Ectopic pregnancy implantation
Ectopic Pregnancy: Causes, Symptoms & Treatments
Overview
What is Ectopic Pregnancy?What is an ectopic pregnancy?
An ectopic pregnancy is a pregnancy that happens outside of your uterus. This occurs when a fertilized egg implants in a location that can’t support its growth. An ectopic pregnancy most often happens in your fallopian tube (a structure that connects your ovaries and uterus). Ectopic pregnancies more rarely can occur in your ovary, abdominal cavity or cervix. Pregnancies can’t continue if they’re ectopic because only your uterus is meant to carry a pregnancy.
Ectopic pregnancies can become life-threatening, especially if your fallopian tube breaks (ruptures). This is a ruptured ectopic pregnancy, and it can cause severe bleeding, infection and sometimes, death. This is a medical emergency. Healthcare providers must treat ectopic pregnancies quickly.
Where does an ectopic pregnancy happen?
An ectopic pregnancy happens when a fertilized egg implants outside of your uterus. The egg is meant to travel down your fallopian tubes and embed itself into the wall of your uterus, where it can develop. In an ectopic pregnancy, the egg implants in one of the structures along the way. The most common place this can happen is inside your fallopian tubes. The majority of ectopic pregnancies happen here — about 90%.
How common are ectopic pregnancies?
Ectopic pregnancies occur in about 2% of all pregnancies.
Symptoms and Causes
What are the symptoms of an ectopic pregnancy?
The early symptoms of an ectopic pregnancy can be very similar to typical pregnancy symptoms. However, you may experience additional symptoms during an ectopic pregnancy, including:
- Vaginal bleeding.
- Pain in your lower abdomen, pelvis and lower back.
- Dizziness or weakness.
If your fallopian tube ruptures, the pain and bleeding could be severe enough to cause additional symptoms. These can include:
- Fainting.
- Low blood pressure (hypotension).
- Shoulder pain.
- Rectal pressure or bowel problems.
When a tube bursts, you may feel sudden, sharp lower abdominal pain. This is a medical emergency. You should contact your healthcare provider or go to the emergency room immediately.
What causes an ectopic pregnancy?
In most cases, conditions that slow down or block the movement of the egg down your fallopian tube cause ectopic pregnancy. This could happen because:
- You have scar tissue, adhesions or inflammation from a prior pelvic surgery.
- Your fallopian tubes have damage, such as from a sexually transmitted infection (STI).
- You were born with an irregularly-shaped fallopian tube.
- You have a growth blocking your fallopian tube.
How do I know if I’m at risk of an ectopic pregnancy?
There are several risk factors that could increase your chance of developing an ectopic pregnancy. You may be at a higher risk of developing an ectopic pregnancy if you’ve had:
- A previous ectopic pregnancy.
- A history of pelvic inflammatory disease (PID), an infection that can cause scar tissue to form in your fallopian tubes, uterus, ovaries and cervix.
- Surgery on your fallopian tubes (including tubal ligation) or on the other organs of your pelvic area.
- A history of infertility.
- Treatment for infertility with in vitro fertilization (IVF).
- Endometriosis.
- Sexually transmitted infections (STIs).
- An IUD in place at the time of conception.
- A history of smoking tobacco.
If you realize that you’re pregnant and have an IUD (intrauterine device) in place, or have a history of a tubal ligation (having your tubes tied), contact your healthcare provider right away. Ectopic pregnancy is more common in these situations.
Your risk can also increase with age. People over age 35 have a higher risk than people under 35.
Up to 50% of people who experience an ectopic pregnancy don’t have any of the above risk factors.
What are the complications of an ectopic pregnancy?
An ectopic pregnancy is a medical emergency. Your uterus is the only organ that can hold a growing fetus. It can stretch and expand as the fetus grows. Your fallopian tubes aren’t as flexible. They can burst as the fertilized egg develops. If this happens, it can cause severe, life-threatening internal bleeding. This is dangerous. An ectopic pregnancy needs to be treated right away to avoid injury to your fallopian tube and other organs, internal bleeding and possibly, death.
Diagnosis and Tests
How is an ectopic pregnancy diagnosed?
