What Is an Ectopic Pregnancy?
Definition and Overview
An ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, typically in the fallopian tube. This is problematic because the fallopian tube isn’t meant to house and grow an embryo, only the uterus is. As such, an ectopic pregnancy is not a viable pregnancy. Thus, an ectopic pregnancy can lead to complications and potentially be life-threatening.
How It Differs from a Normal Pregnancy
With a normal pregnancy, conception begins with a fertilized egg. After the egg becomes fertilized, it then attaches to the uterine lining. Ectopic pregnancy is different because the fertilized egg implants and develops outside of the major uterus cavity. Typically, this is in the fallopian tube, which is a part of the body that connects the uterus and ovaries. However, it can also occur in the cervix, abdominal cavity, or ovary, although it is much less common.
Causes and Risk Factors
Any individual that has the ability to conceive and is sexually active or receiving fertility treatment is at risk of an ectopic pregnancy. Although an ectopic pregnancy is largely unavoidable, there are several circumstances that may increase your risk of experiencing an ectopic pregnancy:
Who Is at Risk?
Things that can increase your risk of an ectopic pregnancy include:
- Previous ectopic pregnancy. If you have had an ectopic pregnancy before, you are at higher risk of having one again versus someone who hasn’t had one in the past.
- Increased age. Older individuals are at increased risk of pregnancy complications like ectopic pregnancy.
- Fertility treatment. Fertility treatments like IVF or embryo transfer carry a risk of ectopic pregnancy.
- Certain medical conditions. Individuals who have pelvic inflammatory disease or endometriosis have a higher chance of having an ectopic pregnancy.
- Smoking. Studies have shown that individuals who smoke cigarettes have increased levels of the protein PROKR1 within the fallopian tubes. This protein is important to egg implantation, however, its presence in the fallopian tubes can lead to ectopic pregnancy.
It is important to note that while some situations can make it more likely that you’ll experience an ectopic pregnancy, abortion is not one of them. Abortion is not associated with a risk of ectopic pregnancy (2).
Can It Be Prevented?
While preventing an ectopic pregnancy is not entirely possible, there are a few ways that you can lower your risk. For example, practicing safe sex to decrease your likelihood of sexually transmitted infections (STIs) and consequent pelvic inflammatory disease is essential to preventing fallopian tube scarring. Additionally, stopping smoking could also help lower your risk.
Signs and Symptoms
You may not experience symptoms of an ectopic pregnancy at first. Additionally, individuals with an ectopic pregnancy may have the normal early signs of pregnancy, including breast tenderness, a missed period, or nausea.
If you have an ectopic pregnancy, a pregnancy test will still be positive although the pregnancy isn’t viable.
Early Symptoms
In the early stages of an ectopic pregnancy, you may experience symptoms such as pelvic pain and light vaginal bleeding. Sometimes, blood will leak from the fallopian tube, which can result in the urge to have a bowel movement or shoulder pain. However, symptoms will vary from person to person.
Emergency Symptoms That Require Immediate Care
It is very important to look out for the emergency symptoms of an ectopic pregnancy, as it can be life-threatening. As a fertilized egg continues to develop within the fallopian tube, it can result in tube rupture. This would cause heavy abdominal bleeding, which may manifest as fainting, lightheadedness, and shock.
Because of the dangers associated with an ectopic pregnancy, you should seek medical attention if you experience:
- Severe lightheadedness or fainting
- Extreme pelvic or abdominal pain
- Vaginal bleeding
- Shoulder pain (3)
Diagnosis of Ectopic Pregnancy
You typically won’t know if your pregnancy is ectopic until you seek medical evaluation.
Medical Evaluation
Diagnosis of an ectopic pregnancy will require an appointment with a licensed healthcare professional, during which your provider will conduct several tests. These will include things like a urine test, bloodwork, and ultrasound. An ultrasound can detect an ectopic pregnancy after 6 weeks.
Just like with any other pregnancy, you may take a urine test at your appointment. For this, you will pee on a test strip or in a cup to test your urine for pregnancy.
Ultrasound and Blood Tests
Your provider will also likely conduct the other following evaluations to confirm the pregnancy and determine if it is ectopic:
- A blood test. A blood test detects the presence of a hormone known as human chorionic gonadotropin (hCG), which is only present during pregnancy.
- An ultrasound. An ultrasound uses sound waves to visualize the internal structure within your body. An ultrasound will help identify where the fertilized egg implanted (1).
Treatment Options
Unfortunately, ectopic pregnancies are not viable pregnancies, meaning that they cannot continue as normal and the developing embryo cannot be saved. Treatment is typically required to remove the pregnancy before it progresses further.
There are several different treatment options, and which is best for you will depend on your symptoms, the stage of the pregnancy, and how much hCG is in your blood.
Medication (e.g., Methotrexate)
If you’ve diagnosed the ectopic pregnancy early but the pregnancy contents need to be removed, you may opt for medication. In particular, the medication methotrexate stops the pregnancy from developing further. It is administered as a single injection into the buttocks.
Surgical Interventions
Oftentimes, a surgery known as a keyhole surgery (laparoscopy) is required to remove the pregnancy. This requires general anesthesia. Sometimes, the entire fallopian tube needs to be removed.
Recovery and Follow-Up
Recovery from methotrexate treatment doesn’t require a hospital stay. However, recovery from surgery usually requires a few days stay at the hospital post-surgery and takes four to six weeks for a full recovery.
Emotional and Physical Recovery
Recovering from an ectopic pregnancy will require both physical and emotional healing.
Coping with the Loss
For many, pregnancy loss can bring about grief. You may find it helpful to speak to a licensed therapist, find a support group, journal, or just take time for yourself while you process your emotions.
Support Networks and Resources
There are many support groups both in-person and online for pregnancy loss and ectopic pregnancy. Additionally, therapists, counselors, or faith leaders may bring about added peace and comfort.
Future Fertility and Pregnancy
Impact on Fertility
Many may worry about the lasting impacts of an ectopic pregnancy on one’s fertility in the future. The impact will vary depending on the stage of the pregnancy, the condition of the fallopian tubes, and the outcomes of surgery if you had one.
In the cases where a fallopian tube was damaged or removed, ectopic pregnancy can reduce fertility. However, it definitely does not eliminate fertility, and many can still conceive naturally. If both tubes are affected, IVF can be a great option.
Getting Pregnant After an Ectopic Pregnancy
You should allow your body time to heal after experiencing an ectopic pregnancy. It is generally recommended to wait two to three months prior to trying to conceive again. For those taking methotrexate, your provider will likely recommend you wait a bit longer.
Abortion and Ectopic Pregnancy
Regarding Abortion and Ectopic Pregnancy, if an Ectopic Pregnancy is diagnosed, the abortion pills will NOT resolve it, and it will require medical attention.
In case you are diagnosed with an ectopic pregnancy, it is recommended to avoid taking pills and to begin treatment with a health care provider as soon as possible.
You may also get an Ultrasound first before taking the abortion pills, to ensure that it is not an ectopic pregnancy, in case of experiencing symptoms that will indicate an E.P.. In case you can not have access to an Ultrasound, you can still proceed with abortion with pills, but please consider that after taking the pills, if you do not experience any symptoms of abortion such as cramping and bleeding more than your normal menstrual period, this might suggest that you are having an ectopic pregnancy and in that case, you should then have an Ultrasound.
Final Thoughts
Ectopic pregnancy can be scary – but it is treatable with prompt diagnosis and proper medical intervention. If you are experiencing signs and symptoms of ectopic pregnancy, be sure to contact a medical professional right away.
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