Baby stuck in fallopian tubes

Ectopic pregnancy - NHS

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

The fallopian tubes are the tubes connecting the ovaries to the womb. If an egg gets stuck in them, it won't develop into a baby and your health may be at risk if the pregnancy continues.

Unfortunately, it's not possible to save the pregnancy. It usually has to be removed using medicine or an operation.

In the UK, around 1 in every 90 pregnancies is ectopic. This is around 11,000 pregnancies a year.

Symptoms of an ectopic pregnancy

An ectopic pregnancy doesn't always cause symptoms and may only be detected during a routine pregnancy scan.

If you do have symptoms, they tend to develop between the 4th and 12th week of pregnancy.

Symptoms can include a combination of:

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

But these symptoms aren't necessarily a sign of a serious problem. They can sometimes be caused by other problems, such as a stomach bug.

Read more about the symptoms of an ectopic pregnancy.

When to get medical advice

Contact your GP or call NHS 111 if you have a combination of any of the above symptoms and you might be pregnant – even if you haven't had a positive pregnancy test.

An ectopic pregnancy can be serious, so it's important to get advice right away.

Your GP will ask about your symptoms and you'll usually need to do a pregnancy test to determine if you could have an ectopic pregnancy.

You may be referred to a specialist early pregnancy clinic for further assessment, where an ultrasound scan and blood tests may be carried out to confirm the diagnosis.

Read more about ectopic pregnancy tests.

When to get emergency help

Call 999 for an ambulance or go to your nearest accident and emergency (A&E) department immediately if you experience a combination of:

a sharp, sudden and intense pain in your tummy
feeling very dizzy or fainting
feeling sick
looking very pale

These symptoms could mean that your fallopian tube has split open (ruptured). This is very serious and surgery to repair the fallopian tube needs to be carried out as soon as possible.

A rupture can be life threatening, but fortunately they're uncommon and treatable, if dealt with quickly. Deaths from ruptures are extremely rare in the UK.

How an ectopic pregnancy is treated

There are 3 main treatments for an ectopic pregnancy:

expectant management – you're carefully monitored and 1 of the treatments below is used if the fertilised egg doesn't dissolve by itself
medicine – an injection of a powerful medicine called methotrexate is used to stop the pregnancy growing
surgery – keyhole surgery (laparoscopy) is performed under general anaesthetic to remove the fertilised egg, usually along with the affected fallopian tube

You'll be told about the benefits and risks of each option. In many cases, a particular treatment will be recommended based on your symptoms and the results of the tests you have.

Some treatments may reduce your chances of being able to conceive naturally in the future, although most women will still be able to get pregnant. Talk to your doctor about this.

Read more about treating an ectopic pregnancy.

Help and support after an ectopic pregnancy

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's not uncommon for these feelings to last several months, although they usually improve with time. Make sure you give yourself and your partner time to grieve.

If you or your partner are struggling to come to terms with your loss, you may benefit from professional support or counselling. Speak to your GP about this.

Support groups for people who have been affected by loss of a pregnancy can also help.

These include:

The Ectopic Pregnancy Trust
Ectopic Pregnancy Foundation
Miscarriage Association
Cruse Bereavement Care

Read more about dealing with loss and find bereavement support services in your area.

Trying for another baby

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.

The chances of having another ectopic pregnancy are higher if you've had one before, but the risk is still small.

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.

What can cause an ectopic pregnancy?

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.

The following are all associated with an increased risk of ectopic pregnancy:

pelvic inflammatory disease (PID) – inflammation of the female reproductive system, usually caused by a sexually transmitted infection (STI)
previous ectopic pregnancy – the risk of having another ectopic pregnancy is around 10%
previous surgery on your fallopian tubes – such as an unsuccessful female sterilisation procedure
fertility treatment, such as IVF – taking medicine to stimulate ovulation (the release of an egg) can increase the risk of ectopic pregnancy
becoming pregnant while using an intrauterine device (IUD) or intrauterine system (IUS) for contraception – it's rare to get pregnant while using these, but if you do you're more likely to have an ectopic pregnancy
smoking
increasing age – the risk is highest for pregnant women aged over 35

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: 23 August 2022
Next review due: 23 August 2025

Ectopic Pregnancy (for Parents) - Nemours KidsHealth

What Is an Ectopic Pregnancy?

In a normal pregnancy, the fertilized egg implants and develops in the uterus. In an ectopic pregnancy, the egg implants somewhere other than the uterus — often, in the fallopian tubes. This is why ectopic pregnancies are commonly called "tubal pregnancies." The egg also can implant in the ovary, abdomen, or the cervix.

