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Ectopic Pregnancy

AMBULATORY CARE:

Ectopic pregnancy

occurs when a fertilized egg attaches and begins to grow outside of the uterus. The most common place for this to happen is in the fallopian tube. This is sometimes called a tubal pregnancy. The egg can also implant on the outside of the uterus, on the ovary or cervix, or in the abdomen. The egg may begin to grow, but the pregnancy cannot continue normally. Ectopic pregnancy can cause heavy bleeding and may be life-threatening.

Common signs and symptoms:

  • One-sided abdominal or pelvic pain and cramping
  • Vaginal bleeding or spotting that happens about 7 weeks after your missed period
  • Nausea or vomiting
  • Dizziness, weakness, or fainting
  • Tissue coming out of your vagina

Call your local emergency number (911 in the US) if:

  • You have chest pain or trouble breathing.

Call your doctor if:

  • You have sharp pain in your lower abdomen that is severe and starts suddenly.
  • You feel lightheaded or like you are going to faint.
  • You have increasing abdominal or pelvic pain or heavy vaginal bleeding.
  • You have shoulder pain.
  • You have a fever.
  • You have questions or concerns about your condition or care.

Treatment

may not be needed. Your body may absorb the pregnancy tissues and your symptoms may decrease without any treatment. If this does not happen, you may need any of the following:

  • Medicine called methotrexate may be given to stop the pregnancy. This may be given as an injection. You may need more than one dose. It is important to follow up with your healthcare provider as directed if you receive this medicine.
  • Surgery may be done to repair or remove tissue or ruptured fallopian tubes. Your healthcare provider will talk to you about possible kinds of surgery. Your provider will consider where the ectopic pregnancy is located and the damage it caused. Talk to your provider about your desire to have children in the future. Some kinds of surgery will prevent future pregnancy.

If you received methotrexate:

  • Do not have sex, and limit physical activity. Heavy physical activity or sexual intercourse may cause the ectopic pregnancy to rupture. This can be life-threatening. Your healthcare provider will tell you when it is okay to have sex and return to your normal activities.
  • Do not get pregnant until your healthcare provider says it is okay. Methotrexate will be harmful to an unborn baby. You will need to wait until at least 1 monthly cycle after you finish the methotrexate course to get pregnant. Your provider may want you to wait until after you have had 3 monthly cycles. This will help make sure all the methotrexate is out of your body.
  • Avoid folic acid and NSAID medicines. Folic acid, and NSAIDs, such as ibuprofen, prevent methotrexate from working correctly. Do not take folic acid supplements or have foods that are high in folic acid. Examples include orange juice, breakfast cereal, and leafy green vegetables. Your healthcare provider can give you more information on foods to avoid.
  • You may have some spotting and abdominal pain. This may start a few days after you begin taking methotrexate. These are normal and should only last a short time. Talk to your healthcare provider if you have any concerns.
  • Limit sunlight exposure. Sunlight can cause a condition caused methotrexate dermatitis (skin irritation).

For support and more information:

  • The American College of Obstetricians and Gynecologists
    P.O. Box 70620
    Washington , DC 20024-9998
    Phone: 1- 202 - 638-5577
    Phone: 1- 800 - 673-8444
    Web Address: http://www.acog.org

Follow up with your gynecologist as directed:

You may need to return for a follow-up exam, treatment, or blood tests. If you received methotrexate to stop your pregnancy, it is important to come in for follow-up tests. Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Ectopic Pregnancy (Ambulatory Care)

IBM Watson Micromedex

Mayo Clinic Reference

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.