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Ectopic Pregnancy: Causes, Treatments and More

An ectopic pregnancy refers to any pregnancy implanted outside of the uterus, most commonly in the fallopian tube. The American Society for Reproductive Medicine reports that ectopic pregnancies account for one to two percent of all conceptions.

What is an ectopic pregnancy?

During a healthy pregnancy, an egg becomes an embryo after it is fertilized by sperm in the fallopian tube. A few days later, the embryo travels through the fallopian tube to reach the uterus. When an embryo implants in the lining of the fallopian tube before reaching the uterus, the result is an ectopic pregnancy.

Most often, ectopic pregnancies occur in one of the fallopian tubes, but it can also take place in the ovaries, the cervix, or somewhere else in the pelvic cavity. Because the uterus is the only place in the pelvic cavity that can support a growing embryo, there is a risk that the fallopian tube will rupture and bleed. An ectopic pregnancy is a dangerous and sometimes life-threatening condition if left untreated.

What are the causes?

Although sometimes there is no clear reason for the occurrence of an ectopic pregnancy, the following factors may put someone more at risk:

  • Individuals with pre-existing damage to the fallopian tubes
  • History of pelvic infections (chlamydia, gonorrhea, and other sexually transmitted diseases)
  • Individuals who have had pelvic surgery
  • Individuals who have been diagnosed with endometriosis
  • Individuals who conceived through the use of in vitro fertilization (IVF) or fertility medication

How is it treated?

An ectopic pregnancy is most commonly diagnosed through blood tests to measure human chorionic gonadotropin (hCG) and/or progesterone or through an ultrasound examination.

If a patient is stable and has received an early diagnosis, the drug methotrexate can be used to stop the pregnancy from developing further. It can be administered through an intramuscular shot, or a series of shots and pills over the course of several days. Most ectopic pregnancies can be treated through the use of methotrexate if diagnosed early enough.

An ectopic pregnancy can also be treated with surgeries such as a laparoscopy or laparotomy. A laparoscopy is minimally invasive procedure in which a camera and telescope is inserted through small incisions made in the lower abdomen to find and remove the ectopic pregnancy. A laparotomy is a more invasive procedure that involves an abdominal incision, usually performed in emergency situations when the ectopic pregnancy has caused internal bleeding.

Will it affect future pregnancies?

The risk for developing another ectopic pregnancy is increased for those who have had one previously. Most individuals can go on to conceive in the future, but fertility testing and treatment can improve the likelihood of a healthy pregnancy.