Ectopic Pregnancy Symptoms

What is an ectopic pregnancy and how do you know if you have one? We look at the symptoms, diagnosis and treatment of this pregnancy condition…

woman suffering from an ectopic pregnancy

Every mama hopes she will have a smooth and easy pregnancy, but not everyone is so lucky. While most American women have healthy pregnancies and deliveries, nearly 20 percent experience a pregnancy complication. Ectopic pregnancy occurs in 1 to 2 percent of pregnancies in the United States.

In this article, we will cover:

  • What is ectopic pregnancy? 
  • Ectopic pregnancy warning signs and symptoms
  • Ectopic pregnancy causes and risk factors
  • Ectopic pregnancy diagnosis and treatment
  • Getting pregnant after an ectopic pregnancy
  • Coping and support after an ectopic pregnancy

Scroll down to find out more…


What is ectopic pregnancy?

Ectopic pregnancy, also called extrauterine pregnancy, is when a fertilized egg grows outside of the uterus. More than 90 percent of ectopic pregnancies occur in a fallopian tube. This type of ectopic pregnancy is called a tubal pregnancy. An ectopic pregnancy can also occur in an ovary, the cervix or the abdominal cavity.

If left untreated, an ectopic pregnancy can cause the fallopian tube to burst (or rupture). A ruptured ectopic pregnancy can cause life-threatening internal bleeding and requires immediate surgery.


What are the early warning signs of ectopic pregnancy?

An ectopic pregnancy can have no symptoms at all at first. It might also feel like a regular pregnancy with symptoms such as a missed period, tender breasts and nausea. 

Early warning signs of an ectopic pregnancy may include:

  • Light vaginal bleeding
  • Mild pelvic or abdominal pain
  • Mild pelvic cramping (on one side)
  • Low back pain

If you experience bleeding and pelvic pain, talk to your healthcare professional.


What are the symptoms of ectopic pregnancy?

As an ectopic pregnancy progresses, you may experience more serious symptoms, including:

  • Heavy vaginal bleeding
  • Severe pelvic or abdominal pain
  • Shoulder pain
  • A sudden urge to do a bowel movement 
  • Lightheadedness, weakness or fainting

These symptoms could indicate a ruptured ectopic pregnancy. If you have any of them, seek emergency medical attention right away. 


What are the causes of ectopic pregnancy?

An egg sometimes gets stuck in the fallopian tube because the tube is damaged or misshapen. Hormonal imbalances or abnormal egg development can also come into play. Sometimes there is no known cause for an ectopic pregnancy.  


What are the risk factors for ectopic pregnancy?

Some factors that increase the risk of ectopic pregnancy include:

  • A previous ectopic pregnancy
  • Prior fallopian tube, pelvic or abdominal surgery
  • Pelvic inflammatory disease (PID)
  • Endometriosis
  • Some sexually transmitted infections (STIs)
  • A history of infertility
  • Fertility treatments including in vitro fertilization (IVF)
  • Tubal ligation (tubes tied) or tubal ligation reversal
  • Use of an intrauterine device (IUD)
  • Aged over 35
  • Cigarette smoking

Approximately half of all women who have ectopic pregnancies don’t have any risk factors.


How is ectopic pregnancy diagnosed?

If you have a suspected ectopic pregnancy, your doctor may:

  • Give you a pregnancy test
  • Perform a pelvic exam to identify areas of pain or tenderness
  • Perform an ultrasound exam to identify where your pregnancy is developing


How is ectopic pregnancy treated?

A fertilized egg can’t survive outside the uterus and an ectopic pregnancy can’t be moved or “reimplanted” into the uterus, so the ectopic tissue needs to be removed. This can be done using one of two methods: medication or surgery.


When is medication used to treat ectopic pregnancy?

If your fallopian tube hasn’t ruptured, your doctor may give you an injection of methotrexate to treat your ectopic pregnancy. Methotrexate stops the cells from growing and your body will absorb them over the course of four to six weeks.

After the injection, your doctor will test your blood levels of the pregnancy hormone human chorionic gonadotropin (hCG) to ensure the treatment is working. If your hCG levels are still too high, you might need a second dose of methotrexate. You’ll be monitored closely until your ectopic pregnancy is resolved.


What are the side effects and risks of methotrexate?

Methotrexate may have some side effects, including:

  • Vaginal bleeding
  • Abdominal pain
  • Nausea
  • Vomiting
  • Diarrhea
  • Dizziness

Because the risk of fallopian tube rupture remains until the end of your treatment, seek medical treatment if you have any symptoms of a rupture after taking methotrexate.

You should also avoid sexual intercourse, strenuous exercise, alcohol, prescription pain medications and nonsteroidal anti-inflammatory drugs (NSAIDs) until your treatment is complete. 


When is surgery used to treat ectopic pregnancy?

You’ll need emergency surgery if your fallopian tube has ruptured, but you may need surgery even if your tube is still intact.

The most common form of ectopic pregnancy surgery is a laparoscopy. During this procedure, your doctor makes a small incision in your abdomen and inserts a tiny camera to look at the tubal area. Your doctor may be able to remove the ectopic pregnancy from the fallopian tube or the entire tube might need to be removed. A ruptured tube can sometimes be saved, but it generally needs to be taken out.

If you’re experiencing heavy bleeding, your doctor might need to perform emergency surgery that involves making a larger incision in your abdomen. This is known as a laparotomy. 


What are the side effects and risks of surgery?

Side effects of ectopic pregnancy surgery can include bleeding, pain, fatigue and infection. Your doctor will inform you of the risks related to your surgery.


Can I get pregnant after an ectopic pregnancy?

Talk to your doctor about how long you should wait before trying to get pregnant again after an ectopic pregnancy. Some suggest waiting three months to give your body time to heal. 

Many women who have had ectopic pregnancies have subsequent healthy pregnancies. But if one of your fallopian tubes was damaged or removed, you might want to discuss your chances of falling pregnant with your doctor or a fertility specialist. If both tubes were removed, you may still be able to have a baby through IVF.

Once you’ve had an ectopic pregnancy, your chances of having a second one are higher. See your doctor as early as possible during subsequent pregnancies and be mindful of the early warning signs of ectopic pregnancy. 


Where can I get support after an ectopic pregnancy?

Losing a pregnancy can be devastating even in the early stages and emergency surgery can be traumatic for some women. Take the time you need to mourn your loss and reach out to friends and family for support. If you feel like you’re not coping, counseling may help. Ask your doctor to refer you to a mental health professional who specializes in pregnancy loss. You may also find online support groups helpful.


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