An ectopic pregnancy is a pregnancy that develops outside the main cavity of the womb (uterus). Ectopic pregnancies most commonly occur in a fallopian tube. This is called a tubal pregnancy. Occasionally, it will occur in other areas of the body, such as the abdominal cavity, the cervix, or even the ovaries. Because of their location in the body, ectopic pregnancies cannot develop safely. The fertilised egg cannot survive and the growing tissue can cause life-threatening bleeding if it is left untreated.
If you suspect you have an ectopic pregnancy, it is important to get a thorough diagnosis. In order to diagnose an ectopic pregnancy, it is necessary to perform some tests including a pregnancy test and an ultrasound scan. If an ectopic pregnancy is confirmed, the treatment options will be explained to you based on your medical condition.
Unfortunately, if you have an ectopic pregnancy, the developing embryo cannot be saved and treatment will be needed to remove it before it grows too large. The main treatment options for ectopic pregnancies are:
Expectant management: This is where your condition is carefully monitored to decide whether treatment will be necessary or the developing embryo will pass on its own.
Medication: A medicine called methotrexate is used to stop the pregnancy from developing any further. This can be a very difficult decision, particularly after IVF treatment. However, if the embryo is not removed, the results could be life-threatening.
Surgery: Sometimes, surgery is needed to remove the pregnancy, particularly if it has affected the fallopian tube.
Each of the above treatments has its advantages and disadvantages. Your doctor will discuss each of these with you in detail and recommend the most suitable option for you. The treatment you are given will depend on several factors, including your symptoms, the stage of the pregnancy, and the level of pregnancy hormone monitored in your blood.
If the fertilised egg continues growing in your fallopian tube, it can cause the tube to rupture. The pain caused by the rupture can be excruciating and can cause heavy bleeding inside the abdomen. Emergency symptoms can cause lightheadedness, severe abdominal pain, fainting and shock. You need to seek medical help immediately if you have any signs or symptoms of an ectopic pregnancy, including the following:
Severe abdominal or pelvic pain during pregnancy
Extreme light-headedness or fainting
Abnormal vaginal bleeding
A tubal pregnancy, which is the most common type of ectopic pregnancy, is caused when a fertilised egg gets stuck on its way to the uterus. This often happens because the fallopian tube is damaged by inflammation or because it is misshapen. Sometimes, hormonal imbalances or abnormal development of the fertilised egg may cause an ectopic pregnancy. However, nothing you have done will have caused the ectopic pregnancy to occur.
Many women do not realise until they attend their first ultrasound. Symptoms of an ectopic pregnancy usually develop within the first 4 to 12 weeks of pregnancy. However, some women won’t have any symptoms at first but may develop more serious symptoms as the pregnancy progresses.
Women who have had a previous ectopic pregnancy are more likely to have another.
Women who have damaged tubes, possibly after an infection, such as chlamydia or gonorrhoea.
Women who have had surgery to correct closed or damaged fallopian tubes.
If you get pregnant with an IUD in place, your risk is increased.
Women who have previously had pelvic inflammatory disease (PID)
While there is no way to completely prevent an ectopic pregnancy, there are steps you can take to decrease your risk:
Don’t smoke, but if you do, quit before you try to get pregnant.
Always use a condom during sex to help prevent sexually transmitted infections and to reduce your risk of pelvic inflammatory disease.
Ectopic pregnancy aftercare is essential. Losing a pregnancy at any stage can be devastating, and many women admit to feeling the same sense of grief as losing a family member or partner. It is not uncommon for the grief of a lost pregnancy to last for several months. Just make sure you give yourself and your partner plenty of time to grieve and work through your feelings in a healthy way.
If you or your partner are struggling to come to terms with your pregnancy loss, you could benefit from the professional fertility counselling services we provide at TFP. Call us today to find out more about this. You could also consider joining a support group for people who have been affected by the loss of a pregnancy. Some of the groups we recommend would be the following:
The Ectopic Pregnancy Trust
The Miscarriage Association
Cruse Bereavement Care
The Ectopic Pregnancy Foundation
Fertility Network UK
While many people shy away from suggestions like support groups, meeting people who are going through similar experiences is invaluable.
When you and your partner feel physically and emotionally ready, you can start trying for a baby. We would advise that you wait until you’ve had at least 2 menstrual cycles after your treatment to allow your body plenty of time to recover. And if you were treated with methotrexate, it is recommended that you wait at least 3 months.
Most women who have had an ectopic pregnancy will be able to get pregnant again, even if they have had a fallopian tube removed. Around 65% of women conceive again within 18 months of an ectopic pregnancy. If you conceive again naturally, it is important to let your doctor know as soon as possible so that early scans can be carried out to check that everything is okay. Occasionally, it may be necessary to have fertility treatment to help increase the chances of successful conception.
If you have experienced an ectopic pregnancy, you may be nervous about trying again for a baby. It is important to remember that many women go on to have healthy pregnancies and babies, even after ectopic pregnancies. When you’re ready, book a consultation at TFP; we would be more than happy to answer any questions you may have and advise you on the best next steps for you.