Ectopic Pregnancy

Overview

Definition

An ectopic pregnancy is a pregnancy that occurs outside of the uterus. Most ectopic pregnancies occur within a fallopian tube. Other, less common locations may include the cervix, an ovary, or the abdominal cavity. This type of pregnancy cannot survive. Only the uterus can support the growth of a fetus and its placenta.

Ectopic Pregnancy
Nuclus factsheet image
Copyright © Nucleus Medical Media, Inc.

Causes

Many ectopic pregnancies occur because the fallopian tube is not functioning normally.

Risk Factors

Ectopic pregnancies are more common in women over 35 years old and those who are non-Caucasian. Other factors that may increase your chance of ectopic pregnancy include:

  • Previous ectopic pregnancies
  • History of pelvic inflammatory disease (PID) and related scar tissue
  • Endometriosis
  • Prior surgery on fallopian tubes or uterus and related scar tissue
  • Fertility treatments
  • Abnormally-shaped uterus and/or fallopian tubes
  • Presence of an intrauterine device (IUD)
  • Pregnancy that occurs after a sterilization procedure—tubal ligation
  • Smoking

SymptomsandDiagnosis

Symptoms

Since you are pregnant you would have had missed or abnormal periods. Ectopic pregnancy may also cause:

  • Abdominal pain
  • Spotty vaginal bleeding
  • Pain in the shoulder or neck due to irritation of the breathing muscle by blood from a rupture ectopic pregnancy
  • Fainting

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be also be done.

Your bodily fluids may be tested. This can be done with:

  • Pregnancy test
  • Pelvic exam
  • Blood tests

Images may be taken of your uterus and fallopian tubes. This can be done with a transvaginal ultrasound.

Treatments

Treatment

You may just be observed if the condition is already resolving. Usually treatment is needed, options include:

Medications

If the ectopic pregnancy is small and has not ruptured (burst), a medication that prevents further growth of the ectopic pregnancy may be advised.

Surgery

Surgery may be needed, especially if the ectopic pregnancy has ruptured or if it is not in the fallopian tube. During the surgery, the pregnancy will be removed.

If the pregnancy is in the fallopian tube, the doctor may be able to repair the tube. In severe cases, the fallopian tube may need to be removed.

Prevention

To help reduce your chance of an ectopic pregnancy:

  • Maintain safe sexual practices to avoid sexually transmitted diseases (STDs) , which can damage to the fallopian tubes and ovaries.
  • Get early diagnosis and treatment of STDs.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Tubal Pregnancy)

RESOURCES

Family Doctor—American Academy of Family Physicians http://familydoctor.org 

American Congress of Obstetricians and Gynecologists http://www.acog.org 

CANADIAN RESOURCES

The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org 

Women's Health Matters http://www.womenshealthmatters.ca 

References

Ectopic pregnancy. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T115772/Ectopic-pregnancy . Updated February 9, 2016. Accessed November 21, 2016.

Ectopic pregnancy. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/abnormalities-of-pregnancy/ectopic-pregnancy. Updated January 2014. Accessed November 21, 2016.

Ectopic pregnancy. Planned Parenthood website. Available at: http://www.plannedparenthood.org/learn/pregnancy/ectopic-pregnancy. Accessed November 21, 2016.

4/22/2011 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T115772/Ectopic-pregnancy : Creanga AA, Shapiro-Mendoza CK, Bish CL, Zane S, Berg CJ, Callaghan WM. Trends in ectopic pregnancy mortality in the United States: 1980-2007. Obstet Gynecol. 2011;117(4):837-843.