An ectopic pregnancy is detected if the fetal egg attaches outside the uterine mucosa (most often in a fallopian tube) in the first weeks after conception.
Such cases account for 2% of all pregnancies.
An ectopic pregnancy can be suspected if:
- your period is late
- the pregnancy test is positive, but one of the two lines is pale
- a blood test for hCG has shown a result below the norm for the current period
Later signs of ectopic pregnancy include pain in the pelvic area, spotting, and nausea. These symptoms can be confused with the symptoms of approaching menstruation.
A combination of these symptoms should put you on high alert, and we urge you to consult a doctor immediately.
In the case of an ectopic pregnancy, spontaneous miscarriage is very unlikely. If the miscarriage does happen, it is accompanied by bleeding and requires hospitalization.
The chance that the pregnancy will move to the uterus is very small. You can wait for it to happen only in a hospital under medical supervision, provided that a steady increase of hCG is observed every day.
Otherwise, laparoscopy will be prescribed to end the pregnancy and keep the fallopian tube, if possible.
In 98−99% of ectopic pregnancies, the fetal egg settles in a fallopian tube, the same place where fertilization usually takes place.
Other ectopic pregnancy types — ovarian, cervical, abdominal — account for the remaining 1−2%.
Most often, such a pregnancy occurs for no apparent reason and is always unexpected, but doctors can still distinguish the high-risk group.
An ectopic pregnancy is more likely to develop if the woman:
- had an inflammatory disease of the pelvic organs
- had one or more ectopic pregnancies and/or surgery on the fallopian tubes
- is using intrauterine contraception (IUD) and sterilization
- is older than 40 years
- smokes more than 20 cigarettes a day
The abnormal (pathological) sperm of the partner can also provoke an ectopic pregnancy.
An ectopic pregnancy always requires removal, either medical or surgical.
If it is discovered in early pregnancy, the embryo is smaller than 1.37 in (3.5 cm), the tube is not damaged, the fetal heartbeat is absent, the patient is not experiencing severe pain and is ready for the subsequent observation, and methotrexate therapy may be prescribed.
The medication inhibits the growth of embryonic cells and the development of the pregnancy.
In other cases, pregnancy is ended by surgery. During a laparoscopy to remove the fertilized egg, most doctors will try to keep the tube, but it’s not always possible.
If bleeding needs to be stopped quickly, a laparotomy — a procedure involving an abdominal incision — is performed.
The chances of subsequent conception with one fallopian tube are still high (about 60%).
To recover from an ectopic pregnancy, you should:
- limit the amount of physical activity for 2 months
- abstain from sex for about 1 month
- not get pregnant within 3 months. It’s recommended that you take oral contraceptives, which also help restore the hormonal balance
- undergo physiotherapy (for example, magnetic therapy or paraffin wax treatment) and doctor-prescribed medications to prevent adhesions
- You should take tests for sexually transmitted infections, herpes simplex virus, and human papillomavirus.
- Your partner should undergo a semen analysis, as pathological sperm are a frequent cause of ectopic pregnancies.
If you’re diagnosed with ectopic pregnancy, the chance that the pregnancy will move to the uterus is very small. The most important thing here is to recover from it, eliminate possible ectopic pregnancy causes and try to get pregnant again when the time comes. Your partner’s support is key here, so don’t be afraid to share your feelings and worries.