Ectopic pregnancy is a common, life-threatening condition that affects 1 in 80 pregnancies. Put very simply, it means “an out-of-place pregnancy”. It occurs when a woman’s ovum (egg), that has been fertilised, implants (gets stuck somewhere) instead of moving successfully down her fallopian tube into the womb to develop there. The most common place for an ectopic pregnancy is the fallopian tube but there are many other sites where an ectopic pregnancy can be located. It is, sadly, not possible to move an ectopic pregnancy.
Any sexually active woman of childbearing age is at risk of an ectopic pregnancy and often the reason for the ectopic pregnancy will never be determined. However, ectopic pregnancies are more likely if you have had:
Pelvic Inflammatory Disease: This is a past infection of the fallopian tubes caused, for example, by a sexually transmitted infection like Chlamydia.
Endometriosis: This is a condition where cells like the ones lining the womb grow elsewhere in the body but still react to the menstrual cycle each month and bleed despite there being no way for the blood to leave the body. This can cause damage to the fallopian tubes.
Abdominal Surgery: Any previous operation on the tummy, such as caesarean section, appendectomy or previous ectopic pregnancy.
Tubal Surgery: An operation on the fallopian tubes, such as sterilisation.
A contraceptive coil (IUCD): The coil prevents a pregnancy in the uterus but is less effective in preventing a pregnancy in the fallopian tube.
The ‘mini-pill’ (progesterone-only pill): This type of contraceptive pill alters the motility of the tube i.e. the ability for an egg to move through it.
The Morning After Pill: It is possible to become pregnant in the same cycle after trying to prevent pregnancy with emergency oral contraception.
Fertility Treatment: There is a chance of ectopic pregnancy resulting from embryo transfer during IVF treatment as embryos can travel into the fallopian tube, for example, during the implantation stage.
A previous ectopic pregnancy: There is an increased risk of a subsequent ectopic pregnancy after someone has experienced an ectopic pregnancy.
Cigarette Smoking: Research by the University of Edinburgh showed that smokers have an increased level of the protein PROKR1 in their fallopian tubes. The protein is instrumental in helping pregnancies implant in the womb, but when present in the fallopian tubes can hinder the progress of a fertilised egg, increasing the chances of a pregnancy being ectopic.
Diethylstilbestrol (DES): This was a synthetic oestrogen given to women with a history or risk of miscarriage in the 1950’s to 1970’s. Unfortunately, in some cases, the medicine resulted in the reproductive organs of the foetus not forming properly. If your mother took this medicine then it may have contributed to changes in the way your reproductive organs developed. However, doctors can usually see this when performing an ultrasound scan or when you are treated with surgery. Any changes in your reproductive organs as a result of DES are unlikely to go unnoticed.
Symptoms of Ectopic Pregnancy
- Abdominal Pain
- Shoulder Tip Pain
- Bladder or Bowel Problems
- Abnormal Bleeding
- Surgical Management
- Medical Management with Methotrexate
- Expectant Treatment