What to Know About Ectopic Pregnancy
Articles On Ectopic Pregnancy
For pregnancy to happen, the ovary has to release an egg into the fallopian tube, where it stays for about 24 hours. There it has to come in contact with a sperm to be fertilized. The fertilized egg stays in the fallopian tube for 3 or 4 days before it heads to the uterus. There it attaches to the lining and continues to grow until a baby is born.
But if the fertilized egg implants in your fallopian tube or somewhere else in your abdomen, you end up with what’s called an ectopic pregnancy. In these cases, the pregnancy can’t continue normally, and it requires emergency treatment.
Most of the time, an ectopic pregnancy happens within the first few weeks of pregnancy. You might not even know you’re pregnant and may not have signs of a problem.
Light vaginal bleeding and pelvic pain are usually the first symptoms, but others could include:
Ectopic pregnancy can lead to fallopian tube rupture. If that happens, you could have major pain and severe bleeding. Call your doctor immediately if you have heavy vaginal bleeding that causes lightheadedness, fainting, or shoulder pain.
You may never know why you have an ectopic pregnancy. One cause could be a damaged fallopian tube. It could prevent the fertilized egg from getting into your uterus, leaving it to implant in the fallopian tube or somewhere else.
But you are more likely to have an ectopic pregnancy if you have any of the following:
It could also happen if you become pregnant with an intrauterine device (IUD) in place.
If your doctor thinks you have an ectopic pregnancy, she will probably perform some tests, including a pregnancy test and a pelvic exam. An ultrasound test may be performed to view the uterus’ and fallopian tubes’ condition.
If she confirms you have an ectopic pregnancy, she will talk to you about the best treatment based on your medical condition and your future plans for pregnancy.
Because a fertilized egg can’t survive outside of the uterus, the tissue has to be removed to keep you from having serious complications. Two methods are used to treat it: medication and surgery.
Medication. If your fallopian tube hasn’t ruptured and your pregnancy hasn’t progressed very far, your doctor can give you an injection of methotrexate (Trexall). It stops the cells from growing, and your body will simply absorb them. Most ectopic pregnancies can be treated with methotrexate if they’re caught early.
Surgery. In other cases, surgery is required. The most common is laparoscopy. Your doctor will make very small incisions in your lower abdomen and insert a thin, flexible instrument (laparoscope) to remove the ectopic pregnancy. If your fallopian tube is damaged, she may have to remove it as well. If you’re bleeding heavily or your doctor suspects your fallopian tube is ruptured, you might need emergency surgery with a larger incision. This is called laparotomy.
After an Ectopic Pregnancy
There is a good chance you can have a normal pregnancy again, but it might be hard. You should consider talking to a fertility specialist early, especially if you had a fallopian tube removed.
And talk to your doctor about how long to wait before trying again. Some doctors suggest at least 3 to 6 months. If you’ve already had an ectopic pregnancy, your chances of having another one go up.
The March of Dimes.
American Society of Reproductive Medicine: “Ectopic Pregnancy.”
Mayo Clinic. “Ectopic pregnancy.”
American College of Obstetricians and Gynecologists: “Ectopic Pregnancy.”
Patient Comments: Ectopic Pregnancy – Treatments
What was the treatment for your ectopic pregnancy? Submit Your Comment
I have total pain in my feet, and legs; burning sensation, needles and all. I have diabetes under control, I cannot sleep at night, I have to constantly move my feet around. I am already taking gabapentin for my neuropathy and it does not help at all.
I had an ectopic pregnancy. I remember it was June 15th, 2012, our ten year anniversary. I was taking a shower getting ready to go out when I felt dizzy with a stomach pain and a severe leg cramp. I went to the emergency room telling all my symptoms. When I asked about the likelihood of an ectopic, the doctor told me he didn’t think I fit into that category. I went home with the pain for two days until my obstetrician/gynecologist could see me on Monday. They did emergency surgery but were able to save my tube. My doctor said I had massive internal bleeding and I feel lucky to be alive today. I’ve been trying for a pregnancy ever since.