Most people don’t know that their pregnancy is ectopic until they visit their pregnancy care provider for a prenatal appointment, bloodwork or ultrasound. Your provider may suspect an ectopic pregnancy based on what happens at this appointment.
To diagnose an ectopic pregnancy, your provider will perform several tests. This may include a pelvic exam and confirmation of pregnancy.
These tests include:
- A urine test: This test involves either peeing on a test strip or into a cup in your provider’s office and then having a test strip dipped into the urine sample.
- A blood test: You provider may test your blood to see how much of the hormone human chorionic gonadotropin (HCG) you have in your body. Your body only makes HCG during pregnancy. A low amount may indicate an ectopic pregnancy because HCG levels increase dramatically when a fertilized egg implants in your uterus.
- An ultrasound exam: An ultrasound uses sound waves to create a picture of your body’s internal structures. Your provider will use this test to see where the fertilized egg has implanted.
If your provider suspects the ectopic pregnancy has ruptured, they can also perform culdocentesis, but this is rarely used.
Once your provider has confirmed an ectopic pregnancy and determined where the fertilized egg has implanted, they’ll discuss a treatment plan with you.
An ectopic pregnancy is an emergency and treatment is very important.
How soon would you know if you have an ectopic pregnancy?
Ectopic pregnancy is typically discovered early in pregnancy. Healthcare providers usually diagnose ectopic pregnancies in the first trimester (up to 12 weeks of pregnancy). However, most people discover they have an ectopic pregnancy around eight weeks of pregnancy.
Management and Treatment
How is an ectopic pregnancy treated?
Healthcare providers treat ectopic pregnancies with medication or surgery.
Methotrexate for ectopic pregnancy
In some cases, your provider may suggest using a medication called methotrexate to stop the fertilized egg from growing, ending the pregnancy. The medication shouldn’t damage your fallopian tubes. You can’t use this medication if your fallopian tube has already ruptured.
Your healthcare provider gives you methotrexate as a single injection. This option is less invasive than surgery, but it does require follow-up appointments so your provider can monitor your HCG levels.
It’s important to have consistent follow-up in these cases. In rare cases, a second injection of methotrexate is necessary if HCG levels don’t decrease enough with one dose. Talk to your healthcare provider about the possible side effects and risks of methotrexate so you know what to expect.
Surgery for ectopic pregnancy
Your provider will want to remove the ectopic pregnancy with surgery if your fallopian tube has ruptured or if you’re at risk of rupture. This is an emergency surgery and a life-saving treatment. The procedure is typically done laparoscopically (through several small incisions in your abdomen) while you’re asleep under anesthesia. The surgeon may remove your entire fallopian tube with the egg still inside it or remove the egg from the tube (preserving your fallopian tube).
Prevention
Can I prevent an ectopic pregnancy?
You can’t prevent an ectopic pregnancy. However, you can try to reduce your risk by following good lifestyle habits.
These can include not smoking, reaching and maintaining a healthy weight and preventing any sexually transmitted infections (STIs). Talk to your healthcare provider about any risk factors you may have before trying to become pregnant.
Outlook / Prognosis
Can I get pregnant again after an ectopic pregnancy?
Most people with a past ectopic pregnancy can have future successful pregnancies. There’s a higher risk of having ectopic pregnancies after you’ve had one. It’s important to talk to your healthcare provider about the causes of your ectopic pregnancy and what risk factors you may have that could cause a future ectopic pregnancy.
How long should I wait before becoming pregnant again after an ectopic pregnancy?
You should talk to your healthcare provider about future pregnancies after being treated for an ectopic pregnancy. Although pregnancy may happen quickly after treatment, it’s often best to wait about three months. This gives your fallopian tube time to heal and decreases the risk of another ectopic pregnancy.
Can I still have a baby if my fallopian tube was removed?
In most cases, you can still have a baby if you’ve had one of your fallopian tubes removed. Most people are born with two fallopian tubes. Only one fallopian tube is necessary for a pregnancy. Eggs can still travel down your remaining fallopian tube. There are also assisted fertility procedures like IVF that don’t involve your fallopian tubes. Have an open conversation about your thoughts on future pregnancies with your healthcare provider. Together, you can form a plan and discuss ways to decrease any risk factors you may have.
