Ectopic Pregnancy

An ectopic pregnancy is one that occurs outside the uterus. Because the pregnancy is not in the uterus, it cannot progress normally and must be removed. About 1 in 60 pregnancies are ectopic. Usually the pregancy is in a fallopian tube. A ruptured tubal pregnancy will cause major bleeding into the abdomen and can even cause death. The symptoms are typically pelvic pain (usually a sharp pain on one side) and vaginal bleeding. If the tube has ruptured, there may be shoulder pain, dizziness, or fainting. Since there may not be much warning, you should call your doctor or midwife if you have pain or bleeding.

The treatment for an ectopic pregnancy varies according to how early the problem is found. Sometimes the pregnancy can be removed from the tube using a laproscope. This will preserve the tube for later use.

If the pregnancy is larger, or the tube has ruptured, a larger incision will need to be made. This is called a laparotomy. The pregnancy may be removed from the tube, or the tube may need to be removed.

Sometimes a drug (methotrexate) may be given to stop the growth of the pregnancy. Your body will absorb the tissue over time. The progression of the treatment is monitored by blood tests.

You are at increased risk of an ectopic pregnancy if:

• You have already had an ectopic pregnancy.
• You have a history of pelvic inflammatory disease (PID) or pelvic infections.
• You have a history of infertility.
• You have had pelvic surgeries.
• You have a history of endometriosis.

Symptoms and Diagnosing
You should call your doctor or midwife if you think you may be pregnant and have the following symptoms:

• Vaginal bleeding - may be lighter or heavier than your normal menstrual bleeding.
• Abdominal pain - it will usually occur on one side of your abdomen. It may be a continual, sharp pain, or it may be intermittent (come and go).
• Shoulder pain - this is caused by the blood accumulating in your abdomen under the diaphragm. It suggests a ruptured ectopic pregnancy and you should call your doctor or midwife immediately.
• Weakness, dizziness, or fainting.

Your doctor or midwife will follow you with blood tests and ultrasound if an ectopic pregnancy is suspected. It is imperative not to delay care as a ruptured ectopic pregnancy can lead to death.

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