None of these areas has the right space or nurturing tissue for a pregnancy to develop. As the fetus grows, it will eventually burst the organ that contains it. This can cause severe bleeding and endanger the mother's life. A classical ectopic pregnancy does not develop into a live birth.

What Are the Signs & Symptoms of an Ectopic Pregnancy?

Ectopic pregnancy can be hard to diagnose because symptoms often are like those of a normal early pregnancy. These can include missed periods, breast tenderness, nausea, vomiting, tiredness, or frequent urination (peeing).

Often, the first warning signs of an ectopic pregnancy are pain or vaginal bleeding. There might be pain in the pelvis, abdomen, or even the shoulder or neck (if blood from a ruptured ectopic pregnancy builds up and irritates certain nerves). The pain can range from mild and dull to severe and sharp. It might be felt on just one side of the pelvis or all over.

These symptoms also might happen with an ectopic pregnancy:

vaginal spotting
dizziness or fainting (caused by blood loss)
low blood pressure (also caused by blood loss)
lower back pain

What Causes an Ectopic Pregnancy?

An ectopic pregnancy usually happens because a fertilized egg couldn’t quickly move down the fallopian tube into the uterus. The tube can get blocked from an infection or inflammation. The tube can get blocked from:

pelvic inflammatory disease (PID)
endometriosis, when cells from the lining of the uterus implant and grow elsewhere in the body
scar tissue from previous abdominal or fallopian surgeries
rarely, birth defects that changed the shape of the tube

How Is an Ectopic Pregnancy Diagnosed?

If a woman might have an ectopic pregnancy, her doctor may do an ultrasound to see where the developing fetus is. Often, pregnancies are too small to see on ultrasound until more than 5 or 6 weeks after a woman’s last menstrual period. If an external ultrasound can’t show the pregnancy, the doctor might do the test with a wand-like device in the vagina.

A woman might need testing every few days if the first tests can’t confirm or rule out an ectopic pregnancy.

How Is an Ectopic Pregnancy Treated?

How doctors treat an ectopic pregnancy depends on things like the size and location of the pregnancy.

Sometimes they can treat an early ectopic pregnancy with an injection of methotrexate, which stops the growth of the embryo. The tissue usually is then absorbed by the woman’s body.

If the pregnancy is farther along, doctors usually need to do surgery to remove the abnormal pregnancy.

Whatever treatment she gets, a woman will see her doctor regularly afterward to make sure her pregnancy hormone levels return to zero. This may take several weeks. An elevated level could mean that some ectopic tissue was missed. If so, she might need more methotrexate or surgery.

What About Future Pregnancies?

Most women who have had an ectopic pregnancy can have normal pregnancies in the future. Having had one ectopic pregnancy does increase a woman’s risk of having another one.

What Else Should I Know?

Any woman can have an ectopic pregnancy. But the risk is higher for women who are older than 35 and those who have had:

PID
a previous ectopic pregnancy
surgery on a fallopian tube
infertility problems or medicine to stimulate ovulation

Some birth control methods also can affect a woman's risk of ectopic pregnancy. Those who become pregnant while using an intrauterine device (IUD) might be more likely to have an ectopic pregnancy. Smoking and having multiple sexual partners also increase the risk of an ectopic pregnancy.

When Should I Call the Doctor?

If you believe you're at risk for an ectopic pregnancy, meet with your doctor to talk about your options before you become pregnant. If you are pregnant and have any concerns about the pregnancy being ectopic, talk to your doctor — it's important to find it early. Your doctor might want to check your hormone levels or schedule an early ultrasound to ensure that your pregnancy is developing normally.

Call your doctor right away if you're pregnant and having any pain, bleeding, or other symptoms of ectopic pregnancy.

Treatment, surgery, early removal of ectopic pregnancy, removal of fallopian tubes, hCG and ultrasound in ectopic pregnancy in Nizhny Novgorod

Ectopic pregnancy: problems and solutions

Ectopic pregnancy is a dangerous complication of pregnancy that threatens life and health of the patient, and also has such adverse consequences as the formation of adhesions in the abdominal cavity and tubal infertility. Let it not surprise you that in this case, experts call pregnancy a disease, since an ectopic pregnancy cannot develop like a normal physiological pregnancy. Usually in the early stages (4-8 weeks), an ectopic pregnancy is interrupted, which leads to internal bleeding and requires emergency surgery. In the absence of timely medical intervention, an ectopic pregnancy is deadly.