Last year I got very sick. I had my son take me to the hospital. After 5 tubes of blood the doctor came in and told me I had sepsis. I almost died. I was also in kidney failure. Then the problem started. He asked me for a urine sample. Urinating before I got to the hospital I did not need to go and I told him I can’t urinate on demand. I’ve been like that all my life. He left and within 10 minutes 2 nurses came in. I asked what was going on and got no answer. They the male registered nurse told my son to leave. I asked again and still got no reply. He then told the other nurse to take my pants off. I started to ask again and I felt the catheter go in me. I gave up after that. He pulled that one out and forced in another one. He was pushing it in and out yelling at me if I have a prostate problem. I told him no, I urinated before I got there. I think he was mad because he never got it in the bladder. My son came in after and I told him what they did and he asked why they did not answer me at all. The second one hurt more than the first and I had blood on my gown. They will never do that to me again. A nurse is supposed to talk to the patient and explain what they are doing. I did not get that. No cleaning, no gel, nothing. I will never let that happen to me again. Sex has never been the same.
I had an ectopic pregnancy back in 2006. I found out I was pregnant at the doctor’s office after having flu like symptoms and breast tenderness/soreness. It was my 1st pregnancy and I was 21 years old. My then husband and I were very excited. One night I got up to use the bathroom and saw blood on the tissue. I didn’t think too much of it because I heard from family members women can spot while pregnant, but I also noticed a knot formation on the lower left side of my abdomen. I guess it was wishing thinking, but I wanted to be pregnant so bad I ignored these warnings signs. The following afternoon I felt the worse pain I had ever felt in my life on the left side of my lower abdomen. It was a terrible shooting pain; it felt like someone was stabbing me with a knife. After an hour or so the pain subsided. My then husband came home from work I knew we had to go to the ER. The doctor asked me a few questions and I told him about the symptoms and pain I was experiencing. He looked at me with concerned eyes and left the room. Then the ER nurse came to my bed with an IV and about 12 hours later I was in surgery having my left fallopian tube removed. I was extremely saddened by the ordeal. And I became depressed. But it was truly a miracle that my fallopian tube didn’t burst because I was far along in my pregnancy, about eight weeks. Now today my breasts have that same tenderness I felt five ago, I am going to go take a pregnancy test after work. If I am pregnant, I’m going straight to urgent care just to be on the safe side. I just want to encourage each and every one of you, life isn’t over if you have an ectopic pregnancy or even a double one. I told myself if can’t get pregnant I will adopt so that I can give a child all the love its needs even if I didn’t give birth to them.
I had an ectopic pregnancy that ruptured my right tube requiring removal. I already have two children with very normal pregnancies with them. I never thought this would happen to me but it obviously can and did. A very painful experience I lost alot of blood and came very close to having to have a blood transfution, I had spotting at 5 weeks pregnant for about 6 days with slight period like cramping but was told it can be normal in early pregnancy I told my husband I didn’t FEEL pregnant but told myself not every pregnancy is the same until 7 weeks pregnant when I had a stabbing pain in my right side like an appendix pain and I knew, in my heart I think I knew from the start something wasn’t right and I did wait. Please don’t hesitate like I did if you suspect anything go investigate straight away it really is a matter of life and death unfortunately!
I had an ectopic pregnancy in 2010 and had my left fallopian tube removed. Now every time that I get my period I get severe cramps on that side. I”m also nauseous as well this time.
I’ve had 2 ectopic pregnancies and both were very painful. My husband and I had been trying for 2 years, I went to the doctor as I has been bleeding for 10 days (my period lasts no longer than 5 days normally) she checked my stomach and sent me away saying nothing was wrong. Two weeks later I was still bleeding and in extreme pain and a bad pain in my shoulder. I went to the hospital myself and they then said it was an ectopic pregnancy and I was lucky I came in as my tube was close to bursting which can cause internal bleeding and can be fatal. As I’ve had 2 already doctors have advised I freeze eggs and have my tubes tied. We are going for IVF in January so fingers crossed it works. Just let all you mums out there if you experience long periods, bad cramping and shoulder pain I’d advise taking a pregnancy test, it can be fatal so act fast!
