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What Is Ectopic Pregnancy? - Symptoms, Causes & Treatment

Instructor: Sarah Lawson

Sarah has taught nursing courses and has a master's degree in nursing education.

Many women get pregnant every day around the world. Occasionally, something goes wrong at the very beginning of pregnancy, which causes the fertilized egg to not implant in the uterus. Learn what ectopic pregnancy is and what the symptoms, causes and treatments are for it.

Symptoms

Normally in pregnancy, a woman's ovary will release an egg into the fallopian tube, where it will join with a man's sperm. This creates a fertilized egg, or embryo, which will travel to the uterus and implant itself into the endometrium, or lining. This is where it will continue to grow throughout the remainder of the pregnancy.

In an ectopic pregnancy, the embryo implants outside of the uterus. This occurs in approximately 1 out of every 50 pregnancies. In most ectopic pregnancies, also known as tubal pregnancies, the embryo fails to travel to the uterus and instead implants itself into the fallopian tube. This is the structure that connects the ovary to the uterus. Approximately 98% of all ectopic pregnancies occur in the fallopian tubes. Ectopic pregnancies can also occur in the ovary, in the cornua (horn) of the uterus, the cervix, or in the abdominal cavity.

Ectopic pregnancies are usually discovered early. Most are found by the eighth week of pregnancy. At this stage of pregnancy, a woman may not even know she is pregnant yet.

Ectopic pregnancy located in left fallopian tube

Symptoms of ectopic pregnancy include:

  • Light vaginal bleeding
  • Lower abdominal pain, usually located on one side
  • Sharp abdominal cramps
  • Nausea and vomiting
  • Dizziness, weakness, or fainting
  • Pain that radiates to the shoulder, neck, or rectum
  • Extreme pain and bleeding if fallopian tube ruptures

Ectopic pregnancies are very scary and sad. Learning that a baby is coming is a time to be happy and celebrate. During an ectopic pregnancy, not only is it unlikely the baby will survive, but the mother's life will also be in danger if she does not receive proper treatment. In very rare cases, a baby may survive in abdominal ectopic pregnancies. It is important to note that survival of the baby is not possible in tubal, cornual, or cervical pregnancies.

Causes

There are many factors that can cause or increase a woman's risk for ectopic pregnancy. The most common reason is damage that has occurred to the fallopian tube that does not allow an embryo to travel to the uterus. Other factors that increase the risk for ectopic pregnancy include:

  • Current use of an intrauterine device (IUD) for birth control
  • History of pelvic inflammatory disease (PID)
  • Current or past sexually transmitted infections, such as chlamydia and gonorrhea
  • Congenital abnormality of the fallopian tube
  • History of pelvic surgery
  • History of ectopic pregnancy
  • Tubal ligation reversal or unsuccessful tubal ligation
  • Use of fertility drugs or treatments, such as in vitro fertilization (IVF)

Treatment

Treatment depends on how far along the pregnancy is. If the ectopic pregnancy has caused a fallopian tube rupture, then emergency surgery is necessary in order to save the woman's life. If a fallopian tube rupture has occurred, it is possible that the tube and ovary may be too damaged to save and will require removal. It is, of course, ideal that the ectopic pregnancy is discovered before this point. If fallopian tube rupture occurs, the woman may die from hemorrhage before she can receive treatment.

Laparoscopic removal of ectopic pregnancy

If the pregnancy has not caused rupture and has not progressed very far, then treatment would be to remove the embryo and repair the damage with laparoscopic surgery. Laparoscopic surgery is performed using a laparoscope. A laparoscope is a thin, flexible instrument used by doctors to see inside the abdomen during laparoscopic surgery. The laparoscope is inserted into the abdomen through very small incisions. During this surgery, the doctor would make a small incision in the fallopian tube to remove the embryo and preserve the integrity of the fallopian tube.

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