Symptoms of miscarriage often are similar to symptoms experienced in early ectopic pregnancy. For more information, see the topic Miscarriage. Normally, at the beginning of a pregnancy, the fertilized egg travels from the fallopian tube to the uterus , where it implants and grows. But in a small number of diagnosed pregnancies, the fertilized egg attaches to an area outside of the uterus, which results in an ectopic pregnancy also known as a tubal pregnancy or an extrauterine pregnancy.
An ectopic pregnancy cannot support the life of a fetus for very long. But an ectopic pregnancy can grow large enough to rupture the area it occupies, cause heavy bleeding, and endanger the mother. A woman with signs or symptoms of an ectopic pregnancy requires immediate medical care. An ectopic pregnancy can develop in different locations. In most ectopic pregnancies, the fertilized egg has implanted in a fallopian tube.
Ectopic pregnancy can damage the fallopian tube, which can make it difficult to become pregnant in the future. Ectopic pregnancies are usually detected early enough to prevent deadly complications such as severe bleeding. A ruptured ectopic pregnancy requires emergency surgery to prevent heavy bleeding into the abdomen. The affected tube is partially or fully removed. For more information, see Surgery.
Things that can increase your risk of having an ectopic pregnancy include:. Medical treatments and procedures that can increase your risk of having an ectopic pregnancy include:. Ectopic pregnancy has been linked to the use of medicine used to make the ovary release multiple eggs superovulation. Experts do not yet know whether this is because many women using it already have fallopian tube damage or because of the medicine itself.
If you become pregnant and are at high risk for ectopic pregnancy , you will be closely watched. Doctors do not always agree about which risk factors are serious enough to watch closely. But research suggests that risk is serious enough if you have had a tubal surgery or an ectopic pregnancy before, had DES exposure before birth, have known fallopian tube problems, or have a pregnancy with an intrauterine device IUD in place.
If you are pregnant, be alert to the symptoms that may mean you have an ectopic pregnancy, especially if you are at risk. If you have symptoms of an ectopic pregnancy or you are being treated for an ectopic pregnancy, avoid strenuous activity until your symptoms have been evaluated by a doctor. Call or other emergency services immediately if:. Call your doctor now or seek immediate medical care if:. Your family doctor , general practitioner , or an emergency medicine specialist can check you for an ectopic pregnancy.
You may be referred to a specialist, such as a gynecologist. Most ectopic pregnancies can be detected using a pelvic examination, ultrasound, and blood tests. If you have symptoms of a possible ectopic pregnancy, you will have:. Sometimes a surgical procedure using laparoscopy is used to look for an ectopic pregnancy. An ectopic pregnancy after 5 weeks can usually be diagnosed and treated with a laparoscope.
But laparoscopy is not often used to diagnose a very early ectopic pregnancy, because ultrasound and blood pregnancy tests are very accurate. During the week after treatment for an ectopic pregnancy, your hCG human chorionic gonadotropin blood levels are tested several times. Your doctor will look for a drop in hCG levels, which is a sign that the pregnancy is ending hCG levels sometimes rise during the first few days of treatment, then drop.
In some cases, hCG testing continues for weeks to months until hCG levels drop to a low level. If you become pregnant and are at high risk for an ectopic pregnancy , you will be closely watched. A urine pregnancy test—including a home pregnancy test—can accurately diagnose a pregnancy but cannot detect whether it is an ectopic pregnancy.
If a urine pregnancy test confirms pregnancy and an ectopic pregnancy is suspected, further blood testing or ultrasound is needed to diagnose an ectopic pregnancy. In most cases, an ectopic pregnancy is treated right away to avoid rupture and severe blood loss. The decision about which treatment to use depends on how early the pregnancy is detected and your overall condition. For an early ectopic pregnancy that is not causing bleeding, you may have a choice between using medicine or surgery to end the pregnancy.
Using methotrexate to end an ectopic pregnancy spares you from an incision and general anesthesia. But it does cause side effects and can take several weeks of hormone blood-level testing to make sure that treatment has worked. Methotrexate is most likely to work:. If you have an ectopic pregnancy that is causing severe symptoms, bleeding, or high hCG levels, surgery is usually needed.
This is because medicine is less likely to work and a rupture becomes more likely as time passes. When possible, laparoscopic surgery that uses a small incision is done. For a ruptured ectopic pregnancy , emergency surgery is needed. For an early ectopic pregnancy that appears to be naturally miscarrying aborting on its own, you may not need treatment.
Your doctor will regularly test your blood to make sure that your pregnancy hormone hCG, or human chorionic gonadotropin levels are dropping. This is called expectant management. Ectopic pregnancies can be resistant to treatment.
If your blood type is Rh-negative , Rh immunoglobulin may be used to protect any future pregnancies against Rh sensitization. For more information, see the topic Rh Sensitization During Pregnancy. Surgery may be your only treatment option if you have internal bleeding. You cannot prevent ectopic pregnancy, but you can prevent serious complications with early diagnosis and treatment.
