Pregnancy happens when the fertilised egg that results from the union of an egg and sperm successfully implants itself into the uterus. However, various complications can occur when it comes to pregnancy, one of them being an ectopic pregnancy.
The term “ectopic pregnancy” is derived from the Greek word “ektopas,” which translates to “out of place.”
During a typical pregnancy, the fertilised egg travels from the fallopian tube to the uterus, where it implants and develops. However, if this process is disrupted, the fertilised egg may implant and begin growing outside the uterus, resulting in an ectopic pregnancy.
Most ectopic pregnancies develop in the fallopian tubes, which is referred to as a tubal pregnancy. Ectopic pregnancy is typically caused by damaged fallopian tubes, which ultimately prevent the fertilised egg from traveling to the uterus.
Below are risk factors that may lead to an ectopic pregnancy:
- Previous ectopic pregnancy
- Prior fallopian tube surgery
- Previous pelvic or abdominal surgery
- Certain sexually transmitted infections (STIs)
- Pelvic inflammatory disease
- Endometriosis
Other factors that may increase a woman’s risk of ectopic pregnancy include:
- Cigarette smoking
- Age older than 35 years old
- History of infertility
- Use of assisted reproductive technology, such as in vitro fertilisation (IVF)
About half of the women who have had an ectopic pregnancy did not have known risk factors. Women who are sexually active should be aware of changes in their bodies, especially if they experience symptoms of an ectopic pregnancy.
Most women experience physical symptoms in the 6th week of pregnancy (about 2 weeks after a missed period). You may or may not be aware that you are pregnant if your periods are irregular, or if the contraception you are using has failed.
Due to the wide variation of symptoms, diagnosing an ectopic pregnancy may not be straightforward. Each woman is affected differently by an ectopic pregnancy. Some women do not experience symptoms, some may experience a few symptoms, while others may experience many symptoms.
The symptoms of an ectopic pregnancy may include:
- Pain in your lower abdomen: This may develop suddenly for no apparent reason or may come on gradually over several days. It may be on one side only.
- Vaginal bleeding: You may have some spotting or bleeding that is different from your normal period. The bleeding may be lighter or heavier or darker than normal.
- Pain at the tip of your shoulder: This pain is caused by blood leaking into the abdomen and is a sign that the condition is getting worse. This pain is there all the time and may be worse when you are lying down. It is not helped by movement and may not be relieved by painkillers. You should seek urgent medical advice if you experience this.
- Upset tummy: You may have diarrhoea or pain during bowel movement.
- Severe abdominal pain: If the fallopian tube bursts or ruptures and causes internal bleeding, you may develop intense abdominal pain or you may collapse. In rare instances, collapsing may be the very first sign of an ectopic pregnancy. This is an emergency, and you should seek urgent medical attention.
Diagnosis of an ectopic pregnancy will be made based on the following:
- Consultation and physical examination: Your doctor will ask about your medical history and symptoms and will examine your abdomen.
- Urine pregnancy test: This test will be done to find out whether you are pregnant.
- Transvaginal ultrasound: This scan will be done to check your uterus, ovaries, and fallopian tubes to evaluate your condition.
- Blood tests: A test for the level of the pregnancy hormone βhCG (beta human chorionic gonadotrophin) or a test every few days to look for changes in the level of this hormone may help to give a diagnosis. This is usually checked every 48 hours because, with a pregnancy in the uterus, the hormone level rises by 63% every 48 hours (known as the ‘doubling time’) whereas, with ectopic pregnancies, the levels are usually lower and rise more slowly or stay the same.
Attending routine prenatal visits and maintaining open communication with your doctor are essential for monitoring your well-being and addressing any questions or worries that may arise during pregnancy.
If you are experiencing any of the symptoms of an ectopic pregnancy, get in touch with us to find out more about our Obstetrics & Gynaecology Services at your nearest Gleneagles Hospital.
