Ectopic pregnancy : London Health

Ectopic pregnancies occur when a fertilised egg is implanted and starts to develop outside of the womb; in 95 percent of cases, the egg becomes implanted in the fallopian tubes. Ectopic pregnancies are very rare; they only affect 1 percent of pregnancies. Ectopic pregnancies can be very serious and potentially life-threatening so they should always be treated as quickly as possible.

What causes an ectopic pregnancy?

An ectopic pregnancy usually occurs when the fertilised egg remains in the fallopian tubes, rather than being pushed down into the womb; this usually happens when the tubes are damaged. Ectopic pregnancies may also occur in the ovary and cervix but these are much rarer. There are a number of risk factors which may increase the likelihood of having an ectopic pregnancy; these include:

  • Pelvic inflammatory disease (PID); 50 percent of women that have ectopic pregnancies have this condition
  • Having an IUD (intrauterine device) or using the mini pill: having an IUD (a coil) prevents pregnancy in most cases but if a woman does fall pregnant it increases the chance of an ectopic pregnancy
  • Natural abnormality in the fallopian tube such as a kink
  • Smoking
  • Previous surgical procedures involving the abdomen, including caesarean sections
  • Previous surgical procedures on the fallopian tubes
  • Previous ectopic pregnancy: this increases the chances of having another ectopic pregnancy by 10 percent

Symptoms of ectopic pregnancy

Initially, many of the symptoms of an ectopic pregnancy are similar to those of a normal pregnancy and include a missed period, tenderness in the breasts and feeling nauseous. However, ectopic pregnancies also cause other symptoms which can be very serious; these usually develop between weeks 4 and 10 of the pregnancy and include:

  • Severe abdominal pain, which may be experienced on only one side of the abdomen
  • Bleeding from the vagina
  • Pain at the shoulder tip (where the shoulder joins the arm)
  • Pain during urination
  • The ‘collapse’: this is potentially very serious and is characterised by feeling faint and dizzy and experiencing a racing heartbeat, diarrhoea and heavy bleeding.

Patients experiencing any of the symptoms above should seek medical help; you should contact the emergency services if you experience ‘the collapse’; in rare cases, it can be fatal as it can cause widespread internal bleeding.

Treatment

If the fallopian tubes have been ruptured surgery must be carried out as quickly as possible. If the pregnancy has been diagnosed prior to the fallopian tubes rupturing, there are different treatments available; these usually involve medication or surgery; medication is used to kill the cells associated with the ectopic pregnancy and then the embryo can be removed by means of surgery.

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