If you have one or more risk factors for ectopic pregnancy, you and your doctor can closely monitor your first weeks of a pregnancy.
If you smoke, quit to lower your risk of ectopic pregnancy. Women who smoke or who used to smoke have higher rates of ectopic pregnancy. Using safer sex practices, such as using a male condom or a female condom every time you have sex helps protect you from sexually transmitted infections STIs that can lead to pelvic inflammatory disease PID. PID is a common cause of scar tissue in the fallopian tubes, which can cause ectopic pregnancy. If you are at risk for having an ectopic pregnancy and you think you may be pregnant, use a home pregnancy test.
If it is positive, be sure to have a confirmation test done by a doctor, especially if you are concerned about having an ectopic pregnancy. If you are receiving methotrexate treatment to end an ectopic pregnancy, you may experience side effects from the medicine.
See these tips for managing methotrexate treatment to minimize these side effects. If you experience an ectopic pregnancy loss, no matter how early in a pregnancy, expect that you and your partner will need time to grieve. It is also possible to develop depression from the hormonal changes after a pregnancy loss. If you have symptoms of depression that last for more than a couple of weeks, be sure to call your doctor or a psychologist, clinical social worker, or licensed mental health counsellor.
You can contact a support group, read about the experiences of other women, and talk to friends, a counsellor, or a member of the clergy. These things may help you and your family deal with a pregnancy loss. If you have had an ectopic pregnancy, you may worry about your chances of having a healthy or ectopic pregnancy in the future.
Your risk factors and any fallopian tube damage you may have will impact your future risk and your ability to become pregnant. Your doctor can answer your questions based on your risk factors. The symptoms of ectopic pregnancy can include:. Ectopic pregnancy is caused by a fertilised egg not being able to move through the fallopian tube. This can be caused by a blockage in the tube or because the tiny hairs inside the tube are not able to sweep the fertilised egg towards the uterus.
The contraceptives currently available in Australia do not increase the risk of ectopic pregnancy. However, of pregnancies that occur while using contraception, a percentage are ectopic. These include around:. If a pregnancy occurs as a result of a failed tubal sterilisation, there is also a higher risk that it will be ectopic, but the percentage is unknown.
Because implants and IUDs are extremely effective methods of contraception and pregnancy is highly unlikely, these methods can be used in women with a past history of ectopic pregnancy. The progestogen-only pill can also be considered. Women who use these forms of contraception need to be aware of the symptoms of ectopic pregnancy.
Around 15 per cent of cases of ectopic pregnancy are diagnosed in the emergency room after the fallopian tube has ruptured. In most cases, ectopic pregnancy can be diagnosed using a range of tests, some of which are standard medical procedures for all pregnant women, including:. A ruptured fallopian tube is a medical emergency.
Laparoscopic surgery is done to remove the embryo and attempts are made to repair the fallopian tube. A blood transfusion may also be needed.
For non-emergency ectopic pregnancy, medication is often successful, but sometimes surgery is still needed. Any woman thought to have or found to have an ectopic pregnancy will need careful observation.
Most women who have had an ectopic pregnancy can become pregnant again, but they will need careful follow up, as their risk of ectopic pregnancy is higher. Screening and developments in early pregnancy monitoring have considerably reduced the number of deaths from ectopic pregnancy. Accessed Dec. Tulandi T. Ectopic pregnancy: Epidemiology, risk factors, and anatomic sites. Cunningham FG, et al. Ectopic pregnancy. Frequently asked questions. Pregnancy FAQ American College of Obstetricians and Gynecologists.
Ectopic pregnancy: Clinical manifestations and diagnosis. Burnett TL expert opinion. Mayo Clinic. Related Ectopic pregnancy. Speak to your GP about this. Read more about dealing with loss and find bereavement support services in your area. You may want to try for another baby when you and your partner feel physically and emotionally ready.
You'll probably be advised to wait until you've had at least 2 periods after treatment before trying again to allow yourself to recover.
If you were treated with methotrexate, it's usually recommended that you wait at least 3 months because the medicine could harm your baby if you become pregnant during this time. Most women who have had an ectopic pregnancy will be able to get pregnant again, even if they've had a fallopian tube removed. Occasionally, it may be necessary to use fertility treatment such as IVF.
If you do become pregnant again, it's a good idea to let your GP know as soon as possible so early scans can be carried out to check everything is OK. In many cases, it's not clear why a woman has an ectopic pregnancy. Sometimes it happens when there's a problem with the fallopian tubes, such as them being narrow or blocked. You can't always prevent an ectopic pregnancy, but you can reduce your risk by using a condom when not trying for a baby to protect yourself against STIs, and by stopping smoking if you smoke.
Page last reviewed: 27 November Next review due: 27 November
0コメント