Stages of Pregnancy Slideshow Pictures
Slideshow of Early Pregnancy Symptoms
Conception (Egg to Embryo) Slideshow Pictures
I’m married and 41 now, we always wanted a baby, until this other morning I was vomiting the whole time I decided to take a pregnancy test, it came out positive. My husband and I went to a doctor to confirm then still the test was positive. The vomiting was worse in the morning and night! Until the 15 June when I started having heavy abdominal pains I went to pee I couldn’t walk after that pee. We went to the hospital da doctor couldn’t find a baby in the uterus and I had to go for surgicay coz it was ectopic! My left tube was removed as the baby was grown too much! Fortunately for me there was no bleeding at 7 weeks pregnant! I pray that it doesn’t happen to any woman. It’s a very bad experience will go for another baby after 6 months and I know this time I will carry my baby full term.
After the first methotrexate injection, I went to the OB/GYN 3 times to have my HCG levels tested. They determined that the injection had not fully worked, and gave me another. I was in extreme pain for almost three weeks, also having bleeding ranging from barely there to almost as heavy as a period. Finally, my HCG levels are down to zero. I hope soon to be able to have a child. I know the risks of another ectopic are high, but I don’t have children, and will try until the doctors tell me I have to stop.
I had an ectopic at age 18 and was treated by surgery. I have a 5-year-old. I had him through surgery too.
I had surgery to remove one of my falopian tubes cause it had already ruptured inside of me.
I had an ectopic pregnancy and was bleeding almost to death internally. The doctor never caught it in time. I was passing out, vomiting, bleeding, hallucinating, had the worst stomach pain, terrible shoulder pain and diarrhea. They removed my right tube and pumped a lot of blood out of my stomach area. My husband and I had our first baby when I was 22. A beautiful little girl. It took 2 1/2 years for me to get pregnant again even with trying very hard. Now I’m waiting to here from the doctor today to see if I have another ectopic pregnancy. I would raher give birth 20 times than go through the pain of an ectopic pregnancy again. Not to mention I’ve lost more babies to ectopic pregnancies than I’ve birthed. I only have one child and I am pregnant now and it’s believed that this one will not make it and I will have no other chances after this.
My period was a week late, and I took 3 pregnancy tests over the next week. They were all negative. I started spotting brown stuff and figured it was a miscarriage. Then I got a weird feeling and took another pregnancy test (it was about 5 days from the last one), and it was positive. About two days later I started bleeding big clots in one day. For 10 days afterwards I had a convective stream of blood. On the 10th day I got really bad pains right where I would expect my ovary to be. The pain got so bad I took up the courage to go to the emergency room. They couldn’t get me an ultra sound right away and were going to send me home, but because I was feeling nausea they admitted me. An hour after I was admitted I got an ultra sound. 30 mins after my ultra sound I was told I was having an emergency surgery. I had an ectopic pregnancy with a great amount of internal bleeding. It’s been 2 days since my surgery and it’s only sinking in now of how fatal it really was; and just how lucky I am.
Last September I found out that I was pregnant but I didn’t know that it was ectopic until I experienced bleeding that hurt. Then doctor said I needed to get an ultra sound so they know what the cause of my bleeding was. Then on September 30th it started to hurt again as well as bleed. So we go to the hospital and that’s when I found out that I have an ectopic pregnancy.
