Ectopic Pregnancy

Ectopic pregnancy is a serious condition whereby a the embryo begins to grow in one of the fallopian tubes rather than in the womb.

The fallopian tubes connect the ovaries to the womb. During a normal pregnancy, the sperm and egg meet in one of these tubes. If an egg becomes fertilised, it travels down into the womb and implants itself into the womb lining (endometrium), where the embryo begins to grow. Sometimes, however, the fertilised egg can implant itself outside the womb – usually the fallopian tube – this is called an ectopic pregnancy. According to BBC Health, it affects around 1 in 100 pregnancies.

What are the risk factors?

Anything that can hinder the movement of the egg from the ovary down to the womb can be a potentially cause an ectopic pregnancy. An infection in the fallopian tubes can leave scarring, making movement more difficult. Scars from a previous ectopic pregnancy also heighten risk.

Other factors, which may heighten risk include:

  • Hormones – women who use the coil as contraception or get pregnant while on the progestogen-only pill are more at risk
  • Pelvic Inflammatory Disease
  • Endometriosis
  • Becoming pregnant despite having been surgically sterilised
  • Some sexually transmitted infections such as chlamydia
  • Structural problems – i.e. if the fallopian tube is abnormally shaped

What are the symptoms?

Many women who have an ectopic pregnancy do not experience any symptoms. It may only be picked up during an early scan or if the woman’s fallopian tube has ruptured. This is known as “collapse“ and can lead to potentially life-threatening internal bleeding, according to the NHS.

Symptoms of collapse may include:

  • Feeling light-headed and faint, accompanied by the feeling of something being very wrong
  • Feeling sick
  • Diarrhoea
  • Paleness
  • Increased heart rate

Aside from collapse, if symptoms do arise, they do so between 5 and 14 weeks of pregnancy and may include:

  • One-sided abdominal pain, which can be persistent and severe
  • Vaginal bleeding, which starts and stops and can be bright or dark red in colour
  • Shoulder tip pain – this is pain at the point where the shoulder ends and arm begins. It is not known why this occurs, but usually happens when the sufferer is lying down and can be a sign of internal bleeding
  • Bowel pain
  • Diarrhoea and vomiting

[adsense]How is it diagnosed?

An ectopic pregnancy is usually diagnosed through a vaginal ultrasound, whereby a small probe is inserted into the vagina to obtain close-up images of the womb and its surrounding area.

If the sufferer begins to have symptoms of an ectopic pregnancy a few weeks into the pregnancy, she may be offered a blood test to measure blood levels of the hormone human chorionic gonadotropin (hCG), which is produced by placental tissue. HCG levels are usually lower than normal if the pregnancy is ectopic or if the sufferer is due to have a miscarriage.

If a diagnosis cannot be obtained through either of the two aforementioned methods, then laparoscopy may be performed. This is when a small incision is made on the outside of the abdomen and a small viewing tube inserted. This procedure is performed under general anaesthetic.

How is it treated?

It is important to diagnose an ectopic pregnancy as soon as possible due to its life-threatening nature. If the fallopian tube ruptures, emergency surgery is needed to prevent fatal internal bleeding and doctors have to remove the tube completely, greatly lessening the woman’s fertility.

In an ectopic pregnancy, the baby cannot be saved. However, if it is diagnosed early, the pregnancy can be ended safely using medication and surgery.

Click here to read about Chris Evans’ wife, who nearly died due to an ectopic pregnancy, and Padma Lakshmi’s struggle with endometriosis.

Also, read more about in virto fertilization (IVF) and what happens during a miscarriage.

Images: Wikimedia Commons