Ectopic Pregnancy

GENERAL INFORMATION:

What is ectopic pregnancy? Ectopic pregnancy is pregnancy where a fertilized egg grows outside of the uterus (womb). Normally, an egg cell fertilized by a sperm cell attaches and grows into a baby inside the uterus. In ectopic pregnancy, the egg does not attach (implant) inside the uterus and grows somewhere else. The most common place for this to happen is in the fallopian tube (tubal pregnancy). It can also implant on the outside of the uterus, on the ovary or cervix, or in the abdomen (stomach). These parts of the body cannot support a growing baby. This is a serious condition for you and your baby. It usually causes loss of the baby and may be life threatening to you as the mother.

What causes ectopic pregnancy? The following may increase your risk of having this condition:

• Abdominal surgery: Having had surgery in your abdomen or on your female organs.
  
  
• Infections: Having had past infections such as chlamydia in the female organs. This is also called pelvic inflammatory disease (PID). These infections may cause scarring and blockage of the egg going to the uterus. Ask your caregiver for more information about PID.
  
  
• IUD: Getting pregnant while an intrauterine device (IUD) is in place. An IUD is a device put into the uterus to prevent pregnancy.
  
  
• Medicines: Taking medicines to treat infertility (having trouble getting pregnant) or that contain female hormones.
  
  
• Prior ectopic pregnancy: Having had an ectopic pregnancy before increases your chances of having it happen again.
  
  
• Fetal abnormalities: Problems with the early growth or genetics of the baby (fetus). Genes are small pieces of information that tell the body how to develop and what to do.
  
  
• Smoking: Too much and too frequent exposure to tobacco smoke.

What are the signs and symptoms of ectopic pregnancy? You may not have had your period (menses) when you should have had it. You may have no other signs or symptoms, or you may have one or more of the following:

• Dizziness, weakness, or fainting.
  
  
• Pain in your abdomen or pelvis with cramping, usually on one side.
  
  
• Nausea (upset stomach) or vomiting (throwing up).
  
  
• Vaginal bleeding that happens about seven weeks after your missed period. This may be very light bleeding (spotting).
  
  
• Tissue coming out of your vagina.

How is ectopic pregnancy diagnosed? Your caregiver will ask you about your medical history and surgeries you have had. He will ask about pregnancies, miscarriages, infertility treatments, and sexually transmitted diseases (STDs) you have had before. He will do a physical exam on you, this may include a pelvic exam to look inside your vagina. You may need to see your caregivers more than once before they can be sure you have this condition. You may have any of the following:

• Blood and urine tests: Blood and urine will be sent to a lab for tests. These tests can show if you are currently pregnant, or if you have infections or other problems.
  
  
• Ultrasound: This simple test uses sound waves to show pictures of the inside of your uterus, ovaries, and abdomen. An ultrasound is usually done over your abdomen, but you may also need a vaginal ultrasound. During a vaginal ultrasound, a small tube is placed into your vagina. This can help caregivers see areas in your abdomen that may be hard to see during an abdominal ultrasound.

How is ectopic pregnancy treated? The baby may have been lost already at an early stage. Your body may absorb the pregnancy tissues and your symptoms may decrease or disappear without any treatment. If this does not happen, you may need any of the following:

• Medicine: Anti-cancer medicines, such as methotrexate, may be given to stop the pregnancy. They may be more effective if the condition is diagnosed early. Talk to your caregiver is you have concerns about this treatment.
  
  
• Surgery: This may be used to remove the condition or damaged structures, such as a fallopian tube that has burst. Surgery may also be done to repair damaged areas of your reproductive system.

When should I call my caregiver?

• You have a fever.
  
  
• You have pain that gets worse or is not controlled with your medicine.
  
  
• You cannot make it to your next appointment.
  
  
• You have questions or concerns about your condition or care.

When should I seek care?

• You feel you are going to faint.
  
  
• You have bad abdominal (stomach) pain or heavy vaginal bleeding.
  
  
• You have chest pain or trouble breathing.

Where can I get support and more information? You will probably lose your baby in having this condition and accepting this may be hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. You may also want to join a support group with other people who have had this condition. Call or contact the following:

• The American College of Obstetricians and Gynecologists
  409 12th Street, SW
  Washington, DC 20090
  Phone: 1-202-638-5577
  Web Address: http://www.acog.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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