Last week I took a home pregnancy test and we were so excited! During that week I had some slight pain in my right side. After three days I decided to go to the doctor. They did a blood test and an exam. Two days later I went in and my blood levels didn’t rise enough, they did an ultrasound and found I had an ectopic pregnancy. Since I was so early in my pregnancy 4-5 weeks they decided to give me the injection to dissolve the pregnancy. Three days later my tube burst, it was the most pain I have ever been in. My husband rushed me to the hospital. I had emergency surgery and lost 60 percent of my blood into my abdomen. I had to have 4 units of blood transfused. I’m home and recovering now. Please don’t wait and if you don’t feel good about the diagnosis please get a second opinion. I’m nervous to try to conceive again but luckily they were able to save my tube.
Stages of Pregnancy Slideshow Pictures
Slideshow of Early Pregnancy Symptoms
Conception (Egg to Embryo) Slideshow Pictures
Over six years ago I had an eptopic pregnancy. I was a little late for my period, then after 2 weeks I started to bleed heavier than normal. It lasted for over a week so I went off to the doctors to find my that my HCH levels indicated I was pregnant but to head off to thr ER as it didnt look good. After lots of tests, scans, and a curette they found I was having an eptopic pregnancy. I didn’t have surgery. Instead I had the anti-cancer drug. It made me nauseous for a few days but it worked. Now I have three healthy boys which includes a set of identical twins. All concieved naturally.
I have had two ectopic pregnancies. The first ruptured. I had to have emergency surgery. I knew I was pregnant. I seemed to be having a normal pregnancy until that day. The second ectopic pregnancy was diagnosed with a blood test and vaginal ultrasound. I was able to have a section of tube removed. I was blessed I had already had a girl and boy before the ectopic pregnancies. I didn’t struggle with a lot of the emotional pain because I had other children. My heart would have been shattered if it had been my first child. My heart goes out to any woman who is faced with such a tragedy.
I am 55. I had a hysterectomy 14 years ago. I was told that I have an ectopic pregnancy. I am having a hard time with this is it even possible. Right now the only thing that is giving my doctor the certainty that I am pregnant is the blood test which came back positive. I have been scheduled for an ultra sound. Feeling scared, not knowing how to deal with all this.
I am 31 years old and have had 2 ectopic pregnancies. The First one I was in a lot of pain. I had started spotting and that lasted for 4-5 days. Then the pains came into it. I had shooting pains up my side and across my stomach and chest. Ended up at the hospital in my army uniform and had emergency surgery. They took my left tube out. Then, 5 months later I had another one. Knowing the signs I thought that’s what it was and went to the dr. Yes I had another one and this one was treated with the shot. After all of that I was very depressed but, I kept going. A year and a half later I found out I was pregnant and I looked at the doctor and said let’s see if I can have this one. I now have a little girl who is turning 5 very soon. I have been trying to have another one and my husband and I have been unsuccessful. Maybe I have just run out of chances.
I was diagnosed with an ectopic pregnancy in the last 2 weeks, after I found out I was pregnant with my first baby. It was so painful when the doctor told me they have to do surgery and remove my 1 fallopian tube, the stitches were taken out 2 days ago and I’m now worried about my next pregnancy. Please guys let’s take it seriously it is happening and what is worse you can die of it.
Stages of Pregnancy Slideshow Pictures
Slideshow of Early Pregnancy Symptoms
Conception (Egg to Embryo) Slideshow Pictures
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An ectopic pregnancy is a pregnancy that implants outside the uterus (womb). Ectopic means ‘outside’ or ‘in the wrong place’.
About one or 2 in 100 pregnancies in Australia is an ectopic pregnancy. Most of the time ectopic pregnancies occur in one of the fallopian tubes, which carry eggs from the ovary to the uterus. An ectopic pregnancy in one of the fallopian tubes is sometimes called a tubal pregnancy. Rarely, ectopic pregnancies can occur in other places, including the ovaries or inside the abdomen.
What are the symptoms of an ectopic pregnancy?
In the early stages an ectopic pregnancy seems just like a normal pregnancy. A period will usually be missed and other common signs of pregnancy (such as sore breasts and morning sickness) may be present.
The pregnancy hormone beta HCG (which is what gives a positive pregnancy test) will be produced as for normal pregnancies.
