Ectopic Pregnancy

An ectopic pregnancy is a serious condition that occurs when the embryo implants outside the uterus, such as in one of the fallopian tubes.

This happens very rarely, in about 2% of naturally conceived pregnancies, but medical attention is needed immediately when it does happen. It can be scary and sad to go through, and the loss may take some time to cope with emotionally. Thankfully, most women who experience an ectopic pregnancy are able to have a healthy pregnancy in the future.

What happens in a normal pregnancy

To get pregnant, an egg is ovulated from the ovary. The fallopian tube then picks it up and carries it to the mid portion of the tube by a series of fibers that sweep the egg. Sperm then meets and fertilizes the egg, which then forms an embryo. An embryo typically grows in the tube for the next week or so, after which time the fibers transport the embryo like a conveyer belt to the uterus. The embryo then implants in the uterus, forming a normal pregnancy.

What happens in an ectopic pregnancy

An ectopic pregnancy is any pregnancy that implants outside the uterus, most often in the fallopian tubes. In many cases, this results from a failure of the tube to move the embryo to the uterus like it should. This is usually due to damage or constriction to the fallopian tubes, when this “conveyer belt” system is not working perfectly.

Ectopic pregnancies are even possible with in vitro fertilization (IVF), with about 1.5% of all IVF pregnancies in the U.S. diagnosed as ectopic.

Signs/symptoms of an ectopic pregnancy

Early signs of an ectopic pregnancy may be an abnormal rise in the pregnancy hormone, hCG. Some women will have a mild discomfort in the pelvis, often located to one side. Many women in the later stages of an ectopic pregnancy may experience abdominal pain and vaginal bleeding. Your doctor may suspect an ectopic pregnancy by an abnormal rise in pregnancy hormone or diagnose it by ultrasound.  Most ectopic pregnancies are evident by five to eight weeks of gestation.

How to treat an ectopic pregnancy

How doctors treat an ectopic pregnancy depends on how advanced the pregnancy is within the fallopian tube. An ectopic pregnancy that continues to grow can ultimately rupture, which can lead to life threatening levels of blood loss and is therefore a surgical emergency.

For many moderate to large sized ectopic pregnancies, surgical removal of the fallopian tube containing the pregnancy is a preferred method to avoid the possibility of tubal rupture.  This is usually performed by an out patient laparoscopy.

In cases that are diagnosed earlier, patients can take medicine known as Methotrexate.  This medicine stops rapidly dividing cells and will in many cases halt the development of the ectopic pregnancy, thus avoiding the need for surgery. Close monitoring with ongoing blood draws is needed with this approach to help resolve the ectopic pregnancy. It is essential that women who take Methotrexate stop all vitamins and supplements with folic acid and any B vitamins. Most clinicians generally recommend waiting several months after Methotrexate before attempting pregnancy.

Thankfully, most women who experience an ectopic pregnancy are ultimately able to achieve a viable pregnancy in the future. If multiple ectopic pregnancies have occurred or if bilateral fallopian tube damage is documented, in vitro fertilization is often used to help achieve a pregnancy.

If you have any signs or symptoms associated with ectopic pregnancies, it is strongly advised that you contact your physician or seek emergency care immediately. Please call Fertility Associates of Memphis at 901-747-2229 if you have questions.