Frequently Asked Questions
Can my pregnancy continue after an ectopic pregnancy?
Unfortunately, an ectopic pregnancy is fatal for the fetus and your pregnancy can’t continue. Once an egg implants outside your uterus, you can’t move it to your uterus. Prompt treatment for an ectopic pregnancy is important. If the egg has implanted in your fallopian tube and the tube bursts, there can be severe internal bleeding.
A note from Cleveland Clinic
An ectopic pregnancy can be unexpected and scary. You’re probably feeling many emotions, including grief, shock and anxiety. Even if your pregnancy was unplanned, going through an ectopic pregnancy can cause trauma. Talking to your partner, healthcare provider or a mental health professional may be helpful as you navigate your feelings. In time, you’ll heal from an ectopic pregnancy. If a future pregnancy is in your plans, be sure to talk to your healthcare provider about your risk for another ectopic pregnancy.
Ectopic Pregnancy: Causes, Symptoms & Treatments
Overview
What is Ectopic Pregnancy?What is an ectopic pregnancy?
An ectopic pregnancy is a pregnancy that happens outside of your uterus. This occurs when a fertilized egg implants in a location that can’t support its growth. An ectopic pregnancy most often happens in your fallopian tube (a structure that connects your ovaries and uterus). Ectopic pregnancies more rarely can occur in your ovary, abdominal cavity or cervix.
Pregnancies can’t continue if they’re ectopic because only your uterus is meant to carry a pregnancy.
Ectopic pregnancies can become life-threatening, especially if your fallopian tube breaks (ruptures). This is a ruptured ectopic pregnancy, and it can cause severe bleeding, infection and sometimes, death. This is a medical emergency. Healthcare providers must treat ectopic pregnancies quickly.
Where does an ectopic pregnancy happen?
An ectopic pregnancy happens when a fertilized egg implants outside of your uterus. The egg is meant to travel down your fallopian tubes and embed itself into the wall of your uterus, where it can develop. In an ectopic pregnancy, the egg implants in one of the structures along the way. The most common place this can happen is inside your fallopian tubes. The majority of ectopic pregnancies happen here — about 90%.
How common are ectopic pregnancies?
Ectopic pregnancies occur in about 2% of all pregnancies.
Symptoms and Causes
What are the symptoms of an ectopic pregnancy?
The early symptoms of an ectopic pregnancy can be very similar to typical pregnancy symptoms.
However, you may experience additional symptoms during an ectopic pregnancy, including:
- Vaginal bleeding.
- Pain in your lower abdomen, pelvis and lower back.
- Dizziness or weakness.
If your fallopian tube ruptures, the pain and bleeding could be severe enough to cause additional symptoms. These can include:
- Fainting.
- Low blood pressure (hypotension).
- Shoulder pain.
- Rectal pressure or bowel problems.
When a tube bursts, you may feel sudden, sharp lower abdominal pain. This is a medical emergency. You should contact your healthcare provider or go to the emergency room immediately.
What causes an ectopic pregnancy?
In most cases, conditions that slow down or block the movement of the egg down your fallopian tube cause ectopic pregnancy. This could happen because:
- You have scar tissue, adhesions or inflammation from a prior pelvic surgery.
- Your fallopian tubes have damage, such as from a sexually transmitted infection (STI).
- You were born with an irregularly-shaped fallopian tube.
- You have a growth blocking your fallopian tube.
How do I know if I’m at risk of an ectopic pregnancy?
There are several risk factors that could increase your chance of developing an ectopic pregnancy. You may be at a higher risk of developing an ectopic pregnancy if you’ve had:
- A previous ectopic pregnancy.
- A history of pelvic inflammatory disease (PID), an infection that can cause scar tissue to form in your fallopian tubes, uterus, ovaries and cervix.
- Surgery on your fallopian tubes (including tubal ligation) or on the other organs of your pelvic area.
- A history of infertility.
- Treatment for infertility with in vitro fertilization (IVF).
- Endometriosis.
- Sexually transmitted infections (STIs).
- An IUD in place at the time of conception.
- A history of smoking tobacco.
