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What is an ectopic pregnancy?

An ectopic pregnancy occurs when a fertilised egg implants itself outside of the womb. The most common place for an ectopic pregnancy is the fallopian tube. Having an ectopic pregnancy is a life-threatening condition. If the embryo develops, it can cause you serious internal damage and bleeding.

The symptoms of an ectopic pregnancy

Ectopic pregnancies can be difficult to diagnose because symptoms can be noticed any time between 5 and 14 weeks. Also, signs of ectopic pregnancy are very similar to those of gastroenteritis and miscarriage.

Common symptoms include:

  • Lower stomach pain – may be at one side and can be continuous or come and go
  • Abnormal bleeding – blood may be a dark, brownish colour
Symptoms which are less common:

  • Shoulder tip pain – may begin suddenly after feeling unwell or after experiencing vaginal pain and bleeding
  • Pain when emptying your bladder or bowel
  • Feeling light-headed and perhaps nauseous, or actually fainting

Ectopic pregnancy treatment

There are currently three ways of managing an ectopic pregnancy. Your healthcare professional will go through your options with you.

  • Expectant management
If a woman’s pregnancy hormone level is low or dropping and the ectopic pregnancy is not causing an immediate threat or severe discomfort, it may simply be monitored closely. Up to 50% of these cases result in a natural termination, without the need for drugs or surgical intervention.

  • Medical management
This is when the drug methotrexate is given to stop the ectopic pregnancy from developing any further. Between 65% and 95% of cases are treated successfully, so there is a possibility of it not working, which may mean the need for surgery.

  • Surgical management
If a woman’s pregnancy hormone level is high or there is a risk of dangerous internal bleeding, an operation under general anaesthetic will be needed to remove the embryo.
Surgery may also be required if expectant management or medical management have been unsuccessful.

Who is at risk?

Here are some of the conditions or situations which can make it more likely for an ectopic pregnancy to occur:

  • Pelvic inflammatory disease – a past infection of the fallopian tubes.
  • Endometriosis – can cause damage to the fallopian tubes.
  • Abdominal surgery – e.g. removal of the appendix, caesarean birth or previous ectopic pregnancy
  • Tubal surgery – an operation on the fallopian tube.
  • Using certain types of contraception (coil, progesterone-only/‘mini-pill’ or morning after pill).
  • Fertility treatment – an ectopic pregnancy may occur following an embryo transfer.
  • Smoking cigarettes – research shows that smokers have an increased level of a protein which, when present in the fallopian tubes, can increase the chances of an ectopic pregnancy.

Finding support

Experiencing an ectopic pregnancy can be very traumatic. Talking to people who understand can be a great help. The Ectopic Pregnancy Trust is a charity dedicated to providing information, advice and support. The Miscarriage Association also offers advice for women affected by ectopic pregnancy. You may also find support from other women who have been through an ectopic pregnancy on our Facebook page.

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