Symptoms that indicate a possible ectopic pregnancy typically occur at about 6 to 7 weeks of pregnancy, but can occur anywhere from 4 to 12 weeks. Many women still do not know that they are pregnant at this stage. Sometimes an ectopic pregnancy is detected during a routine pregnancy ultrasound scan before any symptoms have developed.
As the embryo grows, the fallopian tube cannot enlarge with it and the problem reveals itself. The fallopian tube will stretch and cause pain.
Symptoms may include:
- Vaginal bleeding (which may be mistaken for a delayed period) or discharge that may be watery and brown;
- Pelvic or abdominal pain, sometimes felt more on one side;
- Nausea and vomiting;
- Feeling light-headed or dizzy;
- Fainting; and
- Shoulder tip pain.
If the fallopian tube ruptures, it can result in severe pain and often internal bleeding. This can be life threatening. For this reason vaginal bleeding and lower abdominal pain in early pregnancy must never be ignored.
Pain that is felt at the tip of your shoulder can be a sign of irritation of the diaphragm. In the case of ectopic pregnancy, internal bleeding can collect under the diaphragm and cause this symptom.
When to see your doctor
Contact your doctor immediately or dial 000 for an ambulance if you have any of the following symptoms and it’s possible you could be pregnant (even if you haven’t had a positive pregnancy test).
- Vaginal bleeding and cramping pain shortly after a late period.
- Sudden, severe pain in the lower abdomen.
- Bad pains that do not feel like period pains.
- Dark bleeding which starts after the pain.
- Shoulder tip pain.
- Faintness, nausea, dizziness and vomiting.
What causes ectopic pregnancy?
When a woman becomes pregnant, what usually happens is that sperm travel through the female reproductive system to the fallopian tubes and fertilise an egg that has been released from one of your ovaries. The fertilised egg then continues to travel down the fallopian tubes to the uterus, where it should implant.
In the case of an ectopic pregnancy, the fertilised egg implants in the fallopian tube itself and starts to grow there. Fallopian tubes cannot expand and stretch to accommodate a growing pregnancy the way the uterus can.
Factors that can increase the risk of an ectopic pregnancy include the following.
- Previous infections in the fallopian tubes (pelvic inflammatory disease).
- Previous surgery to the fallopian tubes, including tubal sterilisation (having your tubes tied as a form of permanent contraception).
- Having fertility treatment such as IVF.
- Previous surgery to the pelvis or abdomen (which can cause scar tissue – adhesions – that can increase the risk of an ectopic pregnancy).
- Becoming pregnant with an intra-uterine contraceptive device (IUCD, or IUD) in place.
- Becoming pregnant while taking the progestogen-only pill (mini pill).
- Having endometriosis.
- Being older than 40 years of age.
- Being a smoker.
- Having previously had an ectopic pregnancy.
Diagnosing an ectopic pregnancy
Your doctor will ask about your symptoms and whether you are (or could be) pregnant. They will also perform a physical examination and ask you to do a urine pregnancy test.
If your doctor is at all suspicious of an ectopic pregnancy they will either admit you to hospital or organise special tests such as:
- A pelvic ultrasound; and
- Blood tests measuring the amount of the pregnancy hormone beta HCG in your body.
An ectopic pregnancy may be diagnosed when a pregnancy test is positive but an ultrasound shows that the womb is empty. Sometimes the ultrasound can show the location of the ectopic pregnancy.
Occasionally, a laparoscopic examination is recommended. This involves using a small telescope-like device — a laparoscope — which is inserted through a tiny opening in your abdomen. If an ectopic pregnancy is found it is usually removed by laparoscopic surgery. Sometimes the affected fallopian tube also needs to be removed.
Ectopic pregnancy is a serious condition that needs to be treated. A pregnancy can’t develop normally outside the uterus (womb), and unfortunately treatment cannot save the pregnancy. It is necessary to remove the pregnancy from the fallopian tube to stop it from rupturing, which can cause life-threatening internal bleeding.
