Understanding Ectopic Pregnancy
In a normal pregnancy, the fertilized egg implants and develops in the uterus. In an ectopic pregnancy, the egg implants somewhere other than the uterus — often, in the fallopian tubes, which is why ectopic pregnancies are commonly called "tubal pregnancies."
The egg also can implant in the ovary, abdomen, or the cervix. None of these areas has the right space or nurturing tissue for a pregnancy to develop. As the fetus grows, it will eventually burst the organ that contains it, which can cause severe bleeding and endanger the mother's life.
A classical ectopic pregnancy does not develop into a live birth. Early diagnosis and treatment are essential for the mother's health and safety.
What Is an Ectopic Pregnancy?
In a normal pregnancy, the fertilized egg implants and develops in the uterus. In an ectopic pregnancy, the egg implants somewhere other than the uterus.
In a normal pregnancy, the fertilized egg implants and develops in the uterus. In an ectopic pregnancy, the egg implants somewhere other than the uterus — often, in the fallopian tubes. This is why ectopic pregnancies are commonly called "tubal pregnancies."
The egg also can implant in the ovary, abdomen, or the cervix.
None of these areas has the right space or nurturing tissue for a pregnancy to develop. As the fetus grows, it will eventually burst the organ that contains it. This can cause severe bleeding and endanger the mother's life.
A classical ectopic pregnancy does not develop into a live birth.
What Are the Signs & Symptoms of an Ectopic Pregnancy?
Ectopic pregnancy can be hard to diagnose because symptoms often are like those of a normal early pregnancy.
Ectopic pregnancy can be hard to diagnose because symptoms often are like those of a normal early pregnancy. These can include missed periods, breast tenderness, nausea, vomiting, tiredness, or frequent urination (peeing).
Often, the first warning signs of an ectopic pregnancy are pain or vaginal bleeding. There might be pain in the pelvis, abdomen, or even the shoulder or neck (if blood from a ruptured ectopic pregnancy builds up and irritates certain nerves).
The pain can range from mild and dull to severe and sharp. It might be felt on just one side of the pelvis or all over.
These symptoms also might happen with an ectopic pregnancy: vaginal spotting, dizziness or fainting (caused by blood loss), low blood pressure (also caused by blood loss), and lower back pain.
What Causes an Ectopic Pregnancy?
An ectopic pregnancy usually happens because a fertilized egg couldn't quickly move down the fallopian tube into the uterus.
An ectopic pregnancy usually happens because a fertilized egg couldn't quickly move down the fallopian tube into the uterus. The tube can get blocked from an infection or inflammation.
The tube can get blocked from pelvic inflammatory disease (PID), endometriosis (when cells from the lining of the uterus implant and grow elsewhere in the body), scar tissue from previous abdominal or fallopian surgeries, or rarely, birth defects that changed the shape of the tube.
Risk Factors Include:
- Pelvic inflammatory disease (PID)
- Endometriosis
- Scar tissue from previous abdominal or fallopian surgeries
- Birth defects that changed the shape of the tube
How Is an Ectopic Pregnancy Diagnosed?
If a woman might have an ectopic pregnancy, her doctor may do an ultrasound to see where the developing fetus is.
If a woman might have an ectopic pregnancy, her doctor may do an ultrasound to see where the developing fetus is. Often, pregnancies are too small to see on ultrasound until more than 5 or 6 weeks after a woman's last menstrual period.
If an external ultrasound can't show the pregnancy, the doctor might do the test with a wand-like device in the vagina.
A woman might need testing every few days if the first tests can't confirm or rule out an ectopic pregnancy.
How Is an Ectopic Pregnancy Treated?
How doctors treat an ectopic pregnancy depends on things like the size and location of the pregnancy.
How doctors treat an ectopic pregnancy depends on things like the size and location of the pregnancy.
Sometimes they can treat an early ectopic pregnancy with an injection of methotrexate, which stops the growth of the embryo. The tissue usually is then absorbed by the woman's body.
If the pregnancy is farther along, doctors usually need to do surgery to remove the abnormal pregnancy.
Whatever treatment she gets, a woman will see her doctor regularly afterward to make sure her pregnancy hormone levels return to zero. This may take several weeks. An elevated level could mean that some ectopic tissue was missed. If so, she might need more methotrexate or surgery.
What About Future Pregnancies?
Most women who have had an ectopic pregnancy can have normal pregnancies in the future.
Most women who have had an ectopic pregnancy can have normal pregnancies in the future. Having had one ectopic pregnancy does increase a woman's risk of having another one.
It's important to talk to your healthcare provider about your future pregnancy plans and any increased risks.
Who Is at Risk for Ectopic Pregnancy?
Any woman can have an ectopic pregnancy, but the risk is higher for certain groups:
Age
Women older than 35 have a higher risk of ectopic pregnancy.
Pelvic Inflammatory Disease
PID, often caused by sexually transmitted infections, can damage fallopian tubes.
Previous Ectopic Pregnancy
Having had one ectopic pregnancy increases the risk of having another.
Surgery on Fallopian Tubes
Previous surgery on a fallopian tube increases the risk.
Infertility Treatments
Infertility problems or medicine to stimulate ovulation can increase risk.
