Ectopic Pregnancy: Symptoms, Causes, Risk factors, and Treatment

Ectopic pregnancy is when a fertilized egg implants itself outside the main cavity of the uterus instead of in the uterus and begins to grow. Pregnancy begins when a fertilized egg attaches to the lining of the uterus. However, in ectopic pregnancy, the fertilized egg attaches itself outside the uterus.

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Ectopic pregnancy is called tubal pregnancy when it occurs in the fallopian tube, which carries eggs from the ovaries to the uterus. An ectopic pregnancy can equally occur in other areas of the body, such as the ovary, abdominal cavity, or the lower part of the uterus (cervix), which connects to the vagina.

An ectopic pregnancy can’t grow like normal pregnancy. The fertilized egg can’t survive, and if left untreated for long, the growing tissue may cause deadly bleeding.

Symptoms of Ectopic Pregnancy

Initially, it may be difficult to notice ectopic pregnancy. However, some women have the usual early signs or symptoms of pregnancy such as a missed period, breast tenderness and nausea. Pregnancy test result will even indicate positive. Signs and symptoms increase as the fertilized egg grows in the improper place.

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Warning Signs of Ectopic Pregnancy

The first warning sign of an ectopic pregnancy is:

  • pelvic pain
  • light vaginal bleeding
  • increasing abdominal pain (this occurs if blood leaks from the fallopian tube)
  • urgent need to have a bowel movement
  • shoulder pain (this occurs if bleeding is heavy as blood fills your pelvis and abdomen.

Symptoms depend on where the blood accumulates and which nerves are irritated.

Emergency symptoms

The Fallopian tube can rupture if the fertilized egg continues to grow in it, causing heavy bleeding inside the abdomen. At this stage, it becomes a deadly situation which requires emergency treatment. Symptoms at this stage may include extreme dizziness, fainting, severe abdominal pain and shock.

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When to see a doctor

Seek emergency medical help if you have any signs or symptoms of an ectopic pregnancy, including:

  • Severe abdominal or pelvic pain during pregnancy
  • Irregular vaginal bleeding
  • Extreme lightheadedness
  • Other disturbing symptoms

Causes of Ectopic Pregnancy

The most common type of ectopic pregnancy is tubal pregnancy, which occurs when a fertilized egg gets stuck on its way to the uterus, often because the fallopian tube is damaged by inflammation or is distorted. Hormonal imbalances or abnormal development of the fertilized egg also might play a role.

Risk factors

Some things that make you more likely to have an ectopic pregnancy are:

  • Tubal surgery: Surgery to repair a damaged or blocked fallopian tube can increase the risk of an ectopic pregnancy.
  • Inflammation or infection: Sexually transmitted infections (STIs), such as chlamydia or gonorrhea, can cause inflammation in the tubes and other close organs, and increase your risk of an ectopic pregnancy.
  • Choice of birth control: It’s difficult to get pregnant if you use an intrauterine device (IUD). However, if you do get pregnant with an IUD in place, it’s more likely to be an ectopic pregnancy. Tubal ligation (permanent method of birth control where your tubes tied), also raises your risk of ectopic pregnancy.
  • Fertility treatments: Women who have in vitro fertilization (IVF) or similar treatments are more likely to have an ectopic pregnancy, according to some research.
  • Smoking: Cigarette smoking just before you get pregnant can increase the risk of an ectopic pregnancy.
  • Previous ectopic pregnancy: If you’ve had this type of pregnancy before, you’re more likely to experience another.


An ectopic pregnancy can cause your fallopian tube to burst open. Without treatment, the ruptured tube can lead to deadly bleeding.

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Ectopic cannot really be prevented. However, there are ways to reduce your risk:

  • Reduce your number of sexual partners.
  • Always use a condom during sex to help prevent sexually transmitted infections and pelvic inflammatory disease.
  • Don’t smoke. If you do, quit.

Diagnosis of Ectopic Pregnancy

To diagnose ectopic pregnancy, a doctor will first perform a pelvic exam to locate tenderness, pain, or a mass in the abdomen. An ultrasound will be used to check whether the uterus contains a developing fetus. The measurement of hCG levels is also vital. A low hCG level may signify an ectopic pregnancy.

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Your progesterone level will be checked because low levels of progesterone could be a sign of ectopic pregnancy. Also, your doctor may do a culdocentesis (inserting a needle into a space at the very top of the vagina, behind the uterus and in front of the rectum). The presence of blood in this area may point to bleeding from a ruptured fallopian tube.

Treating Ectopic Pregnancy

An ectopic pregnancy may be treated in any of the following ways:

  • Methotrexate may be administered to allow the body absorb the pregnancy tissue and save the fallopian tube, depending on how far the pregnancy has advanced.
  • If the tube has become ruptured, part or all of it may have to be removed.
  • Laparoscopic surgery under general anesthesia may be performed to remove the ectopic pregnancy and repair or remove the affected fallopian tube.


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