The type of treatment recommended will depend on your symptoms, test results and general health.
Surgery is the most common treatment used to remove the ectopic pregnancy. Sometimes all or part of the affected fallopian tube is also removed.
Surgery is often done laparoscopically, using a small telescope-like device called a laparoscope, which is inserted through a tiny opening in your abdomen. This procedure is done under a general anaesthetic.
Sometimes laparoscopic surgery is not possible and an operation with a larger incision is needed.
Expectant management (watch and wait)
Close monitoring may be the only treatment needed for some women. This treatment is only suitable in certain circumstances. Women with no symptoms and with decreasing levels of pregnancy hormones may be suitable.
In some cases, ectopic pregnancy can be treated with a medicine called methotrexate to stop the pregnancy growing. This is usually only suitable when the ectopic pregnancy is detected early and is still very small. Methotrexate is given as an injection. In some cases, the medication doesn’t work and a second injection or surgery is needed to treat the ectopic pregnancy.
With expectant management and treatment with medication, close follow up is essential. Your doctor will want to check that your pregnancy hormone levels are falling (with repeat blood tests) and that there is no pregnancy tissue remaining (with follow-up ultrasound scans).
Ectopic pregnancies end in the loss of a pregnancy, which can be a difficult time for you and your partner. Support is available following ectopic pregnancy. Talk to your doctor about how you are feeling.
Getting pregnant again
Most doctors recommend that women who have had an ectopic pregnancy don’t try to get pregnant again straight away. If you had treatment with methotrexate, you should wait 3 to 4 months before trying for another baby. Waiting 2 months after surgical treatment is usually recommended.
Surgery for an ectopic pregnancy can affect future fertility, especially if there is a problem with your other fallopian tube. However, having only one fallopian tube usually means your chance of pregnancy is only slightly reduced.
Your doctor will be able to discuss whether your fertility is likely to be affected and if fertility treatment is recommended.
Most women who have had an ectopic pregnancy are able to go on to have a normal pregnancy. In future pregnancies, your doctor may recommend having an ultrasound scan at 6-8 weeks of pregnancy to confirm that it is not an ectopic pregnancy.
Your doctor will be able to give you further information and advice on getting pregnant again that is specific for your circumstances.
2. NHS Choices. Ectopic pregnancy (updated 3 Feb 2016). http://www. nhs. uk/Conditions/Ectopic-pregnancy/Pages/Introduction. aspx (accessed May 2016).
3. American College of Obstetricians and Gynecologists (ACOG). Ectopic pregnancy (updated Aug 2011). http://www. acog. org/Patients/FAQs/Ectopic-Pregnancy (accessed May 2016).
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About Ectopic Pregnancy – How Do You Know?
If you are worried about a possible ectopic pregnancy or have been diagnosed with one, this information may be helpful.
What Is An Ectopic Pregnancy?
The word “ectopic” is derived from the Greek word “ektopos” which means “out of place”. Therefore an ectopic pregnancy is one that is “out of place” and not inside the womb. This happens in about 1% or less of pregnancies.
An ectopic pregnancy is a potentially life-threatening complication caused by the implantation of the embryo Outside the womb.
Normally the sperm and egg meet up in the lower end of the fallopian tube and start dividing as the zygote becomes a morula and then a blastocyst which then implants in the uterus (womb).
In an ectopic pregnancy, this happens either in the fallopian tube (also called a tubal pregnancy), the abdomen, ovaries or the cervix. The majority (about 98%) occur in the fallopian tubes and only a very small percentage occurs elsewhere.
Ectopic tubal pregnancies commonly occur in the lower end or ampulla (about 80%) followed by the isthmus (middle), fimbria (opening) and cornua (top end) of the fallopian tube.
Why Does Implantation Occur Outside The Uterus?
Possible causes of an ectopic pregnancy include:
- Blockage or narrowing of the fallopian tube due to defects, previous infections or surgery causing scarring, endometriosis or previous ectopic pregnancy.
