What is Ectopic Pregnancy?

What is an ectopic pregnancy?

An ectopic pregnancy happens when a fertilized egg cell implants outside of the womb. In most ectopic pregnancies (more than 90%) the embryo grows in one of the fallopian tubes. It’s estimated that around 1 in 90 pregnancies are ectopic.

The fallopian tubes connect your womb to the ovaries, and if a fertilized egg starts to grow here, and if left untreated, it can cause the fallopian tube to rupture. Sadly, an ectopic pregnancy isn’t a viable pregnancy, and if an embryo starts to grow in a fallopian tube, it won’t develop properly, and can instead put you at risk.

When do ectopic pregnancy symptoms start?

Not every ectopic pregnancy has symptoms, and so an ectopic pregnancy may only be detected during a routine pregnancy scan. If you do have symptoms, they’re most likely to present between the fourth and twelfth weeks of pregnancy.

What are ectopic pregnancy symptoms?

Everyone is different, and ectopic pregnancy symptoms can differ depending on the stage of pregnancy.

Early symptoms of ectopic pregnancy

In the early stages, ectopic pregnancy can feel like a regular pregnancy, with a missed period, as well as other signs of early pregnancy such as nausea and tender breasts.

Other ectopic pregnancy signs may include things like unexplained spotting, lower back pain, cramping or pain in your pelvis or abdomen (particularly if this is only felt on one side). 

You may also experience unexplained shoulder tip pain. This strange symptom can be a sign of ectopic pregnancy, so you should speak to your OB-GYN if you have this type of pain.

Additionally, you may experience discomfort when going to the bathroom. This could be a pain when you pee or have a bowel movement, or you may simply notice a change in your normal habits.

Vaginal bleeding is another symptom of ectopic pregnancy. It may be watery and dark brown in color, and while vaginal bleeding can be a normal part of pregnancy, it’s important to get it checked out if you experience this.

If you experience any of these symptoms, it doesn’t necessarily mean that you have an ectopic pregnancy. Many of these signs are normal symptoms of pregnancy and could have other causes such as an ordinary stomach bug. But if you’re concerned, it’s important to speak to your healthcare provider to get more info! 

Symptoms of a rupture

If you have an ectopic pregnancy and the embryo starts to grow in your fallopian tube, it may cause a rupture. This is when the embryo grows large enough to split the tube, which can be very dangerous.

A ruptured fallopian tube is a serious medical issue and you should go to the emergency room immediately if you experience any combination of the following symptoms:

• Sudden, severe pain in your abdomen or pelvis
• Shoulder pain
• Weakness, dizziness or fainting
• Feeling sick
• Looking unusually pale

Is ectopic pregnancy painful?

Depending on your symptoms, ectopic pregnancy can be painful - particularly if you experience a rupture. Never ignore any painful symptoms if you’re pregnant or suspect you may be pregnant.

How is ectopic pregnancy diagnosed?

If you or your OB-GYN suspects you may have an ectopic pregnancy, there are a few ways in which they may confirm this. They could:

• Perform a pelvic exam
• Do an ultrasound to confirm where the pregnancy is developing
• Test your blood for human chorionic gonadotropin (hCG), a pregnancy hormone, the levels of which can be lower and rise more slowly over time in an ectopic pregnancy than a regular pregnancy

Ectopic pregnancy treatment

Unfortunately, an ectopic pregnancy cannot move from the fallopian tube. Unless the embryo dissolves itself, an ectopic pregnancy always requires medical intervention. This usually comes in the form of either medication or surgery.

If the pregnancy is treated with medication, the drug most commonly used is methotrexate. This is a drug that stops the cells from growing, ending the pregnancy. Your body then absorbs the fertilized egg over the next 4-6 weeks. 

Methotrexate is given in a single injection if the fallopian tube has not ruptured, and requires monitoring to measure the levels of hCG in your blood. If these levels don’t reduce over time, you may need another injection.

If your fallopian tube has ruptured, it’s likely that you’ll need surgery - and this may also be required sometimes when the tube hasn’t ruptured, too. A laparoscopy (keyhole surgery) will be performed to remove the fertilized egg, and often the affected fallopian tube will also be removed.

Ectopic pregnancy risk factors

Unfortunately, we don’t know exactly why an ectopic pregnancy happens, but there are some things that can increase your risk of developing one. While these factors on their own are not causes of ectopic pregnancy on their own, they are thought to increase the risk:

• A previous ectopic pregnancy: if you’ve experienced ectopic pregnancy before, the risk of developing another is around 10%
• Previous surgery on your fallopian tubes
• Undergoing fertility treatment like IVF 
• Pelvic inflammatory disease (PID)
• Becoming pregnant while using an intrauterine device (IUD) or intrauterine system (ISU)
• Smoking
• Being aged over 35-40
• Some sexually transmitted infections

If any of these risk factors apply to you, you should speak to your healthcare provider about any measures you can take to reduce your risk of ectopic pregnancy.

Support after an ectopic pregnancy

No matter what stage of your fertility journey you’re at, the impact of an ectopic pregnancy can be hard to deal with.

You may wish to get support after an ectopic pregnancy, and your OB-GYN should be able to recommend a counselor with experience in this area, as well as offering any other medical support you may need in the weeks after your treatment.

If you are trying for a baby and are planning for the future, you should be aware that it’s usually recommended that you wait for three months after taking methotrexate. That’s because the drug may put your baby at risk if you become pregnant during this time.

If you’ve had one ectopic pregnancy, you’re at a higher risk of developing another one, so it’s important to be aware of the symptoms. However, the majority of women who’ve had an ectopic pregnancy can go on to have a healthy pregnancy without any issues.

Get to know your body better with Natural Cycles

We know that ectopic pregnancy can be a distressing subject, but it can be life-threatening if you experience a rupture, so it’s important to know the signs and symptoms to look out for - as well as the treatment options, risk factors, and impact for future pregnancies.

At Natural Cycles we’re passionate about increasing knowledge when it comes to female health. We’ve created the world’s first FDA-cleared birth control app. Using the science of your cycle, Natural Cycles works out your fertile days so you can either abstain from sex or use protection when you’re fertile. By learning the pattern of your cycle you can also get to know what’s normal for you, so it’s easier to spot any symptoms or changes happening in your body.