If you realize that you’re pregnant and have an IUD (intrauterine device) in place, or have a history of a tubal ligation (having your tubes tied), contact your healthcare provider right away.
Ectopic pregnancy is more common in these situations.
Your risk can also increase with age. People over age 35 have a higher risk than people under 35.
Up to 50% of people who experience an ectopic pregnancy don’t have any of the above risk factors.
What are the complications of an ectopic pregnancy?
An ectopic pregnancy is a medical emergency. Your uterus is the only organ that can hold a growing fetus. It can stretch and expand as the fetus grows. Your fallopian tubes aren’t as flexible. They can burst as the fertilized egg develops. If this happens, it can cause severe, life-threatening internal bleeding. This is dangerous. An ectopic pregnancy needs to be treated right away to avoid injury to your fallopian tube and other organs, internal bleeding and possibly, death.
Diagnosis and Tests
How is an ectopic pregnancy diagnosed?
Most people don’t know that their pregnancy is ectopic until they visit their pregnancy care provider for a prenatal appointment, bloodwork or ultrasound.
Your provider may suspect an ectopic pregnancy based on what happens at this appointment.
To diagnose an ectopic pregnancy, your provider will perform several tests. This may include a pelvic exam and confirmation of pregnancy. These tests include:
- A urine test: This test involves either peeing on a test strip or into a cup in your provider’s office and then having a test strip dipped into the urine sample.
- A blood test: You provider may test your blood to see how much of the hormone human chorionic gonadotropin (HCG) you have in your body. Your body only makes HCG during pregnancy. A low amount may indicate an ectopic pregnancy because HCG levels increase dramatically when a fertilized egg implants in your uterus.
- An ultrasound exam: An ultrasound uses sound waves to create a picture of your body’s internal structures. Your provider will use this test to see where the fertilized egg has implanted.
If your provider suspects the ectopic pregnancy has ruptured, they can also perform culdocentesis, but this is rarely used.
Once your provider has confirmed an ectopic pregnancy and determined where the fertilized egg has implanted, they’ll discuss a treatment plan with you. An ectopic pregnancy is an emergency and treatment is very important.
How soon would you know if you have an ectopic pregnancy?
Ectopic pregnancy is typically discovered early in pregnancy. Healthcare providers usually diagnose ectopic pregnancies in the first trimester (up to 12 weeks of pregnancy). However, most people discover they have an ectopic pregnancy around eight weeks of pregnancy.
Management and Treatment
How is an ectopic pregnancy treated?
Healthcare providers treat ectopic pregnancies with medication or surgery.
Methotrexate for ectopic pregnancy
In some cases, your provider may suggest using a medication called methotrexate to stop the fertilized egg from growing, ending the pregnancy.
The medication shouldn’t damage your fallopian tubes. You can’t use this medication if your fallopian tube has already ruptured.
Your healthcare provider gives you methotrexate as a single injection. This option is less invasive than surgery, but it does require follow-up appointments so your provider can monitor your HCG levels. It’s important to have consistent follow-up in these cases. In rare cases, a second injection of methotrexate is necessary if HCG levels don’t decrease enough with one dose. Talk to your healthcare provider about the possible side effects and risks of methotrexate so you know what to expect.
Surgery for ectopic pregnancy
Your provider will want to remove the ectopic pregnancy with surgery if your fallopian tube has ruptured or if you’re at risk of rupture. This is an emergency surgery and a life-saving treatment. The procedure is typically done laparoscopically (through several small incisions in your abdomen) while you’re asleep under anesthesia.
The surgeon may remove your entire fallopian tube with the egg still inside it or remove the egg from the tube (preserving your fallopian tube).
Prevention
Can I prevent an ectopic pregnancy?
You can’t prevent an ectopic pregnancy. However, you can try to reduce your risk by following good lifestyle habits. These can include not smoking, reaching and maintaining a healthy weight and preventing any sexually transmitted infections (STIs). Talk to your healthcare provider about any risk factors you may have before trying to become pregnant.
Outlook / Prognosis
Can I get pregnant again after an ectopic pregnancy?
