Ectopic Pregnancy

What is an ectopic pregnancy?

Ectopic pregnancy occurs when a fertilized egg attaches and begins to grow outside of the uterus. The most common place for this to happen is in the fallopian tube. This is sometimes called a tubal pregnancy. The egg can also implant on the outside of the uterus, on the ovary or cervix, or in the abdomen. The egg may begin to grow, but the pregnancy cannot continue normally. Ectopic pregnancy can cause heavy bleeding and may be life-threatening.

What increases my risk of an ectopic pregnancy?

• Pelvic inflammatory disease (PID) or infections, such as chlamydia.
• Prior ectopic pregnancy.
• Getting pregnant when you have an intrauterine device (IUD).
• Previous surgery in your abdomen or on your reproductive organs.
• Medicines to treat infertility or that contain female hormones.
• Smoking.

What are the signs and symptoms of ectopic pregnancy?

You may have one or more of the following:

• One-sided abdominal or pelvic pain and cramping.
• You may miss your period.
• Vaginal bleeding or spotting that happens about seven weeks after your missed period.
• Nausea or vomiting.
• Dizziness, weakness or fainting.
• Tissue coming out of your vagina.

How is ectopic pregnancy diagnosed?

Your healthcare provider will examine you and ask about other medical conditions or surgeries you have had. He will ask about pregnancies, miscarriages, infertility treatments and sexually transmitted infections (STIs) you have had before. You may need any of the following:

• Pelvic exam: Your healthcare provider will check the size and shape of your uterus, cervix and ovaries.
• Blood and urine tests: These tests can show if you are currently pregnant or if you have infections or other problems.
• Ultrasound: This uses sound waves to show pictures of the inside of your uterus, ovaries and abdomen. An ultrasound is usually done over your abdomen, but you may also need a vaginal ultrasound. During a vaginal ultrasound, a small tube is placed into your vagina. This can help your healthcare provider see areas that may be hard to see during an abdominal ultrasound.

How is ectopic pregnancy treated?

Your body may absorb the pregnancy tissues and your symptoms may decrease without any treatment. If this does not happen, you may need any of the following:

• Medicines: Methotrexate or another medicine may be given to stop the pregnancy. This may be given as an injection. You may need more than one dose of this medicine.
• Surgery: This may be done to repair or remove tissue or ruptured fallopian tubes.

What are the risks of an ectopic pregnancy and treatment?

Surgery may cause bleeding or infection. Even after treatment, you may have another ectopic pregnancy or have difficulty getting pregnant in the future. If left untreated, parts of your reproductive system or other organs may get damaged. This may cause infection or severe bleeding and may become life-threatening.

When should I seek immediate care or call 911?

• You feel lightheaded or like you are going to faint.
• You have increasing abdominal or pelvic pain or heavy vaginal bleeding.
• You have shoulder pain.
• You have chest pain or trouble breathing.

When should I contact my healthcare provider?

• You have a fever.
• You have questions or concerns about your condition or care.