During pregnancy a fertilized egg would implant itself on the inner lining of the uterus as is the normal process. But in some rare cases the egg, instead of implanting itself into the uterus can get attached to some other part of the body. Such kind of pregnancy is termed as abnormal or ectopic pregnancy.

In most cases of ectopic pregnancies a fertilized egg would implant itself on the inner lining of the fallopian tube. Hence most ectopic pregnancies are also called as tubal pregnancies. However they can also happen in other locations of the body such as ovaries, cervix and the abdominal cavity. An ectopic pregnancy occurs in one out of 50 pregnancies.

Causes

Though one cannot find a specific reason that causes an ectopic pregnancy, here are some pointers that can make one susceptible to the condition:

• A previous ectopic pregnancy: If you had two or more ectopic pregnancies then your chances of having a subsequent one increases manifold.


• Damage or abnormality to the fallopian tube: If there is any kinking, scarring or damage to the fallopian tube chances are that a fertilized egg may get stuck in the tube more easily. Any previous surgery to the fallopian tube or nearby structure also makes you susceptible to suffer from an ectopic pregnancy. Or even a condition like endometriosis could give rise to the same.


• Complication of contraceptives: A sterilization operation is a very effective method of contraception, but in case it leads to a pregnancy about one in 20 is ectopic. Again if a pregnancy happens despite the use of an intrauterine contraceptive device ectopic pregnancy could be the outcome.


• If you smoke: The risk of ectopic pregnancy increases in women over the age of 35 years and also in smokers.

However, around one third of women with an ectopic pregnancy do not have any of these risk factors.

Symptoms

The key symptoms that might indicate ectopic pregnancy are –

• Abdominal pain


• Vaginal bleeding


• Shoulder pain


• Dizziness


• Pain in the genital areas


• Diarrhea and vomiting

Read in detail about 6 symptoms of ectopic pregnancy.

Diagnosis

If you notice symptoms of ectopic pregnancy reach out to your doctor to confirm the doubt. Your doctor might ask you to perform the following tests to confirm the condition:

• A urine test. To confirm the fact that you are pregnant. Your urine test report will show the presence of hCG hormone that is secreted in the body during pregnancy.


• An ultrasound. An ultrasound scan is a better way to confirm an ectopic pregnancy. Though this would be a transvaginal ultrasound, it would give a better view of the fallopian tubes to know the exact location of the fertilized egg and confirm the occurrence of ectopic pregnancy. If the scan doesn’t appear clear, then a second scan might be necessary to determine the same.


• Blood tests. To confirm the pregnancy and check the presence of pregnancy hormones in the blood, namely, hCG or human Chorionic Gonadotropin. But this will usually be followed with an ultrasound scan to be certain about the type of the pregnancy.

Treatment

Because the symptoms of ectopic pregnancy can be subtle and go unnoticed most of the time one might reach the hospital with a ruptured fallopian tube or internal bleeding. In such a case a medical surgery becomes inevitable. The main aim of the surgery is to stop the internal bleeding and remove the ruptured fallopian tube and the remnants of the pregnancy. The operation is often life-saving.

But if you reach the hospital before the rupture by picking up the signs early, then your treatment options would be the following:

Medical surgery: A laparoscopic surgery to remove the fallopian tube containing the fertilized egg. Though not every woman suffering from an ectopic pregnancy would need to undergo a surgery. A surgery is recommended if one tube is unhealthy with the impending pregnancy while the other is still healthy and functional.

Medications: Methotrexate is often given in the form of an injection. It works by killing the cells of the pregnancy growing in the fallopian tube. It is normally only advised if the pregnancy is very early. You would still need to be monitored closely with repeated blood tests to check for the hCG levels until they show a low reading confirming that the pregnancy has been terminated. Methotrexate can cause side-effects which include nausea and vomiting in some women. It can be common for some abdominal pains to develop 3-7 days after having methotrexate.

The wait and watch approach: Not all ectopic pregnancies are life threatening. Some might just end on its own and need no further medical attention.

Complications

An ectopic pregnancy never progresses like a normal healthy pregnancy. Here’s what can happen if you suffer from one:

• Your pregnancy would eventually be terminated within a few days. You may or may not suffer from any symptoms of the same and might not even know that you had been pregnant. There might be a slight pain and some vaginal bleeding like that of a miscarriage. Further medical assistance might not be necessary in this case. Know more about the signs and symptoms of ectopic pregnancy.


• But if the egg grows for a while in the fallopian tube it can give rise to other symptoms of the pregnancy. This is when ideally medical help can save you.


• If the pregnancy grows further it can stretch the narrow fallopian tube and rupture it causing heavy internal bleeding and pain. This is a medical emergency.

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