| |
During ovulation, an egg (ovum) is released from one of the ovaries. Conception occurs when the egg is met by a sperm in the fallopian tube. Normally, the fertilised egg travels down the fallopian tube and into the uterus, where it buries into the plump uterine lining.
Ectopic pregnancy refers to a pregnancy that develops outside the uterus, most commonly in one of the fallopian tubes. In almost all cases, the embryo dies. The developing placenta can’t access a rich blood supply and the fallopian tube is not large enough to accommodate the growing embryo.
In one out of five cases, the tube ruptures causing internal bleeding and shock. This is a medical emergency requiring immediate surgery and blood transfusion. Dial triple zero (000) for an ambulance in an emergency or go immediately to the nearest hospital emergency department.
Other sites for an ectopic pregnancy include the cervix (neck of the uterus), the abdominal cavity and the ovary itself, although these sites are rare. Around five in 1,000 pregnancies are ectopic.
Symptoms
The symptoms of ectopic pregnancy can mimic miscarriage or the symptoms of other gynaecological disorders, such as pelvic inflammatory disease (PID) and endometriosis. An ectopic pregnancy can initially appear as a normal pregnancy.
The possible symptoms of ectopic pregnancy include:
- The usual signs of pregnancy, such as amenorrhoea (missed period) morning sickness and breast tenderness
- Pain in the lower abdomen
- Pain in the lower back
- Cramps on one side of the pelvis
- Vaginal bleeding or spotting
- If the fallopian tube ruptures, rapid onset of severe pain in the lower abdomen.
Risk factors
Ectopic pregnancies are caused by the fertilised egg being unable to move through the fallopian tube. This can be caused by a blockage in the tube or the failure of the tiny hairs inside the tube to sweep the fertilised egg on its way.
Factors that may increase a woman’s risk of having an ectopic pregnancy include:
- Prior tubal sterilisation, where the tubes are ‘tied’ as a permanent form of contraception
- Successful reversal of a tubal sterilisation
- Endometriosis
- Previous infection with pelvic inflammatory disease (PID) or salpingitis (inflammation of the fallopian tubes) and subsequent scarring
- Defects of the fallopian tube
- Use of assisted reproductive technologies
- Prior ectopic pregnancy
- Damage to the fallopian tube caused by ruptured appendix.
Contraception
The contraceptives currently available in Australia do not increase the risk of ectopic pregnancy. IUDs and the progestogen-only pill (mini pill) do not give as good protection against ectopic pregnancies as other forms of contraception (such as the combined pill) and may not be a good choice for women at higher risk of ectopic pregnancy. Women using these forms of contraception are warned to be aware of the symptoms of ectopic pregnancy.
Diagnosis
Around one in five ectopic pregnancies is diagnosed in the emergency room, after the fallopian tube has ruptured. In most cases, an ectopic pregnancy can be diagnosed using a range of tests, some of which are standard medical procedure for all pregnant women, including:
- Pelvic examination
- Blood tests
- Ultrasound
- Laparoscopy (‘keyhole’ surgery).
Treatment
A ruptured fallopian tube is a medical emergency. Laparoscopic (‘keyhole’) surgery is performed to remove the embryo and attempts are made to repair the fallopian tube. A blood transfusion may also be necessary.
For non-emergency ectopic pregnancies, medications are often successful, although sometimes surgery is still necessary. Any woman suspected to have or found to have an ectopic pregnancy requires careful observation. Most women who have had an ectopic pregnancy are able to conceive again, but require careful follow-up as their risk of ectopic pregnancy is higher.
Early screening is vital
In the three years from 1988 to 1990, only two of the 96 maternal deaths in Australia were caused by ectopic pregnancy. Early screening and advances in prenatal testing have reduced the maternal mortality rate considerably. For example, a pregnancy ultrasound may reveal an empty uterus, which then prompts further tests (such as a transvaginal ultrasound or laparoscopic surgery) to discover the location of the embryo. However, only around half of all cases of ectopic pregnancy will be diagnosed through clinical methods. Closely monitoring those women who have known risk factors is therefore crucial.
It is important to tell your doctor if your medical history includes any of the known risk factors. You should also see your doctor immediately if you experience unusual pregnancy symptoms such as cramping, pain or vaginal bleeding.
Risk reduction
Many cases of ectopic pregnancy are caused by scarring of the fallopian tubes. Suggestions to reduce your risk of fallopian tube damage include:
- Treat any pelvic infection promptly.
- Treat any sexually transmissible infection (STI) promptly.
- Avoid sexually transmissible infections by always using a condom during sex, if the risk of an STI is at all possible.
Where to get help
- In an emergency, dial triple zero (000) for an ambulance or go immediately to your nearest hospital emergency department
- Your doctor
- Obstetrician
Things to remember
- Ectopic pregnancy refers to a pregnancy that develops outside of the uterus, most commonly in one of the fallopian tubes.
- Symptoms include cramping, abdominal pain and vaginal bleeding.
- A ruptured fallopian tube is a medical emergency and requires immediate treatment.
You might also be interested in:
Conceiving a baby - tips.
Pre-eclampsia.
Pregnancy related cancer.
Want to know more?
Go to More information for support groups, related links and references.
|  |
|
| |
This page has been produced in consultation with, and approved by:
Family Planning Victoria
|
|
Copyight © 1999/2009 State of Victoria. Reproduced from the Better Health Channel (www.betterhealth.vic.gov.au) at no cost with permission of the Victorian Minister for Health. Unauthorised reproduction and other uses comprised in the copyright are prohibited without permission.
|
•
|
This Better Health Channel fact sheet has passed through a rigorous approval process. For the latest updates and more information visit www.betterhealth.vic.gov.au.
|
|
|
Fact sheet currently being reviewed.
Last updated: April 2008
Linking to the Better Health Channel
It's easy to link to this page |
Close
If you would like to link to this fact sheet on your website, simply copy the code below and add it to your page:
Ectopic pregnancy - Better Health Channel
Ectopic pregnancy refers to a pregnancy that develops outside the uterus, most commonly in one of the fallopian tubes. Symptoms include cramping, abdominal pain and vaginal bleeding. Pain may indicate a ruptured tube, which is a medical emergency and requires immediate surgery. Treatment for non-emergency ectopic pregnancy may include medication or surgery...
The link should appear like this:
Ectopic pregnancy - Better Health ChannelEctopic pregnancy refers to a pregnancy that develops outside the uterus, most commonly in one of the fallopian tubes. Symptoms include cramping, abdominal pain and vaginal bleeding. Pain may indicate a ruptured tube, which is a medical emergency and requires immediate surgery. Treatment for non-emergency ectopic pregnancy may include medication or surgery...
© State of Victoria. All rights reserved
The information published here was accurate at the time of publication and is not intended to take the place of medical advice. Please seek advice from a qualified health care professional.
|
|
