Ectopic pregnancy: Causes, symptoms and treatment

ectopic pregnancy

by Emily Gilbert |
Updated on

Pregnancy can be a remarkable experience filled with anticipation, hope, and the promise of new life. Sadly for some parents, this journey can end as a result of what is known as an ectopic pregnancy. Scroll down to find out more about this condition including symptoms to look out for and treatment options.

What is an ectopic pregnancy?

An ectopic pregnancy is when a fertilised egg implants itself outside of the womb – often in one of the fallopian tubes. It affects about one in 80 pregnancies.

"Ectopic means 'an out-of-place pregnancy’," says Alex Peace-Gadsby, chairman of the Ectopic Pregnancy Trust, a charity that provides information and support for those affected by the condition.

Normally, an egg is released each month from the ovaries. If fertilised by the sperm, it will travel down the fallopian tube and implant itself into the wall of the uterus, where it will eventually develop into an embryo.

"But in an ectopic pregnancy, the fertilised egg implants elsewhere – sometimes in the fallopian tube and sometimes outside of the uterus, in the cervix and in the abdomen," says Alex. "The baby continues to grow inside the tube where it can cause the tube to burst or otherwise severely damage it."

Symptoms of ectopic pregnancy

An ectopic pregnancy is most likely to be discovered when you’re between five and 10 weeks pregnant. Most women experience symptoms as early as four weeks pregnant and up to 12 weeks or even later.

Symptoms of an ectopic pregnancy can be tricky to pick up because they can present as other problems such as gastroenteritis, miscarriage or even appendicitis.

"It may feel like period pains. Or it may feel like you're having a miscarriage, with cramping and slight bleeding. Symptoms may come and go, or you may not even feel any symptoms during the early stages," says Alex.

Common symptoms include one-sided pain in the belly, brown discharge and vaginal bleeding different to your normal period. This might be darker or brighter and occasionally stop and resume.

You may feel light-headed, dizziness or actually faint. This is often accompanied by sickness. You should seek emergency medical treatment as this is the most serious symptom. Symptoms of rupture include dizziness, increased heart rate, pale skin and sharp pain in the tummy.

What are the causes of an ectopic pregnancy?

Anyone can have an ectopic pregnancy, but it tends to occur more frequently in women affected by the following:

Pelvic inflammatory disease – An infection of the fallopian tubes often caused by sexually transmitted disease such as chlamydia.

Endometriosis – When the lining of the womb grows elsewhere in the body, but continues to bleed as a menstrual cycle each month. It can damage fallopian tubes.

• Abdominal or tubal surgery – Such as a Caesarean section or operation on your tubes.

• Contraceptive coil – It can prevent a fertilised egg implanting in the uterus, but may not stop one in the fallopian tubes.

• Older age - Those of an older age have an increased risk of an ectopic pregnancy.

• Previous ectopic pregnancy – If you’ve had one ectopic pregnancy, it can increase your chances of further ectopic pregnancies.

• Smoking – Research by the University of Edinburgh showed that smokers have an increased level of protein, which can hinder the progress of a fertilised egg down the fallopian tubes.

How is an ectopic pregnancy diagnosed?

If you have felt faint or experienced any abdominal pain or bleeding, don’t hesitate to contact a doctor immediately. "If your instincts are screaming at you that something doesn’t feel right, it’s OK to trust them and ask for a reassessment at any time," says Alex.

Doctors will carry out various tests, including urinary pregnancy tests (as it’s often so early on that you might not even realise you’re pregnant), ultrasound scans and blood tests.

This is to try and identify where the embryo has implanted and whether the pregnancy is viable. The doctor will then advise you to help make a decision about what will happen next.

Why a speedy diagnosis of ectopic pregnancy is vital

Appropriate referrals, speedy investigations and early diagnosis are all vital for helping to improve care and potentially save lives. While uncommon, if an ectopic pregnancy is left undiagnosed, it can cause bleeding and pain and can be fatal.

"Experiencing an ectopic pregnancy is a very frightening and distressing experience for those affected and their families. Prompt diagnosis reduces distress levels, enables women and people to have treatment options, can preserve fertility and saves lives," says Alex.

Ectopic pregnancy treatment

Sadly, if it’s discovered that you have an ectopic pregnancy, it means the baby cannot be saved.

The most established form of treatment for ectopic pregnancy is called surgical management. This involves performing an operation to remove the ectopic pregnancy while you are under general anaesthetic.

"There are then two courses of action for the surgeon and the one chosen will depend upon the damage to the affected tube and the condition of the other tube," says Alex. "If there is a lot of damage or bleeding, the affected tube will be removed (salpingectomy). If the damage is minimal, then the ectopic pregnancy can be removed from the tube by making a small cut, leaving the tube intact (salpingotomy)."

If your ectopic pregnancy is diagnosed early on, you may instead be offered a drug called methotrexate. This works by stopping the growth of the embryo, but is only suitable if your pregnancy hormone levels are still quite low (levels rise the further into your pregnancy you get). This treatment means you may avoid surgery and potentially save your fallopian tube, as you experience bleeding and the embryo leaves the body through the vagina.

Trying to conceive after an ectopic pregnancy

Women are usually advised to wait three months (or two full menstrual cycles) before trying for another baby. This allows any internal inflammation and bruising from the ectopic pregnancy and any associated treatment to heal. You may also need time to process the loss of your pregnancy and work through your grief – something that shouldn’t be rushed.

"Statistically, the chances of having a future successful pregnancy are very good and 65% of women are healthily pregnant within 18 months of an ectopic pregnancy," says Alex. "Some studies suggest this figure rises to around 85% over 2 years."

If you or someone you know has been affected by an ectopic pregnancy, contact The Ectopic Pregnancy Trust.

About the expert

The Ectopic Pregnancy Trust is a small, niche UK-based charity, with extensive reach and punching above its weight to raise awareness of ectopic pregnancy and provide information and support to those affected by the condition

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