Ectopic pregnancies, which occur when the fertilized egg implants outside of the uterus, are uncommon. According to Mayo Clinic, they occur in roughly 20 out of every 1,000 pregnancies.
What is ectopic pregnancy?
The majority of ectopic pregnancies occur in the fallopian tubes. Early symptoms include vaginal bleeding and lower abdominal pain in the first trimester. They are also dangerous, because if they rupture, the woman risks life-threatening internal bleeding and infection. A diagnosis and treatment can be lifesaving for women with ectopic pregnancies.
Diagnosis
If an ectopic pregnancy is suspected, a woman’s healthcare provider will usually use a combination of methods to make a diagnosis.
- Transvaginal ultrasound: For this test, the provider places a device in a woman’s vagina to get a clear picture of her reproductive organs. This kind of ultrasound is extremely effective for detecting ectopic pregnancy, but it doesn’t always pick up very early ectopic pregnancies. Because of this, sometimes an ultrasound is postponed for a few weeks until the pregnancy is easier to detect.
- Blood test: This helps the provider determine how much hCG (human chorionic gonadotropin, an important pregnancy hormone) is in the woman’s body. If the levels of hCG are lower than normal, this could indicate an ectopic pregnancy.
Treatment
Unfortunately, because ectopic pregnancies are life-threatening due to their risk of rupturing, they do have to be removed as early as it is safe to remove them. A woman’s provider will decide how to treat the ectopic pregnancy after confirming the diagnosis using ultrasound and/or blood tests. Treatment might involve medication or surgery, depending on how early the ectopic pregnancy is diagnosed, risk of rupture, and other considerations.
- Medication: Certain medications stop the growth of an ectopic pregnancy. The most commonly used is methotrexate, which is administered through an injection and helps embryonic tissue exit the body. Methotrexate causes symptoms that are similar to a miscarriage, with the most common symptom being abdominal pain or cramping. Studies haven’t shown a clear time interval that women should wait before trying to conceive again after methotrexate use, but providers may recommend waiting anywhere from three to six months before conceiving, in order to allow the medication to fully leave the body.
- Surgery: A laparotomy is the surgical procedure a healthcare provider might use to remove the developing embryo in an ectopic pregnancy. For the surgery, the provider will make an incision and remove the embryo, as well as repair or remove the fallopian tube if it’s damaged. After surgery, most women experience light vaginal bleeding possibly with some blood clots for at least a few weeks, which is normal. Women will also be instructed on how to keep the incision site clean, and to check for infection.
Future pregnancies
If the ectopic pregnancy is caught early and the fallopian tubes aren’t damaged, it is quite possible for women to have a healthy pregnancy in the future. If the tubes are damaged or removed, however, women may have more difficulty conceiving. If you are having difficulty becoming pregnant again after an ectopic pregnancy, it’s a good idea to meet with a fertility specialist, who can help you determine your next steps.
An ectopic pregnancy diagnosis is often accompanied by feelings of sadness, confusion, and grief. Because women with a history of ectopic pregnancy are at higher risk for ectopic pregnancy in the future, women should talk to their healthcare providers if they are considering pregnancy to make sure that it’s safe for them, both physically and emotionally, to start trying again.
Sources
- “Ectopic Pregnancy.” KidsHealth. The Nemours Foundation, 2016. Web.
- Mayo Clinic Staff. “Ectopic Pregnancy: Tests and Diagnosis.” MayoClinic. Mayo Foundation for Medical Education and Research, Jan 20 2015. Web.
- Karla Blocka and Brian Wu. “Quantitative hCG blood test.” Healthline. Healthline Media, Inc., Oct 8 2015. Web.
- “Ectopic pregnancy: Clinical manifestations and diagnosis.” UptoDate. UpToDate, Inc., Sep 2017. Web. Accessed 10/26/17. Available at https://www.uptodate.com/contents/ectopic-pregnancy-clinical-manifestations-and-diagnosis.