An ectopic pregnancy occurs when the fetus does not descend from the fallopian tube into the uterus and attaches to the inside of the fallopian tube. Normally, the process of fertilization occurs in the fallopian tube, where the zygote formed after the fusion of the spermatozoon and the egg cell divides and turns into an embryo. Further, during a normal pregnancy, the fallopian (uterine) tubes contract and, as it were, “push” the future embryo towards the uterus, where the embryo “attaches” and “sticks” to the uterine mucosa (this process is called implantation), where it will take place. further development. However, with an ectopic pregnancy, this scenario takes on the character of a pathology: the embryo, without reaching the uterus, attaches to the fallopian tube and implants into its mucous membrane. Thus, before reaching the uterus, pregnancy occurs in the fallopian tube.

The fallopian tubes are not adapted to perform the function of a fetus, therefore, such a pregnancy “contradicts” natural processes and threatens the life and health of a woman, and therefore requires prompt medical intervention.

Ectopic pregnancy in the early stages: can it be recognized? From about 4 weeks, symptoms may appear that should alert the pregnant woman: pain in the lower abdomen, uterine or cavitary (into the abdominal cavity) bleeding, with large blood loss, there may be symptoms of shock, such as loss of consciousness, a drop in blood pressure, pallor, weakness. Symptoms are individual and depend on the nature of the pathology and the outcome of such a pregnancy (rupture of the fallopian tube, detachment of the embryo from the fallopian tube, etc.). In any case, a woman should not hesitate, you should immediately consult a doctor. It is best to go to the gynecologist if your period is late and pregnancy is suspected, even if it is not confirmed by the test!

HCG level in ectopic pregnancy: what will be the pregnancy test?

In an ectopic pregnancy, hCG (human chorionic gonadotropin, or pregnancy hormone) rises as in a normal pregnancy, so the test result may be positive. But it is worth noting that the level of hCG during an ectopic pregnancy, although it increases, remains lower compared to a normal uterine pregnancy (hormone production during an ectopic pregnancy is reduced). For this reason, it is necessary that a specialist diagnose your pregnancy. An ectopic pregnancy in the early stages with timely medical intervention has a favorable prognosis for the health and life of a woman, so it is necessary that a specialist deal with the diagnosis of an ectopic pregnancy in the early stages.

Diagnosis of tubal pregnancy

We recommend that if menstruation is delayed by 7-10 days, contact a gynecologist to clarify the diagnosis and conduct an ultrasound examination of the pelvic organs, which clearly reveals signs of pregnancy.

Currently, transvaginal (when the probe is inserted through the vagina) ultrasound in ectopic pregnancy is the first and mandatory step in the complex of diagnostic measures carried out in case of suspected ectopic pregnancy. Ultrasound during an ectopic pregnancy confirms the absence of a fetal egg in the uterus and its presence in the fallopian tube. In some cases, in addition to ultrasound in ectopic pregnancy, diagnostic laparoscopy is performed to clarify the diagnosis. Laparoscopy for ectopic pregnancy is performed under anesthesia, through small punctures an optical system is inserted into the abdomen, which allows the doctor to see the characteristic thickening of the fallopian tube with an enhanced vascular pattern, the presence of blood in the abdominal cavity. At the same time, the condition of the uterus, ovaries and the second fallopian tube is also assessed.

A positive pregnancy test (the appearance of hCG in the blood) in the absence of a fetal egg in the uterine cavity is an alarming condition that requires immediate medical attention.

Treatment of

ectopic pregnancy : is removal of the fallopian tube unavoidable?

Surgery for ectopic pregnancy:

Proper treatment of ectopic pregnancy - complex, which includes surgery, restoration of blood loss and control of shock, if any, restoration of reproductive function, if possible. Today, the generally accepted method of treating an ectopic pregnancy is surgery. Whether it will be radical (removal of the fallopian tube) or organ-preserving depends on the size of the fetal egg, the integrity of the wall of the tube (it may break), the place of attachment of the fetal egg in the tube and other factors.

Conservative operation for ectopic pregnancy (when it is possible to save the tube) are performed in the early stages, if the diameter of the fetal egg does not exceed 2 cm and the tube is intact.

When these conditions exist during ectopic pregnancy, the removal of the fetal egg is not accompanied by the removal of the tube, which means that the woman's reproductive function can be preserved. If these conditions are not present, or when a rupture of the fallopian tube or tubal abortion has already occurred, the operation for an ectopic pregnancy will be radical - fallopian tube removal or tubectomy. This fact once again confirms the need for early ultrasound diagnosis of pregnancy!

