In an ectopic pregnancy, the fertilized egg implants outside the uterus, usually in the fallopian tube, where it cannot develop normally. This can be a life-threatening condition requiring immediate treatment. Ectopic pregnancies occur in one in fifty to a hundred pregnancies. Most are caused by an infection or inflammation of the fallopian tube, scar tissue or adhesions from previous tubal or pelvic area surgeries, or a tubal abnormality. If you have had a previous ectopic pregnancy, pelvic surgery, or pelvic inflammatory disease, or if you conceived using assisted reproductive techniques, your risk may be higher. In addition, if your mother used DES while pregnant with you, your risk may be higher.
If you have an ectopic pregnancy, you may have a positive pregnancy test and all the signs of early pregnancy. Vaginal bleeding, dizziness, weakness, and gastrointestinal discomfort are common early symptoms. As the pregnancy progresses, the pressure in the tube may cause stabbing pains, cramps, pain in your shoulder, or a dull ache that may vary in intensity, and come and go. It is critical to contact your provider if you have vaginal bleeding and/or sharp pain in the pelvic area, abdomen, and/or neck and shoulders. If an ectopic pregnancy is not diagnosed early, the fallopian tube can rupture, causing severe blood loss and shock.
If you have any of the symptoms of ectopic pregnancy, your health care provider will check your hormone levels every other day and do a vaginal ultrasound as early as possible (about 6 weeks). Ectopic pregnancy is occasionally misdiagnosed as an early miscarriage. This is why your provider may ask you to get a blood pregnancy test after a suspected miscarriage. The test can help confirm the presence or absence of fetal tissue in the fallopian tube.
When doctors detect an ectopic pregnancy, they will remove the embryonic tissue and try to save the tube. Blood tests will be performed to check changes in your levels of HCG after any of these treatments in order to confirm that no ectopic tissue remains.
The loss of an ectopic pregnancy may bring on feelings like those that follow miscarriage, including fear that such a pregnancy could happen again. If you have had internal bleeding or a traumatic emergency surgery, talk with your provider about how this may affect future conception and pregnancies, and how to minimize your future risks.