What is an Ectopic Pregnancy?

An ectopic pregnancy is one that develops outside of the womb. The word “ectopic” means “out of place”. 

  • 2-4% of pregnancies worldwide are ectopic. 

  • For many women, this can be a life-threatening condition 

Normally, after an embryo forms in the fallopian tube, it moves down the tube into the uterus, implants into the uterine lining, and continues to grow and develop in the uterus. 

In an ectopic pregnancy, the embryo implants outside of the uterus, usually in one of the Fallopian tubes.

  • An embryo cannot survive in the Fallopian tube since the tube does not allow the embryo to expand and it does not have a sufficient blood supply. 

  • There is no way to safely remove the embryo from the tube and allow it to grow in the uterus. 

  • The devastating fact is that all ectopic pregnancies will end with the loss of the baby. 

Types of Ectopic Pregnancy

Non-tubal ectopic pregnancy (only 3-5% of ectopic pregnancies) 

  • Interstitial ectopic

    • the embryo implants in the top corner of the uterus near the Fallopian tube

  • Cervical ectopic

    • the embryo implants in the cervix

  • Scar ectopic

    • the embryo implants in a scar from a prior Cesarean section 

Tubal ectopic pregnancy/tubal pregnancy 

  • As described above, the embryo remains in the Fallopian tube

  • This is the most common type of ectopic pregnancy

  • Cornual ectopic

    • the embryo implants in a part of the uterus that is not properly formed

  • Heterotopic pregnancy

    • a twin pregnancy where one embryo implants correctly and the other does not

  • Ovarian ectopic

    • the embryo implants in the ovary

What Causes Ectopic Pregnancies?

No one knows for sure what causes ectopic pregnancies, but there are some known causes and risk factors. It is important to know that many women who experience an ectopic pregnancy have no risk factors at all.  

Some possible risk factors are:

  • Previous ectopic pregnancy

  • An infection in the uterus, Fallopian tubes, or ovaries that can lead to PID (pelvic inflammatory disease)

  • Surgery on the Fallopian tubes 

  • Abdominal surgery such as a prior cesarean section, appendectomy, or a previous surgery for an ectopic pregnancy

  • Damage to the Fallopian tubes from endometriosis

  • Some forms of birth control or infertility treatments can increase risk of an ectopic pregnancy

  • Cigarette smoking can cause an increase in protein in the Fallopian tubes that can slow down the movement of the embryo to the uterus

  • Advanced maternal age 

What are the Risks of an Ectopic Pregnancy?

There are several possibilities when an embryo implants outside of the uterus:

  • If this occurs, normally no additional treatment is required. Your doctor may not even be able to tell whether the pregnancy was ectopic or if the baby died for other reasons.

  • Sometimes, since the embryo cannot continue growing, it miscarries naturally and the Fallopian tube pushes the deceased embryo into the uterus. The woman’s body can then gradually absorb or pass the remains of the baby. There may be bleeding or fluid. Further tests and treatment may be necessary.

  • If the embryo continues growing, the thin wall of the Fallopian tube stretches and if left untreated, can rupture. This is an emergency situation and must be dealt with urgently to preserve the life of the mother.

  • A non-tubal ectopic pregnancy may grow longer than a tubal ectopic pregnancy since the embryo has more room, but they rarely resolve without surgery. This type of ectopic pregnancy can also be harder to diagnose.

What are the Symptoms of an Ectopic Pregnancy?

If you have an ectopic pregnancy, you may have one or more of the following symptoms between the 5th and 10th week of pregnancy, but you can also experience no obvious symptoms.

Possible symptoms include:

  • Irregular vaginal bleeding, different from your normal period 

  • Lower abdominal pain, perhaps just on one side.

  • Pain where your shoulder meets your arm

  • Bowel or bladder problems

  • Feeling of distress, dizziness, or fainting

  • No symptoms at all

However, since an ectopic pregnancy can be life-threatening to the mother, it is important that you seek medical assistance immediately as soon as you have any concerns about your pregnancy, even if you aren’t sure you are pregnant.

Resources: www.miscarriageassociation.org.uk

Medical disclaimer: This website does not provide medical advice. All information contained in this website is for informational purposes only. No material on this website is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified medical provider with any questions you may have about any medical condition or concerns. Never disregard medical advice or delay treatment because of something you read on this website.