Ectopic Pregnancy

(Tubal Pregnancy)

by Rosalyn Carson-DeWitt, MD

Definition

An ectopic pregnancy is a pregnancy that occurs outside of the womb (uterus). Most ectopic pregnancies occur within a fallopian tube. Other, less common locations may include the cervix, an ovary, or the abdominal cavity. This type of pregnancy cannot survive because only the uterus can support the growth of a fetus and its placenta.

Ectopic Pregnancy

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Causes

Most ectopic pregnancies occur because the fallopian tube is not functioning normally.

Risk Factors    TOP

Factors that may increase the risk ectopic pregnancy include:

Symptoms    TOP

Symptoms include:

  • Missed or abnormal menstrual period
  • Abdominal pain
  • Spotty vaginal bleeding
  • Pain in the shoulder
  • Fainting

Diagnosis    TOP

The doctor will ask about your symptoms and medical history. A physical exam will be also be done.

Tests may include:

  • Pregnancy test
  • Pelvic exam
  • Blood tests
  • Transvaginal ultrasound (to check the uterus and fallopian tubes for the presence or absence of a pregnancy)

Treatment    TOP

Treatment options include:

Medicine

If the ectopic pregnancy is small and has not ruptured (burst), your doctor will recommend the medicine methotrexate. This medicine prevents further growth of the ectopic pregnancy.

Surgery

Surgery may be needed, especially if the ectopic pregnancy has ruptured or if it is not in the fallopian tube. During the surgery, the pregnancy will be removed.

If the pregnancy is in the fallopian tube, the doctor may be able to repair the tube. In severe cases, the fallopian tube may need to be removed.

Prevention    TOP

While there are no clear ways to reduce your risk of ectopic pregnancies, it may be helpful to:

RESOURCES:

American Academy of Family Physicians
http://www.aafp.org/
American Congress of Obstetricians and Gynecologists
http://www.acog.org/

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org/
Women's Health Matters
http://www.womenshealthmatters.ca/

References:

Daiter E. Ectopic pregnancy: overview. OBGYN.net website. Available at: http://www.obgyn.net/pb/cotm/9902/9902.htm. Published October 26, 2011. Accessed August 13, 2012.
Ectopic pregnancy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated April 23, 2012. Accessed August 13, 2012.
Ectopic pregnancy. The Merck Manual of Diagnosis and Therapy website. Available at: http://www.merck.c.... Updated February 2010. Accessed August 13, 2012.
Ectopic pregnancy. Planned Parenthood website. Available at: http://www.planned.... Accessed August 15, 2012.
4/22/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/: Creanga AA, Shapiro-Mendoza CK, Bish CL, Zane S, Berg CJ, Callaghan WM. Trends in ectopic pregnancy mortality in the United States: 1980-2007. Obstet Gynecol. 2011;117(4):837-843.
Last reviewed September 2012 by Andrea Chisholm
Last Updated: 09/10/2012