Smoking
Smoking increases the risk of ectopic pregnancy.
IUD Use
Those who become pregnant while using an intrauterine device (IUD) might be more likely to have an ectopic pregnancy.
Multiple Sexual Partners
Having multiple sexual partners increases the risk of infections that can lead to PID.
Note: Some birth control methods also can affect a woman's risk of ectopic pregnancy. Those who become pregnant while using an intrauterine device (IUD) might be more likely to have an ectopic pregnancy. Smoking and having multiple sexual partners also increase the risk of an ectopic pregnancy.
When Should I Call the Doctor?
Before Pregnancy: If you believe you're at risk for an ectopic pregnancy, meet with your doctor to talk about your options before you become pregnant.
During Pregnancy: If you are pregnant and have any concerns about the pregnancy being ectopic, talk to your doctor — it's important to find it early. Your doctor might want to check your hormone levels or schedule an early ultrasound to ensure that your pregnancy is developing normally.
Emergency: Call your doctor right away if you're pregnant and having any pain, bleeding, or other symptoms of ectopic pregnancy.
Frequently Asked Questions
What is an ectopic pregnancy?
In a normal pregnancy, the fertilized egg implants and develops in the uterus. In an ectopic pregnancy, the egg implants somewhere other than the uterus — often, in the fallopian tubes. This is why ectopic pregnancies are commonly called "tubal pregnancies." The egg also can implant in the ovary, abdomen, or the cervix. None of these areas has the right space or nurturing tissue for a pregnancy to develop, and a classical ectopic pregnancy does not develop into a live birth.
What are the symptoms of an ectopic pregnancy?
Ectopic pregnancy can be hard to diagnose because symptoms often are like those of a normal early pregnancy, including missed periods, breast tenderness, nausea, vomiting, tiredness, or frequent urination. Often, the first warning signs are pain or vaginal bleeding. There might be pain in the pelvis, abdomen, or even the shoulder or neck. Other symptoms can include vaginal spotting, dizziness or fainting, low blood pressure, and lower back pain.
What causes an ectopic pregnancy?
An ectopic pregnancy usually happens because a fertilized egg couldn't quickly move down the fallopian tube into the uterus. The tube can get blocked from an infection or inflammation, such as pelvic inflammatory disease (PID), endometriosis, scar tissue from previous surgeries, or rarely, birth defects that changed the shape of the tube.
How is an ectopic pregnancy diagnosed?
If a woman might have an ectopic pregnancy, her doctor may do an ultrasound to see where the developing fetus is. Often, pregnancies are too small to see on ultrasound until more than 5 or 6 weeks after a woman's last menstrual period. If an external ultrasound can't show the pregnancy, the doctor might do the test with a wand-like device in the vagina. A woman might need testing every few days if the first tests can't confirm or rule out an ectopic pregnancy.
How is an ectopic pregnancy treated?
Treatment depends on the size and location of the pregnancy. Sometimes doctors can treat an early ectopic pregnancy with an injection of methotrexate, which stops the growth of the embryo. If the pregnancy is farther along, doctors usually need to do surgery to remove the abnormal pregnancy. After treatment, a woman will see her doctor regularly to make sure her pregnancy hormone levels return to zero.
Can I have a normal pregnancy after an ectopic pregnancy?
Most women who have had an ectopic pregnancy can have normal pregnancies in the future. However, having had one ectopic pregnancy does increase a woman's risk of having another one. It's important to talk to your healthcare provider about your future pregnancy plans.
Who is at risk for ectopic pregnancy?
Any woman can have an ectopic pregnancy, but the risk is higher for women who are older than 35 and those who have had PID, a previous ectopic pregnancy, surgery on a fallopian tube, or infertility problems. Those who become pregnant while using an IUD, who smoke, or who have multiple sexual partners also have an increased risk.
When should I call the doctor?
If you believe you're at risk for an ectopic pregnancy, meet with your doctor to talk about your options before you become pregnant. If you are pregnant and have any concerns about the pregnancy being ectopic, talk to your doctor — it's important to find it early. Call your doctor right away if you're pregnant and having any pain, bleeding, or other symptoms of ectopic pregnancy.
Key Takeaways
Early Detection Is Critical
Ectopic pregnancies cannot develop into live births and can be life-threatening if not treated promptly. Early diagnosis and treatment are essential.
Recognize the Symptoms
Pain, vaginal bleeding, dizziness, and shoulder pain are warning signs. If you're pregnant and experience these symptoms, seek medical attention immediately.
Diagnosis Methods
Ultrasound and pregnancy hormone testing are used to diagnose ectopic pregnancy. Early testing may need to be repeated to confirm.
Future Pregnancies Possible
Most women can have normal pregnancies after an ectopic pregnancy, though the risk of another ectopic pregnancy is increased.
Important Medical Disclaimer
The information provided on this page is for educational purposes only and should not replace professional medical advice, diagnosis, or treatment. Always consult with your healthcare provider or obstetrician for personalized guidance regarding ectopic pregnancy, pregnancy concerns, and any questions you may have.
Ectopic pregnancy is a medical emergency. If you are pregnant and experiencing pain, bleeding, dizziness, or other concerning symptoms, seek immediate medical attention. Early diagnosis and treatment are essential for your health and safety.