnancy in the first place, then you are likely to get another in the second time also.
The ectopic pregnancy has detrimental effects on the womans health.
Abdominal And Pelvic Pain
The initial symptoms of an ectopic pregnancy may be experienced by 6 weeks from your last period. A pregnancy test at home may not confirm the pregnancy. If the symptoms aggravate to one-sided abdominal pain, bloating, and vaginal bleeding or spotting, its essential to visit a doctor.
Pain in the lower abdomen or the pelvic area, especially on one side, is a symptom of ectopic pregnancy. The pain may be dull or sharp and will increase with movement, passing stool, or coughing anything that puts pressure on your abdomen. You may also experience a sense of bloating and heaviness when lying down. This is especially seen in women who have had a child before.9 If the area around the implantation ruptures, you would experience sharp pain and cramps.
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Ectopic Pregnancy Causes And Risk Factors
You may never know why you have an ectopic pregnancy. One cause could be a damaged fallopian tube. It could keep the fertilized egg from getting into your uterus.
Youre more likely to have an ectopic pregnancy if you:
- Have a sexually transmitted infection
- Have scarring from pelvic surgery
- Had a previous ectopic pregnancy
- Had fertility treatments such as in vitro fertilization
Do You Get Pregnancy Symptoms With Ectopic Pregnancy
Pregnancy symptoms are common with ectopics because the pregnancy hormone is still present in your system.
- nausea and/or vomiting
- uterine cramping/ abdominal pain / pelvic pain
However, if you experience any of the other symptoms above, speak with your healthcare provider or seek medical attention right away.
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What Are Risk Factors For Ectopic Pregnancy
Common conditions that are known risk factors for ectopic pregnancy include:
Symptoms of an ectopic pregnancy are often confused with those of a miscarriage or pelvic inflammatory disease.
The most common symptoms of a tubal pregnancy are abdominal and pelvic pain and vaginal bleeding. A ruptured ectopic pregnancy is a true medical emergency. If you suspect you have a ruptured ectopic pregnancy, call 911. Common symptoms of a ruptured ectopic pregnancy include the following:
- Lightheadedness, dizziness, almost passing out, loss of consciousness
- Pale complexion, clammy-feeling skin
- Fast heartbeat
- Abdominal or pelvic pain so severe that the woman can’t stand up
Symptoms Of A Rupture
In a few cases, an ectopic pregnancy can grow large enough to split open the fallopian tube. This is known as a rupture.
Ruptures are very serious, and surgery to repair the fallopian tube needs to be carried out as soon as possible.
Signs of a rupture include a combination of:
- a sharp, sudden and intense pain in your tummy
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Early Signs Of An Ectopic Pregnancy
The early signs of an ectopic pregnancy are very much like the early signs of a normal pregnancy. You skip your period and may feel nauseous and develop breast tenderness. An at-home pregnancy test can let you know that youre pregnant.
As with any pregnancy, we recommend that you contact us as soon as you know youre pregnant so we can schedule your first prenatal exam. Normally, we schedule the first visit about eight weeks after your last menstrual period.
As your ectopic pregnancy progresses, you may start to experience other signs and symptoms that may not be so normal, such as pelvic pain or spotting. When the blood comes from the fallopian tube, you may feel pain that radiates to your shoulder or have a sudden urge to move your bowels.
Any signs and symptoms that seem out of the norm benefit from a visit to our office. Finding an ectopic pregnancy early may prevent more serious health complications.
How Different Are Signs Of Ectopic Pregnancy At 3 Weeks 4 Weeks & 5 Weeks
The early signs of ectopic pregnancy are same as that of normal pregnancy. Thats why you may get confused while detecting. The ignorance continues to prevail until you feel the pain growing in your abdomen. And then a sudden vaginal discharge accompanied by bleeding! Signs of ectopic pregnancy varies with time. In the initial stage, the signs are similar to that of a normal pregnancy but in later stage, they can be differentiated with proper knowledge of these symptoms of tubal pregnancy. For the better understanding of signs of ectopic pregnancy at various stages, they have been elaborated in detail as they appear during 3 weeks , 4 week and maily during or after 5 weeks of ectopic pregnancy.
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Why Does An Ectopic Pregnancy Happen
In a normal pregnancy an egg is fertilised by sperm in one of the fallopian tubes, which connect the ovaries to the womb. The fertilised egg then moves into the womb and implants itself into the womb lining , where it grows and develops.
An ectopic pregnancy occurs when a fertilised egg implants itself outside the womb. It most commonly occurs in a fallopian tube , often as the result of damage to the fallopian tube or the tube not working properly.
Less commonly , an ectopic pregnancy can occur in an ovary, in the abdominal space or in the cervix .
In many cases, it’s not clear why a woman has an ectopic pregnancy. Sometimes it happens when there’s a problem with the fallopian tubes, such as them being narrow or blocked.
The following are all associated with an increased risk of ectopic pregnancy:
- increasing age the risk is highest for pregnant women who are aged 35-40
In around half of all cases, there are no obvious risk factors.
Treatment Of Ectopic Pregnancy
If culdocentesis is positive or the patient has peritoneal signs consistent with a surgical abdomen, laparoscopy and laparotomy are indicated. The ovary is preserved as a rule however, ovarian pregnancy may necessitate oophorectomy. Interstitial pregnancy rarely may require hysterectomy abdominal pregnancy requires a laparotomy to remove the fetus, except in rare cases, when the fetus survives to term or calcifies undetected in the abdominal cavity.
