Learn About Ectopic Pregnancy

What is the definition of Ectopic Pregnancy?

An ectopic pregnancy is a pregnancy that occurs outside the womb (uterus).

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What are the alternative names for Ectopic Pregnancy?

Tubal pregnancy; Cervical pregnancy; Tubal ligation - ectopic pregnancy

What are the causes of Ectopic Pregnancy?

In most pregnancies, the fertilized egg travels through the fallopian tube to the womb (uterus). If the movement of the egg is blocked or slowed through the tubes, it can lead to an ectopic pregnancy. Things that may cause this problem include:

  • Birth defect in the fallopian tubes
  • Scarring after a ruptured appendix
  • Endometriosis
  • Having had an ectopic pregnancy in the past
  • Scarring from past infections or surgery of the female organs

The following also increase risk for an ectopic pregnancy:

  • Age over 35
  • Getting pregnant while having an intrauterine device (IUD)
  • Having your tubes tied
  • Having had surgery to untie tubes to become pregnant
  • Having had many sexual partners
  • Sexually transmitted infections (STI)
  • Some infertility treatments

Sometimes, the cause is not known. Hormones may play a role.

The most common site for an ectopic pregnancy is the fallopian tube. In rare cases, this can occur in the ovary, abdomen, or cervix.

An ectopic pregnancy can occur even if you use birth control.

What are the symptoms of Ectopic Pregnancy?

Symptoms of ectopic pregnancy may include:

  • Abnormal vaginal bleeding
  • Mild cramping on one side of the pelvis
  • No periods
  • Pain in the lower belly or pelvic area

If the area around the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include:

  • Fainting or feeling faint
  • Intense pressure in the rectum
  • Low blood pressure
  • Pain in the shoulder area
  • Severe, sharp, and sudden pain in the lower abdomen
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What are the current treatments for Ectopic Pregnancy?

Ectopic pregnancy may be life threatening. The pregnancy cannot continue to birth (term).  Effective treatment requires either medical treatment to end the pregnancy or surgical removal of the pregnancy.

If the ectopic pregnancy has not ruptured, treatment may include:

  • Surgery
  • Medicine that ends the pregnancy, along with close monitoring by your doctor

You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to bleeding and shock. Treatment for shock may include:

  • Blood transfusion
  • Fluids given through a vein
  • Keeping warm
  • Oxygen
  • Raising the legs

If there is a rupture, surgery is done to stop blood loss and remove the pregnancy. In some cases, the doctor may have to remove the fallopian tube.

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What is the outlook (prognosis) for Ectopic Pregnancy?

If diagnosed early, treatment is very effective. It's important to seek early care whenever you believe you may be pregnant so your provider may determine the location of the pregnancy.

One out of three women who have had one ectopic pregnancy can have a baby in the future. Another ectopic pregnancy is more likely to occur. Some women do not become pregnant again.

The likelihood of a successful pregnancy after an ectopic pregnancy depends on:

  • The woman's age
  • Whether she has already had children
  • Why the first ectopic pregnancy occurred
  • The health of her fallopian tubes
When should I contact a medical professional for Ectopic Pregnancy?

Contact your provider if you have:

  • Abnormal vaginal bleeding
  • Lower abdominal or pelvic pain or
  • Suspect you might be pregnant
How do I prevent Ectopic Pregnancy?

Most forms of ectopic pregnancy that occur outside the fallopian tubes are probably not preventable. You may be able to reduce your risk by avoiding conditions that may scar the fallopian tubes. These steps include:

  • Practicing safer sex by taking steps before and during sex, which can prevent you from getting an infection
  • Getting early diagnosis and treatment of all STIs
  • Stopping smoking
Pelvic laparoscopy
Ultrasound in pregnancy
Female reproductive anatomy
Uterus
Ultrasound, normal fetus - foot
Ectopic pregnancy
What are the latest Ectopic Pregnancy Clinical Trials?
Modified Downregulation for Women With Adenomyosis of the Uterus Prior to Frozen-thawed Embryo Transfer.

Summary: 1 in 7 couples experience difficulty in conceiving. Many will require in vitro fertilization (IVF). IVF involves an initial period of downregulation to suppress the ovaries and prevent premature ovulation. Hormone injections are then used to stimulate a woman's ovaries to produce eggs which are removed by a minor operation. The harvested eggs are mixed with sperm to create embryos in the laborator...

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The Effect of the Education Provided to Reproductive Age Women on the Prevention of Sexually Transmitted Diseases With the Teach Beck Method on Their Behaviors

Summary: Sexually transmitted infections (STIs) are an important public health problem as they affect more than 1 million people worldwide every day. The extent of sexually transmitted diseases is still unknown due to underreporting, underdiagnosis or asymptomatic course of these diseases. When the literature is examined, it is seen that the incidence of STD has increased in recent years. The prevalence of...

What are the Latest Advances for Ectopic Pregnancy?
Laparoscopic myomectomy to facilitate laparoscopic resection of a bleeding interstitial ectopic pregnancy.
Clinical analysis of high-intensity focused ultrasound (HIFU) combined with hysteroscopy-guided suction curettage (HGSC) in patients with cervical pregnancy.
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Restoring tubal patency with laparoscopic tubocornual anastomosis.
Who are the sources who wrote this article ?

Published Date: January 10, 2022
Published By: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Alur-Gupta S, Cooney LG, Senapati S, Sammel MD, Barnhart KT. Two-dose versus single-dose methotrexate for treatment of ectopic pregnancy: a meta-analysis. Am J Obstet Gynecol. 2019;221(2):95-108.e2. PMID: 30629908 pubmed.ncbi.nlm.nih.gov/30629908/.

Henn MC, Lall MD. Complications of pregnancy. In: Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 173.

Hur HC, Lobo RA.. Ectopic pregnancy: etiology, pathology, diagnosis, management, fertility prognosis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 17.

Nelson AL, Gambone JC. Ectopic pregnancy. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker & Moore's Essentials of Obstetrics and Gynecology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 24.