What You Need to Know about Ectopic Pregnancy

Ectopic pregnancies occur in 1 out of every 50 pregnancies, making them more common than we are comfortable with. They present a high-risk situation to the mother because they can cause permanent damage to her reproductive tract if the ectopic pregnancy is missed or isn’t treated soon enough. 

Ectopic Pregnancies Defined 

In an ectopic pregnancy, the fertilized egg attaches outside of the uterine lining. In most cases, it implants into one of the fallopian tubes, called an ectopic tubal pregnancy, accounting for 90% of ectopic pregnancies. Developing embryos (zygotes) have also been found attached to other organs in the pelvic or abdominal cavity, but it is much less common. 

Unfortunately, there is no way for an ectopic pregnancy to go full-term. In a healthy pregnancy, fertilized eggs are meant to travel through the fallopian tube, into the uterus, and implant into the thick, nourishing lining of the uterus. Without that lining, the zygote cannot grow and develop for very long; however, they do continue to grow and develop for a little while. When this happens in the narrow fallopian tube, it poses a severe threat to the mother.  

According to The American College of Obstetrics and Gynecology (ACOG), “A ruptured ectopic pregnancy can cause major internal bleeding. This can be a life-threatening emergency that needs immediate surgery.” It also means the loss of a functioning fallopian tube. Because it is so serious, an ectopic pregnancy is considered a medical emergency. 

Risk Factors & Symptoms 

There are two critical steps fertile women should take to ensure quick treatment for ectopic pregnancy: know the risk factors and the symptoms. 

Risk factors 

Women are more likely to experience an ectopic pregnancy if they have  experienced: 

• A previous ectopic pregnancy. Women who have had one are more likely to have another. If one egg failed to implant in the uterus, there is a chance another fertilized egg is programmed to do it again. 
• Prior tube surgery, as well as other pelvic/abdominal surgeries. Surgeries in the pelvic or abdominal cavity can cause lasting scar tissue. If enough scar tissue exists in a fallopian tube, it slows the egg’s journey, which can cause a fertilized egg to implant into the tube instead of making a complete journey to the uterus. 
• A Sexually-transmitted Infection (STI). This is another reason it is so essential for sexually active women to use protection, get tested for sexually transmitted infections (STIs), and be honest with their OB/GYN. Like surgeries, STIs commonly cause scar tissue leading to tubal blockages. 
• Pelvic Inflammatory Disease (PID). This falls into the STI category, but PID is such a specific risk factor for ectopic pregnancy we are giving it its own bullet point. PID affects 25% or more of all sexually active women. Since symptoms can be mild to nonexistent, scar tissue can form without you even knowing it. 

• Endometriosis. Also, one of the most common causes of infertility, endometriosis, causes scar tissue and pelvic inflammation, both of which can negatively impact fallopian tubes. 
• Infertility and IVF. Women with a history of infertility and those who pursue IVF are more prone to experiencing ectopic pregnancies. 
• Smoking. Women who smoke have a higher incidence of ectopic pregnancy. While most women quit smoking once they find out they’re pregnant, this is a sound argument for quitting long before you ever get pregnant. 

Other risk factors include: 

• Being 35-years or older. 

• Using an IUD (intrauterine device). 
• Having your tubes tied (tubal ligation). 
• Oddly shaped fallopian tubes.  

Symptoms 

While all of these factors increase the chances of ectopic pregnancy, it can happen to anyone. Nearly 50% of all women who experience an ectopic pregnancy don’t have risk factors. 

Seek immediate medical attention if you experience any of the following symptoms and there is even the slightest risk you might be pregnant. 

• Irregular vaginal bleeding. If you notice any irregular bleeding, lighter or heavier than usual, give your OB/GYN a call and check in.
• Mild to sharp pain in your pelvis, abdomen, lower back, or shoulder. A swelling fallopian tube is uncomfortable, and that discomfort increases as the tube swells in response to the developing zygote. If the tube ruptures, you’ll feel a sharp pain, and pain may be felt in the shoulder due to the nerve pathways and signaling.
• Dizziness or fainting spells. Always check in with your physician or head to urgent care if you’re experiencing unexplained dizziness or fainting. It’s a red flag that the body has something that needs to be addressed.

It is true that some of the symptoms are rather general in nature and not uncommon; however, physicians and medical professionals would much rather have you call or come in to verify nothing is wrong than assume nothing is wrong and not get the treatment you need. 

Treatment for Ectopic Pregnancies 

The most common treatment for ectopic pregnancy, before tube rupture, is a prescription medication called methotrexate. This medication stops the egg from growing anymore, and the body absorbs the fertilized egg. As a result, there is no harm to the fallopian tube other than any damage or scarring the fertilized egg may have caused. 

If the egg has grown too much and the tube is acutely threatened, or the tube ruptures, we repair the damage surgically. This often requires removing the tube. 

Can I Get Pregnant with One Tube? 

Experiencing an ectopic pregnancy is devastating for a woman because it is also a miscarriage. If a woman loses one of her fallopian tubes due to an ectopic pregnancy, she may worry she will have a hard time getting pregnant again. The good news is that most women can absolutely get pregnant with one tube.  

Have you had an ectopic pregnancy in the past? Are you trying to get pregnant with only one fallopian tube? Visit Premier OB/GYN and begin working with a team that goes the extra mile to provide personalized care to each one of our patients. 

Author

Valerie Ramsay, CNM Valerie Ramsay, CNM, is a board-certified nurse midwife at Premier Obstetrics and Gynecology in Maitland and Oviedo, Florida. She is proud to empower women and encourage them to be active participants in their own healthcare. She is extremely excited to be a part of the Premier OB-GYN family. Valerie graduated from Valencia College in Orlando with her associate degree in nursing, where she earned an award for the highest overall GPA. Valerie then pursued her bachelor’s degree in nursing from Polk State College in Winter Haven, Florida, where she earned cum laude honors. She received her master’s degree in nurse-midwifery from the University of Cincinnati in Ohio in 2019. Valerie has worked as a nurse in the obstetric field for the past 15 years and considers it her passion and personal calling. She chose to pursue midwifery because she felt a deep passion to care for women and their families. Valerie is happily married and is the proud mother of two beautiful children, Paige and Jacob.