- Pregnancy with an intrauterine device (IUD) in place.
- Surgery to reverse a tubal ligation.
- Previous pelvic surgery causing adhesions.
However, sometimes no underlying cause can be found.
What Is A Tubal Pregnancy?
A tubal pregnancy is an ectopic pregnancy that has occurred in one of the fallopian tubes.
During implantation, the blastocyst burrows into the tubal lining (as it normally would do in the uterus) and may invade blood vessels which will cause bleeding and the spontaneous expulsion of the tubal pregnancy (also called a tubal abortion but is more comparable to a miscarriage).
If the tubal pregnancy continues to grow, because the fallopian tube is not designed to stretch to accommodate a pregnancy, the threat of a rupture occurring increases. This is potentially life-threatening to the mother as the risk of haemorrhage is high with a ruptured ectopic pregnancy.
What Are The Signs Of A Tubal Pregnancy?
Early signs include:
- Pain in the lower abdomen which can vary from mild to strong cramps.
- Pain while urinating or having a bowel movement.
- Slight to moderate vaginal bleeding.
Late signs include:
- Recent onset pain in the lower abdomen, lower back and/or shoulder tip that gets worse. Pain in the shoulder tip is a sign of internal bleeding that is irritating the diaphragm.
- Vaginal bleeding.
- Nausea and vomiting.
- Weakness, dizziness or fainting.
Signs of a possible ruptured ectopic pregnancy include:
- Onset of sudden severe sharp pain,
- Shoulder tip pain,
- Nausea or diarrhoea,
- Dizziness or fainting.
How Is An Ectopic Pregnancy Diagnosed?
Early ectopic pregnancies may be difficult to diagnose as they can mimic the symptoms of gastroenteritis, appendicitis, miscarriage or even a urinary tract infection.
An ectopic pregnancy is considered in any woman who has had a positive pregnancy test and then presents with pelvic pain and/or vaginal bleeding.
An transvaginal or abdominal ultrasound and the Human Chorionic Gonadatrophin (hCG) levels in the blood are used to diagnose an ectopic pregnancy. There is no definitive blood hCG level that correlates with an ectopic pregnancy. What is considered is that in a normal pregnancy, at a blood hCG level of 700-1000 mIU/ML, a gestational sac should be visible in the uterus on transvaginal ultrasound and ≥ 6000 mIU/ml on an abdominal ultrasound.
The diagnosis is made on the correlation of a positive pregnancy test, physical signs and symptoms, physical findings on examination, ultrasound results and blood hCG levels.
As the ability to diagnose ectopic pregnancy improves, doctors will be able to intervene sooner to prevent tubal damage and possible life-threatening situations and preserve future fertility.
What Is The Treatment For An Ectopic Pregnancy?
Some (approximately half) resolve without treatment as a tubal abortion.
Early treatment with methotrexate for an ectopic pregnancy stops the growth of the embryo which may then be passed as a tubal abortion or reabsorbed by the woman’s body. Methotrexate is administered intramuscularly (IM) either in a single or multiple doses, depending on your hCG levels.
For example, if your hCG levels have not started dropping by day 7 after the first injection of methotrexate, a second dose or surgery may be considered.
Feeling tired after methotrexate treatment is one of the side effects of the drug.
When is methotrexate treatment offered to a patient with an ectopic pregnancy? Patients have to meet the following criteria:
- Medically stable with no signs or symptoms of active bleeding or evidence of tubal rupture,
- Must be complaint and reliable for follow up care,
- No evidence of a fetal heartbeat on ultrasound,
- The size of the gestational sac should be ≤ 4 cm (1.575 inches) on ultrasound,
- A beta hCG level < 5000 mIU/ml,
- And no contraindications to the use of methotrexate such as kidney, liver, lung or blood disorders, sensitivity to methotrexate and breastfeeding.
