Patient education: Ectopic pregnancy (The Basics)

What is an ectopic pregnancy? — This is the term doctors use for a pregnancy that is not located in the uterus, where a pregnancy usually is. It is located somewhere else in the body. An ectopic pregnancy is a serious condition and can even be life-threatening.

Pregnancy begins when an egg joins together with a sperm. These cells grow into a bigger group of cells, called an "embryo." In a normal pregnancy, the embryo attaches to the lining of the uterus (figure 1). Then, it can grow into a baby (figure 2).

In an ectopic pregnancy, the embryo does not attach to the lining of the uterus. Instead, it attaches to a place in the body that it should not attach to and starts to grow. Even though the embryo gets bigger, it cannot grow into a baby. As the embryo gets bigger, it can cause pain and bleeding and lead to other problems. Some of these problems can be life-threatening.

In most ectopic pregnancies, the embryo attaches to the lining of 1 of the fallopian tubes (the tubes that connect the ovaries to the uterus). When this happens, doctors also call it a "tubal pregnancy." In rare cases, the embryo can also attach to the cervix, ovary, or the inside of the belly.

Some people have a higher chance than others of having an ectopic pregnancy. You can have a higher chance of having an ectopic pregnancy if you:

●Have abnormal or damaged fallopian tubes, such as from past infections or surgeries

●Have had an ectopic pregnancy before

●Are getting certain treatments to help you get pregnant

●Smoke cigarettes

People who use a type of birth control called an "intrauterine device" or "IUD" have a very low chance of getting pregnant at all. But, if a person using an IUD does get pregnant, they are at higher risk of ectopic pregnancy. If you have an IUD and you think you are pregnant, tell your doctor or nurse right away. They can check for ectopic pregnancy.

What are the symptoms of an ectopic pregnancy? — People who have an ectopic pregnancy don't always have symptoms early on. When early symptoms do happen, they can include:

●Lower belly pain

●Bleeding from the vagina (the bleeding can be heavy or light, or it can even be just spots of blood or brown staining)

Some people don't have any symptoms until the ectopic pregnancy causes more serious problems. For example, an embryo growing in a fallopian tube can cause the fallopian tube to burst open or "rupture." When this happens, symptoms can include:

●Severe lower belly pain

●Heavy bleeding from the vagina

●Fainting or passing out, or feeling like you might faint or pass out

If you are pregnant and have any of the symptoms listed above, go to an emergency room as soon as possible.

Is there a test for an ectopic pregnancy? — To check if you have an ectopic pregnancy, your doctor or nurse can do:

●A blood test to measure a hormone called hCG – This test checks if you are pregnant and how much hCG the pregnancy is making.

●An imaging test called an ultrasound to see where the embryo is in your body – Imaging tests create pictures of the inside of the body.

Sometimes, test results show an ectopic pregnancy right away. But most of the time, doctors need to repeat the tests every few days to know for sure if you have an ectopic pregnancy.

How is an ectopic pregnancy treated? — Doctors can treat an ectopic pregnancy in 2 ways, depending on the size of the embryo, your symptoms, and other factors. Both treatments involve removing the embryo. It is important to do this, because if the embryo continues to grow, it could cause the fallopian tube to burst (rupture). If this happens, it can be life threatening.

Options for treatment include:

●Medicine – Your doctor can give you a shot of a medicine called methotrexate. This medicine stops the embryo's growth and causes it to dissolve. If you are treated with medicine, you will need follow-up blood tests for a few weeks to make sure that the treatment worked.

●Surgery – A doctor can do surgery to remove the embryo. Your doctor might or might not need to remove your fallopian tube, too.

Can an ectopic pregnancy be prevented? — Most ectopic pregnancies cannot be prevented. If you are planning to try to get pregnant, there is nothing specific you can do to prevent ectopic pregnancy.

The chance of having an ectopic pregnancy is higher in people who have had certain infections that are spread through sex ("sexually transmitted infections").

Can I get pregnant in the future? — Most people are able to have a normal pregnancy after having an ectopic pregnancy. But let your doctor or nurse know if you are trying to get pregnant. That way, they can follow your pregnancy to make sure everything is normal.

More on this topic

Patient education: Female infertility (The Basics)
Patient education: Chlamydia and gonorrhea (The Basics)
Patient education: Choosing birth control (The Basics)

Patient education: Ectopic (tubal) pregnancy (Beyond the Basics)
Patient education: Gonorrhea (Beyond the Basics)
Patient education: Chlamydia (Beyond the Basics)
Patient education: In vitro fertilization (IVF) (Beyond the Basics)