Every month, one of your ovaries releases an egg into a fallopian tube. If you don’t become pregnant, the lining of your uterus sheds and your period arrives. But if an egg becomes fertilized with sperm, it makes its way to the uterus and implants into the uterine lining and continues to develop into a fetus. Show
In approximately 2 percent of all pregnancies, however, a fertilized egg implants outside of the uterus, usually in a fallopian tube. Known as an ectopic pregnancy, it happens early on — before some women even realize they’re pregnant. And it requires prompt treatment: As an ectopic pregnancy grows, it can rupture the fallopian tube and cause life-threatening internal bleeding. The good news? With a timely diagnosis and care, it is possible that you can have a healthy pregnancy in the future. What is an ectopic pregnancy?An ectopic pregnancy (also known as a tubal pregnancy) is when a fertilized egg implants outside of the uterus, where it can’t continue to develop normally. About 2 percent of all pregnancies are ectopic. And more than 90 percent of ectopic pregnancies occur in one of the fallopian tubes, though they can also happen in the cervix, on an ovary or in the abdomen. If the ectopic pregnancy goes unnoticed and continues to grow, it can rupture a fallopian tube and cause severe bleeding. That’s why it’s essential to call your doctor right away if you think you’re experiencing ectopic pregnancy symptoms. What are early signs and symptoms of ectopic pregnancy?Symptoms of ectopic pregnancy develop between weeks 4 and 12 of pregnancy (or about two to 10 weeks after fertilization). However, ectopic pregnancy can be hard to diagnose since many signs — including breast tenderness, nausea and fatigue — are similar to normal early pregnancy symptoms. Continue Reading Below Read This NextOccasional cramping and slight vaginal spotting are not cause for alarm during pregnancy. But you should contact your practitioner if you experience the following signs of ectopic pregnancy, especially if your symptoms persist or worsen:
If the ectopic pregnancy goes unnoticed and a fallopian tube ruptures, you may experience:
What are the causes of ectopic pregnancy?Ectopic pregnancies often occur because an egg’s movement is slowed or obstructed after fertilization, usually because a fallopian tube is scarred, misshapen or possibly infected or inflamed. Problems with the development of the fertilized egg or hormonal imbalances may also play a role. What are the risk factors for ectopic pregnancy?Although any woman can develop an ectopic pregnancy, the following conditions are linked with an increased risk of ectopic pregnancy:
If you’re at increased risk for an ectopic pregnancy, be sure to see your doctor before you start trying to get pregnant, and schedule a visit as soon as you find out you’re expecting. Ectopic pregnancy tests and diagnosisA pregnancy that's ectopic is usually diagnosed at about four to six weeks into pregnancy. Ectopic pregnancy tests and diagnosis often include:
Ectopic pregnancy treatmentUnfortunately, there’s no way to preserve an ectopic pregnancy. There are several options to treat it, all of which require careful follow-up with your doctor to ensure your hCG levels drop back down to zero. MedicationThe smallest ectopic pregnancies — where a fetal heartbeat isn’t present and a fallopian tube hasn’t ruptured — can usually be treated with methotrexate. The drug keeps cells from growing, so the pregnancy ends and is reabsorbed by the body over four to six weeks. Following a shot of this medication, you’ll undergo important follow-up blood tests to ensure hCG levels are decreasing appropriately. If your hCG level does not drop by at least 15 percent between the fourth to seventh day after treatment, a second dose is required. It’s important to avoid alcohol, folic acid (in both vitamins and foods) and pain medications like ibuprofen to ensure the medication works correctly, as well as heavy exercise and sex (for at least two weeks). During the process, the ectopic pregnancy can still rupture, which is why it’s so important to make sure to make your doctor’s appointments and follow his or her instructions for follow-up care. Laparoscopic surgeryIn most other cases, including when a fallopian tube has ruptured or the pregnancy is further along, your practitioner may perform surgery under general anesthesia to remove an ectopic pregnancy. Women usually leave the hospital within 24 hours after a laparoscopy, and the recovery time is a week or two. The surgery can be done using a laparoscope (a thin, light-transmitting instrument with a camera) that’s inserted through small incisions in the abdomen. It allows surgeons to see inside without having to make larger incisions while surgical instruments are used. In some cases where the fallopian tube has ruptured, part or all of it may need to be removed. LaparotomySometimes a bigger incision is needed to treat an ectopic pregnancy. In this case, you’d leave the hospital in a day or two, and your recovery time would be about six weeks. Ectopic pregnancy complicationsWithout early diagnosis of an ectopic pregnancy and treatment, a fertilized egg can continue to grow in the fallopian tube, leading to a rupture. If a fallopian tube bursts, it can't carry a fertilized egg to the uterus in the future. And if a rupture is uncared for, it can result in severe internal bleeding and shock. The good news is that with early detection and medication or surgery, doctors can remove the tissue before these complications occur — so always be sure to let your practitioner know right away if you’re experiencing any symptoms you think may be related to an ectopic pregnancy. Preventing ectopic pregnancyAlthough some factors are out of your control, there are a few ways you can decrease your risk of ectopic pregnancy:
And of course anytime you’re trying to get pregnant, the best way to stay healthy is to exercise, eat well and remember to take a daily prenatal vitamin. Coping with pregnancy lossAlthough it occurs early on, an ectopic pregnancy is a loss just like any other miscarriage — especially if you’ve been planning for a child. You may feel sad or shocked, and healing emotionally can take time. Lean on your friends and family for support following a pregnancy loss, and consider a support group or grief counseling. Getting pregnant again after ectopic pregnancyHaving an ectopic pregnancy should have little bearing on your future fertility. Even if you lost a fallopian tube, the other tube should take over. Some research has shown that about two-thirds of women treated for ectopic pregnancy conceive and have a normal pregnancy within two years. On average, about 85 percent of couples who haven't experienced ectopic pregnancy conceive within one year of trying. Be aware that having one ectopic pregnancy does increase your risk of having another, and the same factors that led to it in the first place may be still at work. If you’d like to try and get pregnant again, make sure to see your practitioner for a checkup and follow-up blood tests first to make sure the pregnancy hormone hCG has dropped to an undetectable level. It may be a good idea to wait until you’ve had three to six menstrual cycles before trying to get pregnant again. From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You're Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy. Was this article helpful? What are 3 signs of an ectopic pregnancy?Symptoms of an ectopic pregnancy. a missed period and other signs of pregnancy.. tummy pain low down on one side.. vaginal bleeding or a brown watery discharge.. pain in the tip of your shoulder.. discomfort when peeing or pooing.. Can you have an ectopic pregnancy with negative test?Since 1987, eight cases of ruptured ectopic pregnancy have been reported with a negative urine pregnancy test. These patients were taken to the operating room for suspected hemoperitoneum (5). These cases and ours suggest that ectopic pregnancy should be considered even with a negative pregnancy test.
Can you have a ectopic pregnancy and not test positive?Although hCG is still produced during ectopic pregnancy, the levels of this hormone are lower and harder for a pregnancy test to pick up than in a regular pregnancy. For this reason, 1% of ectopic pregnancies will have a negative pregnancy test result.
How early can an ectopic pregnancy be detected?Symptoms of an ectopic pregnancy usually develop between the 4th and 12th weeks of pregnancy. Some women don't have any symptoms at first. They may not find out they have an ectopic pregnancy until an early scan shows the problem or they develop more serious symptoms later on.
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