If the fallopian tube has ruptured, or is in danger of rupturing, surgical intervention is required. This may be through a laparoscopy (keyhole surgery) or laparotomy (open surgery). Depending on where in the fallopian tube the ectopic pregnancy is situated and the danger of rupture, either a salpingostomy (removing the ectopic pregnancy only) or a salpingectomy (removing the fallopian tube) is performed.
What Happens After Treatment?
It is not unusual to have spotting or intermittent bleeding for up to 6 weeks after treatment. There should be no pain associated with the bleeding or spotting.
You could still have a feeling of being pregnant after treatment. This will subside as the hCG levels drop.
Depending on whether you had medical or surgical treatment, mild pain and discomfort could persist for a few weeks.
Fertility After An Ectopic Pregnancy
This depends on the type of treatment, a history of infertility, the reason for the ectopic pregnancy and how long it takes for hCG levels to drop.
Having an intrauterine pregnancy following methotrexate treatment is higher compared to surgical treatment and better after having a salpingotomy compared to a salpingectomy.
It will also depend on the health of your fallopian tubes. It is important that you discuss this with your health care provider so that you know what to expect.
If you had medical treatment only (your fallopian tubes are still intact), on average, you have a 60% to 65% chance of an intrauterine (normal) pregnancy within the following 18 months.
How Soon After An Ectopic Pregnancy Can I Try To Conceive Again?
Your menstrual cycle will resume sometime within the 2 nd and 10 th week after surgery and within 4 weeks after your hCG levels have dropped to <5 mIU/ml after treatment with methotrexate.
Your body needs time to recover and you need time to recover emotionally too, therefore it is recommended that you wait for at least 2 full menstrual cycles or 3 months.
After methotrexate treatment it is recommended that you wait at least the full 3 months.
Methotrexate is a powerful drug used in cancer treatment and may diminish the levels of folic acid in your body. If you fall pregnant with a low folate level, the risk of a neural tube defect such as a cleft palate or lip is higher.
Therefore it is recommended that you wait until your hCG levels have dropped to <5 mIU/ml before starting with a folate supplement. You should then take a folate supplement for approximately 12 weeks before trying to conceive again.
Coping With The Emotional Side Of An Ectopic Pregnancy
Knowing that you were pregnant but that it was just growing in the wrong place and then having to go through the treatment can be an emotionally difficult, fearful and stressful period in your life. What began as a very joyful experience has been taken away so abruptly.
You need time to heal emotionally and physically and you need time to grieve. Don’t be afraid to ask for help and support. Take your time easing back into your normal routine and work.
Do not blame yourself as chance may be the only culprit. Remember there is no possibility that the pregnancy would have survived and that your life could have been at risk too.
When you are ready, start planning ahead by getting all the relevant information from your health care provider regarding if and how your ectopic pregnancy and treatment have affected your fallopian tubes.
In the wrong place at the right time
Hoping, praying for such a long time
For the someday baby who would be mine
Month after month failing the test
Trying so hard refusing to rest
But then came a day when the lines became two
At last my dream was about to come true
With my hand on my belly I was touching my baby to be
And looking forward to the day when you I would see
But then came the pain so sharp and so strong
I couldn’t believe that things could go wrong
My baby is growing the heartbeat echoes in my heart
But baby was not where baby should start
How could this happen, when for so long I had dreamed
Please don’t take my baby I begged and I screamed
Can you not fix this, can you save the life?
The pain cuts through me as sharp as a knife
They tell me that I will die if it is not done
So instead of two I once again become one
I will always remember that you wanted to be
But you had to go because instead they saved me
I loved you so, and I think of you every day
My teeny tiny baby who got lost on the way
In heaven there is angel of mine
Who was in the wrong place at the right time.
Http://www. webmd. com/baby/pregnancy-ectopic-pregnancy
Http://www. medicinenet. com/ectopic_pregnancy/patient-comments-677.htm
Http://www. mydr. com. au/babies-pregnancy/ectopic-pregnancy