Ectopic Pregnancy

Published at 03 November 2024

Ectopic pregnancy means pregnancy occurs in another place outside the uterus, usually inside the fallopian tube, or less often in the ovaries, or cervix. It is not considered a normal pregnancy, and poses a risk to your health, as it cannot continue, and must be terminated. (2)(3)

Here is the most important information about ectopic pregnancy: (1)(2)

Ectopic pregnancy occurs in 1 or 2 out of every 100 pregnancies.
In a normal pregnancy, fertilization occurs in the fallopian tube, and the fertilized egg moves to the uterus, where it implants and develops into a fetus.
In an ectopic pregnancy, the fertilized egg implants in another place, such as the fallopian tube, cervix, etc.
If the ectopic pregnancy is not eliminated, the fertilized egg and fallopian tube may burst, causing serious symptoms for the mother, such as abdominal pain, severe vaginal bleeding, and severe low blood pressure, which may lead to death.
An ectopic pregnancy cannot survive or should not continue, because the place is not suitable for the growth of the fetus.
It needs urgent treatment to remove the pregnancy either using medications or resorting to surgery, depending on its location and the mother's health condition at the time of diagnosis.

Symptoms

An ectopic pregnancy may not cause noticeable symptoms at first; as the pregnancy test is positive, and normal signs of pregnancy appear, and doctors usually discover it during the first pregnancy visit when the ultrasound shows that there is no pregnancy in the uterus. (4)

After one to three months of pregnancy, symptoms of an ectopic pregnancy may appear, including: (5)

Lower abdominal pain on one side, which gets worse over time.
Vaginal bleeding, or light brown discharge.
Discomfort when urinating or defecating.

Remember that these symptoms may appear with a normal pregnancy, but you should see a doctor to make sure that your pregnancy is healthy as soon as possible!

If the fallopian tube containing the pregnancy ruptures, it causes severe symptoms that require immediate emergency treatment, including: (6)

Severe lower abdominal pain, especially on one side.
Severe vaginal bleeding.
Shoulder pain due to internal bleeding.
Dizziness and loss of consciousness.

Causes

An ectopic pregnancy can happen to any woman, but there are some risk factors that may increase the chances of it happening, including: (7)(8)

Previous ectopic pregnancy
Problems in the fallopian tube: such as deformities, scars or inflamation.
Pregnancy on an IUD.
Endometriosis.
Other factors, such as age 35 years or older or smoking.

Diagnosis

Doctors usually detect this type of pregnancy using ultrasound, when the fetus cannot be seen in the uterus despite the presence of pregnancy according to the pregnancy test result.

Blood tests can indicate an ectopic pregnancy, when the doctor requests a pregnancy hormone test more than once, and notices that the levels of the pregnancy hormone do not rise to the amount that is consistent with the expected pregnancy period, or when progesterone levels are low. (2)

Treatment

An ectopic pregnancy is not a normal pregnancy, and it cannot continue, and it must be removed. There are 3 ways to treat it depending on the case: (1)

Monitoring and waiting: until the body gets rid of the pregnancy on its own without medical or surgical intervention. This method is only used if the woman's condition is stable, and her pregnancy hormone gradually decreases in preparation for the pregnancy to disappear.

Medications: A drug called methotrexate is used in the form of injections, and the woman needs to follow up on the result by conducting pregnancy hormone tests to ensure that the pregnancy has been terminated.

Surgery: It is used in the event of a pregnancy rupture or if there is a risk of pregnancy rupture and complications for the woman; the ectopic pregnancy is removed under general anesthesia, using a laparoscope or through an open abdominal operation. Sometimes, it may be necessary to remove the fallopian tube with the pregnancy.

Is it possible to get pregnant again?

Yes, it is possible to get pregnant naturally again after getting rid of an ectopic pregnancy, even if one fallopian tube is removed, because the other tube is sufficient for pregnancy. But before you plan to get pregnant again, you should consult your doctor, especially if you have taken methotrexate, as you should wait 3-4 months before getting pregnant. Your doctor can give you some advice to increase the chances of a healthy pregnancy inside the uterus. (1)(9)

Our doctors in the Women's Clinic at Al-Ahli Hospital are experts in treating ectopic pregnancy and supporting women who have gone through a similar experience. We provide excellent medical care, psychological support, and the procedures you need to prepare for a healthy pregnancy.