Northside Hospital - Ectopic pregnancy
An ectopic pregnancy is a pregnancy that occurs outside the womb (uterus). It is a life-threatening condition to the mother. The baby (fetus) cannot survive. Alternative Names
An ectopic pregnancy is often caused by a condition that blocks or slows the movement of a fertilized egg through the fallopian tube to the uterus. Such causes include: Birth defect in the fallopian tubes Complications of a ruptured appendix Endometriosis Having an ectopic pregnancy before Scarring from past infections or surgery
The following also increase your risk for an ectopic pregnancy: Age over 35 Getting pregnant while having an intrauterine device (IUD) Had surgery to untie tubes (tubal sterilization) to become pregnant Having had many sexual partners In vitro fertilization Having your tubes tied (tubal ligation) - more likely 2 or more years after the procedure
The most common site for an ectopic pregnancy is within one of the tubes through which the egg passes from the ovary to the uterus. However, in rare cases, ectopic pregnancies can occur in the ovary, stomach area, or cervix. Symptoms You may have early pregnancy symptoms, such as breast tenderness or nausea. Other symptoms of ectopic pregnancy may include:Abnormal vaginal bleeding Low back pain 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 feel faint Intense pressure in the rectum Low blood pressure Pain in the shoulder area Severe, sharp, and sudden pain in the lower abdomen Exams and Tests
HCG is a hormone normally produced during pregnancy. Checking blood levels of this hormone (quantitative HCG blood test) can diagnose pregnancy. A rise in quantitative HCG levels over 1 to 2 days may help tell a normal pregnancy from an ectopic pregnancy. Treatment
Ectopic pregnancies is a life-threatening condition. The pregnancy cannot continue to birth (term). The developing cells must be removed to save the mother's life.
You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to shock, an emergency condition. Treatment for shock may include: Blood transfusion Fluids given through a vein Keeping warm Oxygen Raising the legs
If there is a rupture, surgery (laparotomy) is done to stop blood loss. This surgery is also done to: Confirm an ectopic pregnancy Remove the abnormal pregnancy Repair any tissue damage
If the ectopic pregnancy has not ruptured, treatment may include: Mini-laparotomy and laparoscopy Medicine called methotrexate and close monitoring by your doctor Outlook (Prognosis)
One-third of women who have had one ectopic pregnancy are later able to have a baby. A repeated ectopic pregnancy may occur in one-third of women. 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. Possible Complications
The most common complication is rupture with internal bleeding that leads to shock. Death from rupture is rare. When to Contact a Medical Professional
Most forms of ectopic pregnancy that occur outside the fallopian tubes are probably not preventable. However, a tubal pregnancy (the most common type of ectopic pregnancy) may be prevented in some cases by avoiding conditions that might scar the fallopian tubes.
The following may reduce your risk: Avoiding risk factors for pelvic inflammatory disease (PID) such as having many sexual partners, having sex without a condom, and getting sexually transmitted diseases (STDs) Early diagnosis and treatment of STDs Early diagnosis and treatment of salpingitis and PID Stopping smoking References
Houry DE, Salhi BA. Acute complications of pregnancy. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 176.
Lobo RA. Ectopic pregnancy: Etiology, pathology, diagnosis, management, fertility prognosis. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 17.
ACOG Practice Bulletin Committee. ACOG Practice Bulletin No.94: Medical management of ectopic pregnancy. Obstet Gynecol. 2008;111:1479–1485. Review Date: 2/26/2012 Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited. Medical Services Locations Classes Events Find a Doctor Online Bill Pay Careers Medical Services
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