Supportive treatment includes transfusion with whole blood or packed red cells to replace excessive blood loss,administration of broadspectrum antibiotics I. V. for septic infection, and administration of supplemental iron by mouth or I.M. .
An alternative treatment to surgery is a medicine called methotrexate , which decreases the growth of cells in the ectopic pregnancy . As a result the pregnancy shrinks and eventually disappears. The advantage of methotrexate is that it avoids the need for surgery but success rates with methotrexate tend to be slightly lower than with surgery. Occasionally, both surgery and methotrexate will be necessary.
Who’s at Risk for an Ectopic Pregnancy?
The risk of ectopic pregnancy is highest for women who are between 35 and 44 years old and have had:
- surgery on a fallopian tube
- infertility problems or medication to stimulate ovulation
Special considerations or prevention
To prevent ectopic pregnancy:
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Risk Factors For Ectopic Pregnancies
Fallopian tube damage increases the chances for ectopic pregnancies, because eggs could get stuck and implant near the areas of blockage. Women over 35 also experience greater risk. Various conditions can cause damage to the tubes, including the following situations.
- Smoking increases the chances of an abnormal pregnancy.
- Sexually transmitted diseases could cause fallopian tube damage.
- Women exposed to the chemical DES before birth could be at risk.
- Women who have had prior tubal pregnancies are more likely to encounter the problem again.
- Fertility treatments increase the chances of abnormal pregnancy.
- Surgery on the fallopian tubes or reproductive organs constitute another possible threat to successful pregnancy.
Pressure In The Rectum And Change In Bowel
Intense pressure in the rectum or the abdominal area that feels like gas pain should not be ignored. Often internal bleeding from the ruptured site of pregnancy puts pressure on these areas. Pain while passing urine or stool as well as a change in bowel movement can also be symptoms of an ectopic pregnancy.
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How Is An Ectopic Pregnancy Diagnosed
An ectopic pregnancy is typically diagnosed during an appointment in your healthcare providers office. Your provider will perform several tests to first confirm a pregnancy, and then look for the ectopic pregnancy. These tests include:
- A urine test: This test involves either urinating on a test strip or urinating into a cup in your providers 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 you have in your body. This hormone is produced during pregnancy. You may also hear this called your serum beta-hCG level.
- An ultrasound exam: An imaging test, an ultrasound uses sound waves to create a picture of your bodys internal structures. Ultrasound is often used during pregnancy. Your provider will use this test to see where the fertilized egg has implanted.
Once your provider has confirmed the pregnancy and determined where the fertilized egg has implanted, a treatment plan will be created. Ectopic pregnancy is an emergency and treatment for this condition is very important.
If your fallopian tube ruptures, you will need to go to the emergency room and be treated immediately. In those cases, theres no time to wait for an appointment.
Other Signs Of Ectopic Pregnancy
Less common symptoms include:
- Bowel and bladder problems, such as diarrhea, and pain when defecating or urinating
- A feeling of fullness when lying down that is not associated with eating, particularly in people who have already had a child
- Back pain
It is possible to have an ectopic pregnancy without experiencing any symptoms until rupture of the fallopian tube or close organs. After rupture, signs and symptoms may include:
- Severe stomach pain
- Vaginal bleeding
- Lightheadedness, sometimes followed by fainting
- Shoulder pain, described as a strange pain that feels different to any pain that a person has otherwise experienced, located at the tip of the shoulder, where it joins the arm, caused by internal bleeding
If you are concerned that you may have an ectopic pregnancy, you can use the Ada app for a free symptom assessment.
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How Do You Treat An Ectopic Pregnancy
There are two treatment options: medical and surgical treatment.
Medical treatment involves the use of an injection of methotrexate. This is a chemotherapeutic medication that stops rapidly dividing cells from growing. .
This approach has a success rate of about ~85% depending on the patient.
Laparoscopic surgery is needed in the remaining ~15% due to
- incomplete treatment with methotrexate,
- inability to take methotrexate due to allergies or other contraindications,
- or if your ectopic pregnancy has ruptured
In some rare cases, expectant management can be reasonable.
Speak to your doctor to learn if this is an option for you.
Tubal Pregnancies Often Appear Normal At First
Sometime these pregnancies are called tubal pregnancies, and they put the health of mothers in jeopardy. Early detection of this condition requires immediately ending the pregnancy. The longer the pregnancy continues, the more likely irreversible damage to the reproductive organs will occur.
Expectant mothers who exhibit unusual warning signs should have their doctors test for the condition, but many symptoms mirror the normal signs of pregnancy. These indicators include the following signs.
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Sites Of Ectopic Pregnancy
Over 98% of ectopic pregnancies occur in some part of the fallopian tube. Very rarely, the egg may implant itself in the abdomen, ovary, or even a C-section scar.
If the egg isnt in the uterus, where does it go? More than 98% of ectopic pregnancies happen in some part of the fallopian tube including:
- Ampulla: the part that curves above the ovary
- Isthmus: bordering the ampulla
- Fimbria: finger-like projections at the end of the fallopian tube
Sometimes, the embryo ends up in a part of the fallopian tube that penetrates the muscular layer of the uterus, leading to interstitial or cornual ectopic pregnancy. Interstitial pregnancies are rare but riskier. In fact, their mortality rate is twice as much as any other fallopian tube ectopic pregnancy.
In very rare cases, an ectopic pregnancy may implant in locations outside the fallopian tubes, such as the abdomen, liver, spleen, cervix, ovary, or even a Cesarean section scar.2