Diagnosis and treatment of ectopic pregnancy in Nizhny Novgorod

In Nizhny Novgorod, ectopic pregnancy is an urgent problem that requires a woman to see a doctor in a timely manner. Gynecologists at TONUS PREMIUM Medical Center are ready to offer accurate diagnosis and surgical treatment of ectopic pregnancy. Trust your health to professionals!

You can make an appointment with a gynecologist by calling 8 (831) 411-13-13

Ectopic pregnancy - Family Clinic

24 July 2016 Gynecology

This is the settling and development of the fetal egg outside the uterus. It poses a great danger to the life of a pregnant woman. A fertilized egg can graft on the ovaries, peritoneum, omentum and other abdominal organs, but most often in the tubes (99%).

Causes of ectopic pregnancy

Unfortunately, this pathology is quite common. During the operation, the couple had to take the fetal egg from anywhere: from the fallopian tubes, ovaries, even from the abdominal cavity. But more often than others, there is still a tubal pregnancy. Why does the attachment of a fertilized egg occur outside the uterus? What makes it go astray and begin to develop in an unintended place? As a rule, the fallopian tubes are to blame, unable to perform their functions.

Clinical experience shows that ectopic pregnancy is almost always preceded by inflammatory or infectious diseases of the genitals, abortion, difficult childbirth, complicated by the inflammatory process. In this case, the mucous membrane of the fallopian tubes swells, its folds stick together, the tubes are deformed and lose their ability to contract normally. Infantilism also predisposes to ectopic pregnancy.

With this disease, the tubes are excessively elongated, tortuous, their lumen is narrowed, they contract weakly. A healthy tube must contract actively in order to move the egg into the uterus. Moreover, this must be done within strictly defined deadlines, otherwise delay is fraught with disaster. After all, a fertilized egg develops and at a certain stage, villi appear in it, which need to gain a foothold and begin to receive a stable blood supply. If by this time the fetal egg has not been delivered to the uterus, it attaches anywhere, to the wall of the fallopian tube, for example, and begins to grow, unaware that this is the most inappropriate place for the development of the fetus.

After all, the lumen of the pipe is in its different sections from 1 mm to 1.5 cm, and a thin and delicate machine is not capable of stretching like a uterus. Therefore, approximately on the 4th-6th week, the chorionic villi “gnaw through” the wall, the tube breaks - and bleeding occurs into the abdominal cavity, accompanied by a sharp cramping pain in the lower abdomen, a feeling of lightheadedness, dizziness, and often loss of consciousness.

If a large vessel is damaged, massive blood loss threatens the woman with death, and only an emergency operation can save her. Sometimes events develop according to a slightly modified "scenario". It is not the tube that breaks, but the wall of the fetal egg, which is then expelled into the abdominal cavity. There is a so-called tubal abortion, also accompanied by severe pain in the lower abdomen, sometimes vomiting and dark brown bloody discharge from the vagina. After a while, the pain subsides and the woman begins to reassure herself that everything will be fine. No, it won't! And in this case, surgical intervention is necessary, otherwise peritonitis, a purulent inflammation of the peritoneum, may develop.

Diagnosis of ectopic pregnancy

Are there any special signs by which a woman herself can guess about an ectopic pregnancy? Alas, there are no special signs. A catastrophe (ruptures, bleeding) sometimes comes like a bolt from the blue: almost nothing bothers, except for a slight aching pain in the lower abdomen and spotting ...

And suddenly! But more often, an ectopic pregnancy is disguised as a normal one: the same delay in menstruation, the mammary glands are also engorged, sometimes there is slight nausea, taste and olfactory sensations are distorted. Therefore, a woman cannot independently recognize an ectopic pregnancy, but she certainly can prevent trouble without bringing the matter to bleeding, pain, loss of consciousness. How?

Yes, you just need to go to the antenatal clinic on the 4-7th day after the delay in menstruation. And there the experts will determine what it is connected with. Modern diagnostic methods, including ultrasound, allow you to establish pregnancy in the early stages. It is especially desirable to undergo an ultrasound examination for those who have a delay in menstruation accompanied by spotting bloody discharge.

If you don’t feel like going to the clinic, buy any test indicator for early diagnosis of pregnancy at the pharmacy. There are a lot of them, and it’s easy to use them (the instructions indicate how). With the help of the indicator, you can make sure that the pregnancy has occurred, but only a specialist can determine what kind of pregnancy it is - normal or pathological. At the slightest suspicion of an ectopic pregnancy, the doctor suggests that the woman go to the hospital.

Do not refuse: only in a specialized institution equipped with modern equipment, you can conduct the necessary studies and make an accurate diagnosis, determine where the embryo was implanted - in the uterus or outside it.