Most people with a past ectopic pregnancy can have future successful pregnancies. There’s a higher risk of having ectopic pregnancies after you’ve had one. It’s important to talk to your healthcare provider about the causes of your ectopic pregnancy and what risk factors you may have that could cause a future ectopic pregnancy.
How long should I wait before becoming pregnant again after an ectopic pregnancy?
You should talk to your healthcare provider about future pregnancies after being treated for an ectopic pregnancy.
Although pregnancy may happen quickly after treatment, it’s often best to wait about three months. This gives your fallopian tube time to heal and decreases the risk of another ectopic pregnancy.
Can I still have a baby if my fallopian tube was removed?
In most cases, you can still have a baby if you’ve had one of your fallopian tubes removed. Most people are born with two fallopian tubes. Only one fallopian tube is necessary for a pregnancy. Eggs can still travel down your remaining fallopian tube. There are also assisted fertility procedures like IVF that don’t involve your fallopian tubes. Have an open conversation about your thoughts on future pregnancies with your healthcare provider. Together, you can form a plan and discuss ways to decrease any risk factors you may have.
Frequently Asked Questions
Can my pregnancy continue after an ectopic pregnancy?
Unfortunately, an ectopic pregnancy is fatal for the fetus and your pregnancy can’t continue.
Once an egg implants outside your uterus, you can’t move it to your uterus. Prompt treatment for an ectopic pregnancy is important. If the egg has implanted in your fallopian tube and the tube bursts, there can be severe internal bleeding.
A note from Cleveland Clinic
An ectopic pregnancy can be unexpected and scary. You’re probably feeling many emotions, including grief, shock and anxiety. Even if your pregnancy was unplanned, going through an ectopic pregnancy can cause trauma. Talking to your partner, healthcare provider or a mental health professional may be helpful as you navigate your feelings. In time, you’ll heal from an ectopic pregnancy. If a future pregnancy is in your plans, be sure to talk to your healthcare provider about your risk for another ectopic pregnancy.
Ectopic pregnancy - causes, most common symptoms and treatment.
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3 decembris 2021 | 3.
5 minutes of reading
SUMMARY An ectopic pregnancy, that is, the implantation and development of an embryo in a pathological site, is quite rare. However, this causes very dangerous complications that endanger the life of the mother, so it is very important to quickly diagnose an ectopic pregnancy and start appropriate treatment.
What is an ectopic pregnancy?
In an ectopic pregnancy, the fetus develops outside the mucous membrane of the uterine cavity . The course of a normal pregnancy is as follows: the egg meets the sperm in the fallopian tube, where fertilization takes place. The fertilized egg then passes through the fallopian tube into the uterus, where the implantation process takes place, that is, the embryo is implanted in the endometrium of the uterus. The situation when the embryo implants outside the endometrium is called an ectopic pregnancy. The most common pathological sites of embryo implantation are the fallopian tubes, but sometimes an ectopic pregnancy develops in the ovaries, cervix, and even the abdominal cavity.
In these cases, the development and bearing of pregnancy is impossible, and this endangers not only the health of the woman, but also her life. Usually, the treatment of an ectopic pregnancy requires surgery.
Do you have any questions? Contact us!
Types of ectopic pregnancy
Depending on the place of implantation of the embryo , the following types of ectopic pregnancy are distinguished:
Causes of ectopic pregnancy
Most ectopic pregnancies develop without a specific cause. Factors contributing to the development of ectopic pregnancy:
- endometriosis,
- narrowing of the fallopian tubes,
- inflammation of the ovaries or fallopian tubes,
- sexually transmitted infections - such as gonorrhea, chlamydia,
- gynecological and other abdominal surgeries,
- fallopian tube defects,
- smoking,
- ectopic pregnancy,
- intrauterine device.
Symptoms of ectopic pregnancy
Early ectopic pregnancy is asymptomatic. Pregnancy tests show a positive result, just like a normal pregnancy. Signs of an ectopic pregnancy may appear about two months after conception, making early detection difficult. In the case of a progressive ectopic pregnancy, improper implantation of the embryo may be indicated by:
- painful abdomen;
In case of rupture of the fallopian tubes, symptoms of shock may occur - cold sweat, shortness of breath, fainting, "hard stomach", rapid heartbeat. In this case, immediate medical attention is required.
