Ectopic pregnancy 

Introduction 

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Charities and support groups

The main charity for people affected by ectopic pregnancies is The Ectopic Pregnancy Trust, which offers useful information, advice and support.

The Ectopic Pregnancy Foundation offers information for health professionals dealing with ectopic pregnancies.

The Miscarriage Association also offers advice for women affected by ectopic pregnancy (although not technically a miscarriage, the emotional effects are often the same).

An ectopic pregnancy is when a fertilised egg implants itself outside of the womb, usually in one of the fallopian tubes.

This means the egg will not develop into a baby, which can be devastating to the pregnant woman.

Occasionally, an ectopic pregnancy doesn't cause any noticeable symptoms and is only detected during routine pregnancy testing. However, most women do have symptoms, and these usually become apparent between week 5 and week 14 of pregnancy.

They include:

Read more about the symptoms of an ectopic pregnancy.

How is an ectopic pregnancy treated?

If an ectopic pregnancy is detected at an early stage, a medication called methotrexate is sometimes needed to stop the egg developing. The pregnancy tissue is then absorbed into the woman’s body.

However, methotrexate is not always needed  in around half of cases, the egg dies before it can grow.

Ectopic pregnancies detected at a more advanced stage will require surgery to remove the egg.

If an ectopic pregnancy is left to develop, there is a risk that the fertilised egg could continue to grow and cause the fallopian tube to split open (rupture), which can cause life-threatening internal bleeding.

Signs of a ruptured fallopian tube are:

  • sudden, severe, sharp pain
  • feeling faint and dizzy
  • feeling or being sick
  • diarrhoea
  • shoulder tip pain

A ruptured fallopian tube is a medical emergency. If you think that you or someone in your care has experienced this complication, call 999 and ask for an ambulance.

Read more about treating ectopic pregnancy.

Why does an ectopic pregnancy happen?

In a normal pregnancy an egg is fertilised by sperm in one of the fallopian tubes, which connect the ovaries to the womb. The fertilised egg then moves into the womb and implants itself into the womb lining (endometrium), where it grows and develops.

An ectopic pregnancy occurs when a fertilised egg implants itself outside the womb. It most commonly occurs in a fallopian tube (this is known as a tubal pregnancy), usually as the result of damage to the fallopian tube or the tube not working properly.

Less commonly (in around 2 in 100 cases), an ectopic pregnancy can occur in an ovary, in the abdominal space or in the cervix (neck of the womb).

Things that increase your risk of ectopic pregnancy include:

In around half of all cases, there are no obvious risk factors.

Read more about the causes of, and risk factors for, an ectopic pregnancy.

Support

Losing a pregnancy can be devastating and many women feel the same sense of grief as if they had lost a family member or partner.

It is not uncommon for feelings of grief and bereavement to last for 6-12 months, although these feelings usually improve with time.

Many women affected by an ectopic pregnancy benefit from counselling. Read more about dealing with loss and the emotional impact of ectopic pregnancy.

Trying for another pregnancy

How long it is advisable to wait before you try for another pregnancy will depend on your specific circumstances. Your doctor should be able to advise you when (or if) it will be safe to do so.

In most cases it is recommended that you wait for at least two full menstrual cycles before trying for another pregnancy, as this will allow time for your fallopian tubes to recover. However, if you were treated with methotrexate, it is usually recommended that you wait at least three months.

However, many women are not emotionally ready to try for another pregnancy so soon.

Your chances of having a successful pregnancy will depend on the underlying health of your fallopian tubes. In general, 65% of women achieve a successful pregnancy 18 months after having an ectopic pregnancy.

If you cannot conceive in the normal way, then fertility treatment such as in-vitro fertilisation (IVF) may be an option.

IVF treatment is where an egg is fertilised by a sperm outside the womb (usually in a test tube) and, after fertilisation, the embryo is surgically implanted into the womb.

Who is affected

It is estimated that around 1 in 90 pregnancies in the UK develops into an ectopic pregnancy. This is around 10,700 pregnancies a year.

Nowadays, deaths from ectopic pregnancies are extremely rare.




Page last reviewed: 09/04/2014

Next review due: 09/04/2016

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Comments

The 3 comments posted are personal views. Any information they give has not been checked and may not be accurate.

cosmiccg said on 06 April 2014

I had an ectopic pregnancy almost 2 years ago. I was called by the hospital to tell me I would have to come in for surgery as they had identified that I had it. I drove myself there. Shortly after arriving I felt a pressure on my right hand side like there was something pushing to get out of me and I felt very faint. There was no change in my blood pressure, shoulder tip pain, diarrhoea, nausea, vomiting or sharp pain. The nurse and doctor looking after me said that as I had no shoulder tip pain and my blood pressure was stable that indicated it had not ruptured. I waited a further 3 and a half hours to go into surgery. The laporotomy revealed that it had ruptured and I had bled out 1.25 litres of blood whilst I had been waiting in hospital. I had to have a laporotomy to remove part of my fallopian tube.

I have since had to have further surgery to remove the rest of my fallopian tube as it poses a risk of a further ectopic pregnancy. My current consultant also advised me that in a healthy woman of my age (36) blood pressure and shoulder tip pain can not be relied upon to be the main indicators of an ectopic pregnancy rupturing.

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mumfour said on 23 January 2014

I recently suffered an ectopic pregnancy, despite being on birth control (more detail in my blog: http://mum4x2.blogspot.co.uk/2014/01/against-oddsheshe-baby-almost-made-it.html).

I just wanted to go on record to thank the wonderful NHS staff that looked after me, including: the out-of-hours GP that night, the ambulance crew (2 of them), the staff in the hospital, including the Gynaecologist and all the nurses in the Gynaecology Department. I was lucky and blessed to have such professional and compassionate people looking after me.

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chezh said on 21 February 2013

I only just recently had a ectopic pregnancy in which I was 4 weeks 6 days. I had the methotrexate injection a week ago and my question is, how long after does my hcg drop?Below are my bhcg results
13/2 310
17/2 659
20/2 551.
I want to retry again in middle of may, however my hcg needs to drop before then. Also how long after hcg has dropped to either under 5 or 0 will my periods return.
Thankyou

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