Ectopic Pregnancy
Pregnancy implants outside uterus, usually in fallopian tube - medical emergency requiring immediate treatment.
Affects: 1-2% of pregnancies
Overview
Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in a fallopian tube. The embryo cannot survive, and if untreated, the growing pregnancy can rupture the fallopian tube, causing life-threatening internal bleeding.
This is a medical emergency requiring immediate treatment. Early detection through monitoring hCG levels and ultrasound allows for medication treatment. Late detection may require emergency surgery.
Ectopic pregnancy accounts for 6% of pregnancy-related deaths in the US. Quick diagnosis and treatment are critical for the mother's survival and preserving future fertility.
🩺 Symptoms
- •Missed period with positive pregnancy test
- •Vaginal bleeding (lighter or different than period)
- •Sharp abdominal pain, often on one side
- •Shoulder pain (if rupture - internal bleeding)
- •Pelvic pain
- •Dizziness, fainting, or weakness (if rupture)
- •Nausea and vomiting
- •Rectal pressure
- •Many have no symptoms initially
🔍 Causes
- →Fertilized egg can't travel through damaged or blocked fallopian tube
- →Tube inflammation or scar tissue
- →Previous pelvic or abdominal surgery
- →Previous ectopic pregnancy
- →Congenital fallopian tube defects
- →Abnormal embryo development
⚠️ Risk Factors
- •Previous ectopic pregnancy (15% recurrence risk)
- •Pelvic inflammatory disease (PID)
- •Sexually transmitted infections (chlamydia, gonorrhea)
- •Endometriosis
- •Previous pelvic or abdominal surgery
- •Previous tubal surgery or tubal ligation
- •IVF or fertility treatments
- •Smoking
- •Maternal age over 35
- •Use of IUD when pregnancy occurs
🔬 Diagnosis
- →Blood hCG levels don't rise appropriately
- →Ultrasound shows no pregnancy in uterus
- →May see mass in fallopian tube
- →Empty uterus with positive pregnancy test
- →Pelvic exam showing tenderness
- →May need serial hCG tests to track levels
- →Laparoscopy if diagnosis uncertain
💊 Treatment
- ✓Medical: Methotrexate injection (stops cell growth)
- ✓Requires hCG levels to be low enough and no rupture
- ✓No drinking, no sex, avoid sun during treatment
- ✓Serial hCG monitoring to ensure levels drop
- ✓Surgical: Laparoscopy to remove ectopic pregnancy
- ✓May remove part or all of fallopian tube
- ✓Emergency surgery if ruptured
- ✓Blood transfusion if severe bleeding
- ✓Cannot save the pregnancy - not viable
🛡️ Prevention
- →Prevent STIs through safe sex practices
- →Treat pelvic infections promptly
- →Quit smoking before conceiving
- →Early prenatal care in next pregnancy
- →Close monitoring if high risk
⚠️ Potential Complications
- !Ruptured fallopian tube - life-threatening
- !Severe internal bleeding
- !Shock from blood loss
- !Loss of fallopian tube
- !Reduced fertility
- !Difficulty conceiving in future
- !Maternal death if untreated
- !Emotional trauma and grief
🚨 When to Call Your Doctor
Contact your healthcare provider immediately if you experience:
- ⚠Sharp abdominal or pelvic pain
- ⚠Vaginal bleeding when pregnant
- ⚠Shoulder pain with positive pregnancy test
- ⚠Dizziness, fainting, or weakness
- ⚠Rectal pressure
- ⚠Call 911 if severe pain, heavy bleeding, or fainting
- ⚠Any unusual symptoms with positive pregnancy test
Related Conditions
This information is for educational purposes and should not replace medical advice. Always consult your healthcare provider for personalized guidance.