Ectopic pregnancy

What is ectopic pregnancy?

Sometimes a pregnancy develops outside of the uterus, most commonly in the fallopian tube, sometimes in the ovary or very rarely in the abdomen. That sort of pregnancy unfortunately cannot continue as the fallopian tube is far less distensible as uterus. Once a pregnancy reaches a certain size it erodes blood vessels or ruptures the structures it grows in. This is a potentially a life threatening emergency.

What are symptoms of ectopic pregnancy?

Initially you may experience all the usual pregnancy symptoms such as nausea, vomiting, and breast tenderness. When a pregnancy stretches the fallopian tubes it causes abdominal pain which is usually located on the side of the ectopic pregnancy. You may experience vaginal bleeding, but this is less common. If an ectopic pregnancy ruptures, it can cause severe abdominal pain; bleeding in the abdominal cavity which may be severe and you may experience light-headedness, dizziness and may lose consciousness. This is a medical emergency and an ambulance should be called immediately.

How is ectopic pregnancy diagnosed?

Pregnancy will be confirmed with a blood test or urine test. If a patient is stable ,we usually perform pelvic ultrasound to confirm diagnosis.

How is ectopic pregnancy managed?

A surgical procedure is indicated to remove an ectopic pregnancy.

If an ectopic pregnancy is diagnosed by performing “dating” ultrasound and a patient is without pain, it is possible to undergo treatment with medication that dissolves the pregnancy. If this option is chosen, a follow-up over several weeks may be needed. You will also be advised against falling pregnant within 3 months of treatment.

What are risk factors for ectopic pregnancy?

Anyone with a uterus, fallopian tubes and ovaries can have an ectopic pregnancy. You may be at higher risk if:

• You had previous ectopic pregnancy
• Have damaged fallopian tubes do to prior infection or surgery or sterilisation procedure
• Using minipill
• Have an IUD inserted
• Are you a smoker
• Are having fertility treatment