Have you ever heard of ectopic pregnancy? In a normal pregnancy, the egg is fertilized by the sperm in a fallopian tube. The fertilized egg then travels through the fallopian tubes to the uterus, over the course of three or four days. The fertilized egg implants in the uterus and grows, over time, into a baby.
In one to two percent of all conceptions, the fertilized egg will implant outside the uterus, sometimes in a fallopian tube, more rarely in the cervix, ovary or even in the abdomen. This is an ectopic pregnancy, and is extremely dangerous for the woman. It isn’t possible to carry a baby outside the uterus in almost all cases, and is never possible when the egg implants in a fallopian tube.
What causes an ectopic pregnancy? Are you at risk? What are the symptoms?
Causes of Ectopic Pregnancy
The majority of ectopic pregnancies occur in the fallopian tubes, when the tubes are blocked in some way and the early embryo can’t travel down to the uterus. Fifty percent of ectopic pregnancies are associated with some kind of damage to the tubes, according to the American Society for Reproductive Medicine (ASRM.) Fallopian tube damage commonly results from prior pelvic infections, such as gonorrhea, chlamydia or other sexually transmitted diseases. It may also result from endometriosis, appendicitis or previous pelvic surgery.
Women who conceive after having had their tubes tied (tubal ligation), reversal of tubal ligation or any other tubal surgery have a higher risk of ectopic pregnancy. Women who are having fertility treatment with fertility drugs have a slightly higher than normal risk of ectopic pregnancy, according to ASRM. Other risk factors for ectopic pregnancy are being over age 35, having had a previous ectopic pregnancy, and getting pregnant while having an intrauterine device (IUD.)
Symptoms of Ectopic Pregnancy
In the early stages you may have the usual early pregnancy symptoms such as breast tenderness and nausea. Other symptoms include:
• Lower back pain
• Abnormal vaginal bleeding
• Mild cramping on one side of the pelvis
• Pain in the lower belly or pubic area
• Delayed or abnormal menstruation
If you know or suspect you are pregnant and experience any of these symptoms, call your doctor immediately, even if they lessen or go away. Your doctor can order tests to measure the level of hCG, a hormone produced by the placenta, in your blood. An ultrasound of your uterus may also be performed to look for a pregnancy inside your uterus. These tests can help your physician find an ectopic pregnancy early on before it causes a rupture and internal bleeding. Your life could be in danger if that happens.
Fortunately, in recent years most ectopic pregnancies are discovered early on, even before the patient is aware there is a problem, thanks to the use of sensitive hormonal testing and ultrasound examinations. Ectopic pregnancies require emergency treatment to prevent the woman’s life from being endangered. The embryo has to be removed, terminating the pregnancy. In extremely rare cases where the embryo has implanted in the abdomen it may be possible for a baby to be born, but in virtually all cases the embryo cannot grow into a baby and the woman will die if it is not removed.
The good news is over half of women who’ve had an ectopic pregnancy will have a normal pregnancy in the future. Since an ectopic pregnancy is often due to tubal damage, your doctor may recommend you see a reproductive endocrinologist and have IVF treatment to increase your chances of getting pregnant.