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Ectopic Pregnancy – What It Is & Common Symptoms

A woman in pain due to ectopic pregnancy,  in consultation with a doctor taking notes
Woman in pain from ectopic pregnancy

(Tina Dawn/ VM-Med) — Finding out you are pregnant can be both an exciting and unnerving time, as you can worry about your and your baby’s health. It’s important to remember that most pregnancies progress without incident, but minor or even major complications can occur for some.

One of those complications is an ectopic pregnancy. If you’re pregnant, you should understand what this serious complication is, how to detect something that may be wrong, and how best to manage it. An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus. It’s a serious medical issue –often life-threatening if not treated immediately–and it almost always requires medical intervention.

While ectopic pregnancies are relatively rare, they still occur in an estimated 1 per cent to 2 per cent of pregnancies. It’s important to note that even if the pregnancy is ectopic, and the baby is non-viable, you will still have a positive pregnancy test. This is because, regardless of the location of the implanted fertilized egg, it still produces HCG, a hormone made by the placenta during pregnancy.

Signs of an ectopic pregnancy

Often, the first warning signs of an ectopic pregnancy are pain or vaginal bleeding. There might be pain in the abdomen, pelvis, or even the shoulder or neck. The pain can range from mild and dull to severe and sharp.

The symptoms are not always easy to detect. According to Web MD , “only about half of women with an ectopic pregnancy will have all three of the main signs: a missed period, vaginal bleeding, and belly pain.”

Symptoms of an ectopic pregnancy usually develop between the 4th and 12th weeks of pregnancy. Some women don’t have any symptoms at first. They may not find out they have an ectopic pregnancy until an early scan finds the problem or they start developing more serious symptoms later.

Your doctor can determine if you are dealing with an ectopic pregnancy via a pelvic exam and a non-invasive ultrasound that will look at your uterus and fallopian tubes.

How dangerous is an ectopic pregnancy?

Ectopic pregnancies are very dangerous if not treated. As the fertilized egg grows, it can burst and can cause life-threatening bleeding. If your fallopian tube ruptures, you will experience major pain, with or without bleeding and will need medical care right away.

Studies in the Canadian Medical Association Journal show that “between 6 per cent to 16 per cent of pregnant people who go to an emergency department in the first trimester for bleeding, pain, or both have an ectopic pregnancy.”

Ectopic pregnancies are the leading cause of pregnancy-related deaths in the first trimester. Luckily, with access to healthcare and increased knowledge of the signs early on, deaths from ectopic pregnancies are very rare today.

An ectopic pregnancy will always result in pregnancy loss because the baby is not viable. It should not be confused with a miscarriage. While an ectopic pregnancy usually ends in a miscarriage, a miscarriage can happen for a variety of other reasons.

Types of ectopic pregnancies

There are different types of ectopic pregnancy, depending on where the fertilized egg implants. When a fertilized egg implants on the outside of your ovary that’s referred to as an ovarian ectopic pregnancy. On a rare occasion, a pregnancy can happen in the abdominal cavity, in the space between your abdominal wall and spine and is referred to as an abdominal ectopic pregnancy. A cervical ectopic pregnancy happens when an egg implants in the cervical canal, and finally, a cesarean scar ectopic pregnancy is when a fertilized egg attaches to scar tissue from a C-section.

A cornual pregnancy (interstitial pregnancy) is a rare form of ectopic pregnancy where implantation occurs in the interstitial segment of the fallopian tube which is defined as the tubal section crossing uterine muscular tissue. A diagnosis of cornual pregnancy remains challenging because this specific type of ectopic pregnancy poses a higher level of risk compared to other forms, as it has the potential to result in severe haemorrhage, shock, and uterine rupture. In very rare circumstances, cornual pregnancies can result in a viable fetus.

It is impossible to move a fertilized egg back to the uterus once it has started erroneously growing in a fallopian tube, cervix, ovary, abdomen, or cesarean scar, according to the American College of Obstetricians and Gynecology (ACOG).

For tubal ectopic pregnancies, treatment is usually your physician administering medications that dissolve the ectopic pregnancy tissue, or surgery. The smaller the pregnancy, the more uncomplicated treatment is, making it essential to consult with your healthcare provider once you find out you’re pregnant. Further along, ectopic pregnancies are far more complex and may require surgery.

Ectopic pregnancy risk factors

The risk factors for someone to experience an ectopic pregnancy include the following:

·   Previous ectopic pregnancy

·   Prior fallopian tube surgery

·   Previous pelvic or abdominal surgery

·   Certain sexually transmitted infections (STIs)

·   Pelvic inflammatory disease

·   Endometriosis

Other risk factors that may increase a woman’s risk of ectopic pregnancy include:

·   Cigarette smoking

·   Being older than 35 years

·   History of infertility

·   Use of in vitro fertilization (IVF)

It’s important to note that one-half of all women who have an ectopic pregnancy do not have any known risk factors. Women who have experienced an ectopic pregnancy have, however, a 15 per cent chance of another ectopic pregnancy after the first one.

Considering how dangerous ectopic pregnancies can be if left untreated, it’s essential to get suspicious symptoms such as bleeding or stomach pain checked out as early as possible and to consult with your doctor as soon as you discover you’re pregnant. A healthy pregnancy and a healthy outcome for the person experiencing the pregnancy require early and prompt intervention.

VM Med’s gynecology centre supports every aspect of our patients’ gynecological health throughout the course of their lives. We offer a welcoming environment and specialized counselling and treatments on a wide range of issues, including all prenatal care.

Genetic and first-trimester screening are also vital tools for helping diagnose the potential for certain genetic disorders or conditions that can be dangerous.

For more information, you can read our extensive archive of VM Med blogs, including how to detect the early signs of pregnancy.

Still have questions? Book a consultation with our experts.