Diagnosis of ectopic pregnancy
Women usually see a doctor immediately after a positive pregnancy test. Then it is still impossible to distinguish a normal pregnancy from an ectopic pregnancy. During the first visit, the doctor determines the date of the last menstrual period and the duration of the woman's menstrual cycle. If, according to ultrasound, there is no fetal egg in the uterine cavity, a test for beta-hCG (human chorionic gonadotropin) should be performed as soon as possible and appropriate treatment should be prescribed.
The level of the hCG hormone in the blood and the rate of its growth indicate the course of pregnancy - if the level of the hormone increases too slowly, an ectopic pregnancy can be suspected. In some cases, a diagnostic laparoscopy is performed to confirm the diagnosis.
Treatment of ectopic pregnancy
The method of treatment depends on the period of development of the fetus, the site of abnormal implantation and the degree of risk to the health of the woman. Early detection of ectopic pregnancy the doctor may prescribe pharmacological drugs that inhibit the development of the embryo . This will protect the fallopian tubes from damage. If the diagnosis is made after 8 weeks of gestation, surgery is usually required, and sometimes removal of the fallopian tube, especially for internal bleeding . Currently, this procedure is performed using laparoscopy, after which there are no visible scars, and recovery is much faster. In only a few cases, an incorrectly implanted embryo spontaneously disappears - is absorbed into the tissues.
With an ectopic pregnancy, a consultation with a gynecologist is always required.
Re-pregnancy after an ectopic pregnancy
Although an ectopic pregnancy is a very unpleasant and sometimes very painful experience, it usually does not prevent a second, healthy pregnancy. If it was necessary to remove the fallopian tube during an ectopic pregnancy, this possibility is slightly reduced, but a second pregnancy is still possible if the second fallopian tube is not damaged. Before planning your next pregnancy, you should wait 3 months and use contraceptives, as well as take care of your mental health and comfort. The risk that the next pregnancy will also be ectopic is small, but it is possible. It is worth checking the patency of the fallopian tubes . If the patient has both fallopian tubes removed, or if tests show that the fallopian tubes are impermeable, medical methods of insemination should be considered. Procedures can be performed at My Clinic Riga.
See also
- Gynecological laparoscopy
- Fertility Clinic
- PCOS
- endometriosis
- ECO
Inpatient operations - Surgical treatment of ectopic pregnancy by laparoscopic method close to home
Paracelsus Medical Center
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Ectopic pregnancy - pregnancy in which the attachment (implantation) of the ovum does not occur in the uterine cavity.
The main treatment for ectopic pregnancy is surgery.
In our Medical Center Paracelsus, a laparoscopic method is used, during which the surgeon uses Karl Storz equipment, which allows in most cases to save the fallopian tube, which increases the woman's chances of having a future pregnancy.
The operation is performed under endotracheal anesthesia.
Stay in the hospital for this pathology 2-3 days. All the necessary examination before this operation can be done within 30 minutes at the National Medical Center Parcels.
Further rehabilitation, examination of women and preparation for a new pregnancy can also be carried out at the specialists of the NMC Paracelsus.
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Dear patients!
Multidisciplinary Clinic and Maternity Hospital "Paracelsus" informs you, according to the Letter of the Ministry of Finance of the Russian Federation to the Federal Tax Service dated March 25, 2022.
N BS-4-11 / 3605, that subparagraph 3 of paragraph 1 of Article 219 of the Tax Code of the Russian Federation provides for the taxpayer's right to receive a social tax deduction in the amount paid by him in the tax period for medical services provided by medical organizations engaged in medical activities , him, his spouse, parents, children (including adopted children) under the age of 18, wards under the age of 18 (in accordance with the list of medical services approved by the Government of the Russian Federation).
Joint order of the Ministry of Taxation of Russia and the Ministry of Health of Russia of July 25, 2001 N 289 / BG-3-04 / 256 (hereinafter - the order of July 25, 2001) approved the form of the Certificate of payment for medical services for submission to the tax authorities of the Russian Federation (hereinafter - the Certificate payment for medical services).
This certificate certifies the fact of receiving a medical service and its payment through the cash desk of a healthcare institution at the expense of the taxpayer.
