Ectopic pregnancy, sometimes called tubal pregnancy, occurs about once in every 100 pregnancies. Ectopic pregnancy happens when implantation of the embryo occurs outside the uterine cavity, usually in the Fallopian tube. It can also occur on the ovary, in the entrance to the tube, at the point the tube joins the uterus and at the mouth of the uterus. An ectopic pregnancy is serious because heavy bleeding may result when the ectopic pregnancy ruptures.
It isn't unusual to have mild pain early in pregnancy from a cyst on the ovary or stretching of the uterus or ligaments. Sometimes women are afraid this signals an ectopic pregnancy. It probably doesn't, but if the pain is bad enough to cause you concern, call your doctor.
Symptoms associated with ectopic pregnancy include abdominal pain and bleeding from the vagina. It may be confused with appendicitis, the flu or a bladder infection. Factors that can increase your risk for an ectopic pregnancy include:
| pelvic infections (PID or pelvic inflammatory disease) |
| previous ruptured appendix |
| previous ectopic pregnancy |
| surgery on your Fallopian tubes (such as reversal of a tubal ligation) |
| use of an IUD |
Diagnosis
Diagnosis can be difficult and may require a couple of tests and some waiting. Tests used include ultrasound, quantitative HCGs and laparoscopy (a visual examination inside the abdomen). Even with these tests, it may be a few days or weeks before a definitive diagnosis can be made.
A quantitative HCG (human chorionic gonadotropin) is a special pregnancy test done with your blood. HCG is a hormone produced during pregnancy; it increases very rapidly early in pregnancy. A regular pregnancy test, using blood or urine, gives you a positive or negative ("yes" or "no") answer. A quantitative HCG assigns a number to tell how pregnant you are. The numbers aren't exact, but they increase in a way that can help your doctor decide if it is a normal pregnancy. This test is not used in normal pregnancies but can be very helpful when you are concerned about a miscarriage or ectopic pregnancy. The hormones produced with an ectopic pregnancy still make your pregnancy test positive.
Treatment
Many ectopic pregnancies result in reabsorption of the embryo before the tube ruptures. The woman may never know she was pregnant. If you are diagnosed with an ectopic pregnancy, you may be treated with methotrexate (a medication), but often surgery is necessary to correct the problem, which results in loss of the pregnancy. An ectopic pregnancy cannot be carried to full term. It is either terminated by the woman's body or terminated surgically.