Ectopic Pregnancy

Ectopic pregnancy | University of Maryland Medical Center

An ectopic pregnancy is a pregnancy that occurs outside the womb (uterus). It is life-threatening to the mother.Alternative Names


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 tubesScarring after a ruptured appendixEndometriosisHaving had an ectopic pregnancy in the pastScarring from past infections or surgery of the female organs


The following also increase risk of an ectopic pregnancy:Age over 35Getting pregnant while having an intrauterine device (IUD)Having your tubes tied. This is more likely 2 or more years after the procedureHaving had surgery to untie tubes to become pregnantHaving had many sexual partnersSome infertility treatments


The most common site for an ectopic pregnancy is within 1 of the 2 fallopian tubes. In rare cases, ectopic pregnancies can occur in the ovary, abdomen, or cervix.


You may have early pregnancy symptoms, such as breast tenderness or nausea. Other symptoms may include:Abnormal vaginal bleedingLow back painMild cramping on one side of the pelvisNo periodsPain 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 faintIntense pressure in the rectumLow blood pressurePain in the shoulder areaSevere, sharp, and sudden pain in the lower abdomen Exams and Tests


HCG is a hormone normally produced during pregnancy. Checking the blood level of this hormone can diagnose pregnancy. If the blood level of HCG is not rising fast enough, your provider may suspect an ectopic pregnancy.Treatment


Ectopic pregnancy is life threatening. The pregnancy cannot continue to birth (term). The developing cells must be removed to save the mother's life.


If the ectopic pregnancy has not ruptured, treatment may include:SurgeryMedicine 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 transfusionFluids given through a veinKeeping warmOxygenRaising 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.Outlook (Prognosis)


One out of three women who have had 1 ectopic pregnancy are later able to have a baby. 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 ageWhether she has already had childrenWhy the first ectopic pregnancy occurred When to Contact a Medical Professional


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 infectionGetting early diagnosis and treatment of all infections caused by sexual relations (STDs)Stopping smoking Pelvic laparoscopyUltrasound in pregnancyFemale reproductive anatomyUterusUltrasound, normal fetus - footEctopic pregnancyReferences


American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 94: Medical management of ectopic pregnancy. Obstet Gynecol. 2008;111(6):1479-1485. PMID: 18515537 www.ncbi.nlm.nih.gov/pubmed/18515537.


Houry DE, Salhi BA. Acute complications of pregnancy. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 178.


Lobo RA. Ectopic pregnancy: etiology, pathology, diagnosis, management, fertility prognosis. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 17.


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