Are you TTC? Worried about having an ectopic pregnancy? Let’s talk about what an ectopic pregnancy is, what symptoms to look for, and how they’re treated. 

 

By fertility expert and OBGYN Dr. Kenosha Gleaton

Ectopic pregnancies are uncommon, impacting just two percent of pregnancies in the US.

However, I suspect the rate is much higher. The true current incidence of ectopic pregnancy is difficult to estimate because many patients are treated in an outpatient setting where events are not tracked, and national surveillance data on ectopic pregnancy have not been updated since 1992.

Ectopic pregnancies can cause major complications for the woman and need to be diagnosed and treated as soon as possible. Let’s break down how an ectopic pregnancy develops, what signs you should look out for, and what treatment and recovery may be like. 

What’s an ectopic pregnancy?

When an egg is fertilized, it will typically travel through the fallopian tube and into the uterus, where it implants into the uterine lining. When an ectopic pregnancy occurs, the fertilized egg grows outside of the uterus. This can potentially be very dangerous, as the majority of ectopic pregnancies occur in a fallopian tube. This can cause the tube to burst and may cause internal bleeding. 

Signs of an ectopic pregnancy

An ectopic pregnancy will likely feel like a typical pregnancy at first, with symptoms such as a missed period, tender breasts, or an upset stomach. Some other symptoms you may notice include:

  • Abnormal vaginal bleeding
  • Low back pain
  • Mild cramping on one side of the pelvis  

Symptoms specific to ectopic pregnancy typically develop around four to 12 weeks.

In the early stages, it may be hard to know if you are experiencing a typical pregnancy or an ectopic pregnancy. Symptoms specific to ectopic pregnancy typically develop around four to 12 weeks. If you notice any unusual symptoms, you should talk to your doctor. As an ectopic pregnancy grows, more serious symptoms may develop, especially if a fallopian tube ruptures. Symptoms may include the following:

  • Sudden, severe pain in the abdomen or pelvis
  • Shoulder pain
  • Weakness, dizziness, or fainting  

If you notice any of these symptoms, you should alert your doctor immediately. 

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Risk factors for an ectopic pregnancy

Some factors could increase your risk of an ectopic pregnancy. These include:

  • Previous ectopic pregnancy
  • Past surgeries or complications with your fallopian tubes
  • Certain STIs
  • Endometriosis
  • Cigarette smoking
  • Use of ART, such as IVF

How to manage/treat ectopic pregnancy

There are two methods used to treat an ectopic pregnancy: medication and surgery. Both of these treatment options require several weeks of recovery and follow up. 

The most common medication used to treat an ectopic pregnancy is methotrexate. This is used to stop the cells from growing and ultimately ending the pregnancy. Methotrexate is often given by injection, then the body will absorb the pregnancy over a month or so. You will be monitored for a few weeks until there are no traces of hCG in your blood. 

If the fallopian tube has ruptured, medication will no longer be an option, and instead, surgery will be necessary. Surgery is done laparoscopically using a small camera inserted into the abdomen, with the patient under general anesthesia. 

Can you still have your baby with an ectopic pregnancy?

Unfortunately, it is not possible to save the pregnancy in an ectopic pregnancy. This is because a fertilized egg can't survive outside the uterus. 

Healing after an ectopic pregnancy

Experiencing an ectopic pregnancy can be really difficult and may require some physical and emotionally healing. Make sure you take the time to work through your feelings, seek out counseling if you think it could be helpful for you, try online forums or support groups, and be sure to go easy on yourself while you heal. Read more about pregnancy loss here. 

Physically, your body will also need to do some healing. Whether you treat your ectopic pregnancy with medicine or surgery, you may experience fatigue, discomfort, and pain for a few weeks. It can take some time for the level of hCG in your body to drop, so you may continue to feel pregnant for a few cycles until your period returns to normal. 

What does having had an ectopic pregnancy mean for future pregnancies?

Experiencing one ectopic pregnancy, unfortunately, means you’re at a higher risk of having another one. In fact, women who have suffered from an ectopic pregnancy are 15 percent likely to have another. That being said, about 33 percent of women who have had one ectopic pregnancy go on to have a healthy pregnancy later. Make sure you are on alert for any signs or symptoms of an ectopic pregnancy, and be sure to see your OBGYN regularly for checkups. 

Take-aways

  • In North America, ectopic pregnancies occur at a rate of 19.7 per 1,000 pregnancies. 
  • Symptoms of an ectopic pregnancy are very similar to regular pregnancy symptoms, but if you feel shoulder pain, dizziness or weakness, or severe pain in the abdomen or pelvis, you should see your doctor immediately.
  • Treating an ectopic pregnancy involves either medication or surgery.
  • Healing from an ectopic pregnancy is a physical and emotional journey. Read more about pregnancy loss here.