Ectopic pregnancy occurs when implantation takes place outside of the endometrial lining. In the majority of cases, it occurs in the fallopian tube, which is why it is often referred to as a tubal pregnancy. However, an ectopic pregnancy may also implant in the ovary, cervix, abdominal cavity, or cornual portion of the uterus (close to the fallopian tubes).

Unfortunately, pregnancy implantation must occur in the endometrium of the uterus for a pregnancy to safely continue. Allowing a pregnancy to progress in the fallopian tube or other ectopic site will result in tubal or other rupture in the first trimester, unavoidable fetal death, and potential maternal death. If you are diagnosed with an ectopic pregnancy, it will need to be surgically removed or treated with the drug methotrexate. Early treatment can preserve your fertility for subsequent pregnancies.

Women who have had previous ectopic pregnancies, who become pregnant with an IUD contraceptive device in place, who have a history of endometriosis and/or pelvic inflammatory disease (PID), and who have had a tubal ligation procedure are at a higher risk for ectopic pregnancy. The March of Dimes estimates that one in 50 pregnancies are ectopic.

Early signs of ectopic pregnancy include low hCG levels or abnormally rising hCG levels (hCG should approximately double every two days in a normal pregnancy), abdominal pain, and irregular bleeding. An abdominal or transvaginal ultrasound can usually confirm the diagnosis. If it remains undiagnosed, ectopic pregnancy is potentially life-threatening and can endanger future fertility.

Warning signs that an undetected ectopic pregnancy may have ruptured include:

• Severe abdominal and/or pelvic pain

• Vaginal bleeding

• Dizziness

• Shoulder pain

• Nausea and vomiting

If you experience any of these symptoms, seek medical care immediately.