Ectopic pregnancy is defined as a pregnancy that occurs in an abnormal place (in other words, the fertilized egg is implanted outside the uterus). More than 90 percent of all ectopic pregnancies occur in the fallopian tube. Therefore, the more common name for this early pregnancy loss is called a “tubal pregnancy.” Other locations of ectopic pregnancies can be the cervix, the ovary, the abdomen, or the cornua (the portion of the uterus where the fallopian tubes enter) of the uterus.
This type of pregnancy is the leading cause of death for women in the first trimester. The warning signs can seem like other pregnancy losses, but include: bleeding from the vagina, abdominal pain or tenderness, shoulder pain, and/or weakness or dizziness. If you experience any of these, you should contact your doctor or midwife immediately to seek treatment.
Types of ectopic pregnancies
Testing for ectopic pregnancy is difficult, because the answers are not always clear-cut, nor are they always available right away. Your hCG levels may be tested to check the rate of rise — they normally double about every two days in a normal pregnancy, but if the pregnancy is ectopic hCG levels may rise more slowly — though this alone is not an indicator of an ectopic pregnancy.
Ultrasound is frequently used, along with vaginal ultrasound, to try to visualize the pregnancy. If a uterine pregnancy is confirmed then the chance of ectopic pregnancy is low. Sometimes it is too early to diagnose an ectopic via ultrasound, and the exam will have to be repeated later. If an ectopic pregnancy is visualized then you will proceed to treatment options available depending upon your situation.Treatment
Sometimes in urgent situations a laparoscopy procedure will be done to provide diagnosis and treatment. This is done in an operating room as surgery. Treatment for an ectopic pregnancy will always end the pregnancy. Unfortunately, there is no way to continue a pregnancy in these locations. Doctors do not yet have the technology to move the pregnancy to a viable location.
There are two main types of treatment for ectopic pregnancies: chemical and surgical. Chemical treatment is done with a drug called methotrexate. It is used in nonurgent cases to dissolve the pregnancy without harming the tubes and other organs. Repeat hCG level tests will be taken to ensure that the pregnancy is dissolving and that further treatment is not needed.
Surgery is usually done in cases that are further along in their pregnancy or have another medical reason to not use the chemical process. It may be necessary, especially when the tube ruptures or there is other damage. Sometimes the woman will lose her tube and possibly her uterus if the bleeding can't be stopped.
Some factors that increase your chance of having an ectopic pregnancy include:
Pelvic Inflammatory Disease (PID) or salpingitis
Previous ectopic pregnancies
Previous pelvic or abdominal surgery
Previous tubal ligation
Intrauterine device (IUD) in place