Ectopic Pregnancy

An ectopic pregnancy happens when a pregnancy develops outside of the uterus. Ectopic pregnancies are rare but can become life-threatening if not treated promptly. Early diagnosis and treatment are key to preventing serious complications.

At Banner Health, we offer comprehensive care for ectopic pregnancies. Our team supports you throughout pregnancy to ensure your and your baby's health.

What is an ectopic pregnancy?

When a sperm fertilizes an egg, it creates a fertilized egg or zygote. In a healthy pregnancy, a fertilized egg travels down the fallopian tube to the uterus, where it implants (attaches) and grows. 

In an ectopic pregnancy, the egg gets stuck in the fallopian tube or another part of the body. The most common location is the fallopian tube, but it can occur in the ovary, cervix or abdomen (stomach cavity). 

Unfortunately, a pregnancy outside the uterus can’t survive, and the growing tissue may cause life-threatening bleeding, infection and sometimes death. Ectopic pregnancy is a medical emergency. 

Causes and risk factors of ectopic pregnancy

Ectopic pregnancies are rare, occurring in less than 2% of all pregnancies in the U.S. It is not clear why a fertilized egg doesn’t make it to the uterus. However, several factors can increase your risk of having an ectopic pregnancy.

Common risk factors include:

• Age: If you are over 35 years old, you may have a higher risk of ectopic pregnancy.
• Previous ectopic pregnancy: If you’ve had an ectopic pregnancy before, your risk of having another is higher.
• Fallopian tube damage: Surgery on the fallopian tubes or past infections, like sexually transmitted infections (STIs), can cause scarring. This may block or slow down the fertilized egg. 
• Pelvic inflammatory disease (PID): Having PID, often caused by STIs, increases the chance of fallopian tube damage. 
• Tubal ligation: A tubal ligation (getting your tubes tied) is a permanent form of birth control. The risk of getting pregnant after a tubal ligation is low. However, if pregnancy occurs after the procedure, the risk of ectopic pregnancy is higher.
• In vitro fertilization (IVF): A fertility treatment known as IVF involves placing fertilized eggs directly into the uterus. However, there is a small risk that the egg implants outside the uterus. 
• Smoking: Smoking or vaping has been shown to increase the risk of ectopic pregnancy, possibly due to damage to the fallopian tubes.

Other factors include becoming pregnant while using an IUD (intrauterine device) or after taking fertility medications. Although the risk of getting pregnant with an IUD is extremely low, if you were to become pregnant while using an IUD, the pregnancy is more likely to be abnormal. 

Symptoms of an ectopic pregnancy

It’s important to recognize the symptoms of an ectopic pregnancy early. The symptoms can mimic those of a normal pregnancy at first, such as a missed period and positive pregnancy test. But other signs soon appear, such as:

• Sharp or stabbing pain in the stomach, pelvis, lower back or shoulder
• Vaginal bleeding, which may be heavier or lighter than usual
• Weakness, dizziness or fainting
• Low blood pressure
• Nausea or vomiting

These signs can happen suddenly, especially if the fallopian tube ruptures. A ruptured ectopic pregnancy is a medical emergency and can cause severe internal bleeding. 

Diagnosing an ectopic pregnancy

Health care providers usually diagnose ectopic pregnancy in the first trimester (up to 12 weeks of pregnancy). If your provider suspects an ectopic pregnancy, they will perform several tests. 

In addition to a pelvic exam these tests include:

• Pregnancy test: A blood or urine test will check your (human chorionic gonadotropin) hCG levels, a hormone that rises during pregnancy. Low levels of this hormone can be a sign of an ectopic pregnancy or a miscarriage.
• Ultrasound: An ultrasound can detect if the pregnancy is located outside the uterus or elsewhere. A transvaginal ultrasound, where a probe (special camera) is inserted into the vagina, provides a clearer picture of the uterus and fallopian tubes.

If necessary, your provider may run additional tests to assess your condition.

Treatment options for ectopic pregnancy

An ectopic pregnancy is fatal for the baby, and your pregnancy can’t continue. Once an ectopic pregnancy is diagnosed, treatment must start right away. If it is not treated, it could lead to serious internal bleeding and even death.

There are two main options for treating an ectopic pregnancy: medication or surgery.

Medication

If the ectopic pregnancy is caught early, a medication called methotrexate may be used. This drug stops the cells from growing, and the body absorbs the pregnancy tissue. Methotrexate is often used if there is no immediate risk of infection or the fallopian tube rupturing. 

Surgery

Surgery will be needed if the fallopian tube has ruptured, is at risk of rupturing or if methotrexate isn’t an option. The procedure is an emergency surgery, and it is typically done laparoscopically (through small cuts in your belly) while you are asleep under anesthesia. 

The surgeon will remove the ectopic pregnancy and, if necessary, the damaged part of the fallopian tube. In some cases, the entire fallopian tube may need to be removed. 

Recovery after treatment

Recovering from an ectopic pregnancy can take time, both physically and emotionally. After surgery, your body may take a few weeks to heal. Pain or discomfort is normal, and your provider may prescribe medication.

Emotionally, it can be difficult to process the loss of a pregnancy. Many people feel grief, anger or sadness. It’s important to reach out for support during these times. Support groups and grief counseling are two ways to receive support after an ectopic pregnancy.

Can I try for another baby after an ectopic pregnancy?

You may worry about your future fertility. However, most people can still have a successful pregnancy after an ectopic pregnancy. 

Wait at least two to three months after medication or surgery before trying to get pregnant again. This gives your body time to heal and decreases the risk of another ectopic pregnancy.

Can I still have a baby if my fallopian tube is removed?

Yes, it’s possible to have a baby if one fallopian tube has been removed. Many people with one healthy fallopian tube can conceive naturally. The remaining tube can pick up an egg released during ovulation.

If you have concerns about your fertility or pregnancy options, talk to your health care provider. They can provide guidance based on your individual health and circumstances.

Preventing an ectopic pregnancy

While it’s not always possible to prevent an ectopic pregnancy, there are steps you can take to reduce your risk:

• Treat STIs: STIs can cause PID, which damages the fallopian tubes. Using protection during sex and getting regular STI screening can help prevent infections.
• Quit smoking: If you smoke, quitting can improve your reproductive health and lower your risk of an ectopic pregnancy.
• Work with your health care provider: If you have a history of ectopic pregnancy or other risk factors, discuss your options with your provider. Regular checkups and early monitoring during pregnancy can help catch any issues early. 

Learn more tips for a happy, healthy pregnancy.

When to seek medical help

If you are pregnant and experience any of the symptoms mentioned earlier, such as sharp pain, vaginal bleeding or dizziness, seek immediate medical attention. Early diagnosis is key to preventing severe complications, such as internal bleeding. A ruptured ectopic pregnancy is a medical emergency and requires surgery right away.

Getting care

If you suspect you may have an ectopic pregnancy or have concerns about your reproductive health, don’t wait. Contact Banner Health for prompt and compassionate care. Our experienced team is here to support you every step of the way.