Ectopic pregnancy: Symptoms, causes, risks, and treatment

An ectopic pregnancy happens when a woman becomes pregnant, but the egg settles outside of its normal location in the inner lining of the womb. The egg cannot develop normally, and the consequences can be serious for the woman.

Most ectopic pregnancies occur in the fallopian tube, but they can also happen in the neck of the womb, in the ovary, or in the abdominal cavity.

In a normal pregnancy, fertilization occurs in the fallopian tubes, where an egg, or ovum, meets a sperm cell. The fertilized egg then travels into the uterus and becomes implanted in the womb lining. The embryo develops into a fetus and remains in the uterus until birth.

An ectopic pregnancy can be fatal without prompt treatment. For example, the fallopian tube can burst, causing internal abdominal bleeding, shock, and serious blood loss.

According to the Centers for Disease Control and Prevention, between 1 and 2 percent of all pregnancies are ectopic. However, ectopic pregnancy is the cause of 3 to 4 percent of pregnancy-related deaths.

Fast facts on ectopic pregnancy

Ectopic pregnancy involves the growth of an embryo outside of the womb during pregnancy. Most ectopic pregnancies take place in the fallopian tubes.

An embryo cannot survive an ectopic pregnancy. However, if a rupture occurs, the consequences can be serious, and prompt treatment is essential.

Risk factors include previous fallopian tube infections such as salpingitis, smoking, a history of infertility, use of contraceptive intrauterine devices (IUDs) and medications, and advanced age.

Treatment options include laparoscopic surgery and methotrexane drug therapy.

Symptoms

Ectopic pregnancy
Abdominal pain is a key symptom of ectopic pregnancy.

At first, an ectopic pregnancy appears similar to a normal pregnancy. A woman will have a positive pregnancy test.

The woman will miss a menstrual cycle and may experience nausea. Her breasts will become tender, and she may experience fatigue.

After 4 to 10 weeks of an ectopic pregnancy, however, symptoms will start to indicate an abnormal pregnancy.

Symptoms may include:

Pain on one side of the abdomen: This may be severe and continuous.

Vaginal bleeding: The blood will be lighter or darker than during menstrual bleeding, and usually less viscous. If a woman does not know that she is pregnant, she may confuse vaginal bleeding for menstrual blood.

Shoulder tip pain: This is a common sign of internal bleeding. The bleeding may irritate the phrenic nerve, and this leads to pain in the shoulder.

Pain when passing urine or feces: This may also indicate an ectopic pregnancy.

Fainting or collapse: If the fallopian tubes rupture, this may cause a woman to faint and collapse. This would be considered a medical emergency.

Other signs of internal bleeding include:

lightheadedness

faintness

diarrhea

pale skin

Fallopian tube rupture can occur after between 6 and 16 weeks of pregnancy. A ruptured fallopian tube can, however, be treated successfully.

A fertilized egg cannot survive outside the womb, and therefore will not survive an ectopic pregnancy. The pregnancy cannot be saved.

Ectopic pregnancy risk
Using contraceptive pills can increase the risk of an ectopic pregnancy.

The following factors lead to a higher risk of an ectopic pregnancy:

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