How can pregnancies occur in the uterine tube

Most ectopic pregnancies can be detected using a pelvic examination, ultrasound, and blood tests. If you have symptoms of a possible ectopic pregnancy, you will have:. Sometimes a surgical procedure using laparoscopy is used to look for an ectopic pregnancy. An ectopic pregnancy after 5 weeks can usually be diagnosed and treated with a laparoscope. But laparoscopy is not often used to diagnose a very early ectopic pregnancy, because ultrasound and blood pregnancy tests are very accurate.

During the week after treatment for an ectopic pregnancy, your hCG human chorionic gonadotropin blood levels are tested several times. Your doctor will look for a drop in hCG levels, which is a sign that the pregnancy is ending hCG levels sometimes rise during the first few days of treatment, then drop. In some cases, hCG testing continues for weeks to months until hCG levels drop to a low level. If you become pregnant and are at high risk for an ectopic pregnancy , you will be closely watched.

A urine pregnancy test—including a home pregnancy test—can accurately diagnose a pregnancy but cannot detect whether it is an ectopic pregnancy. If a urine pregnancy test confirms pregnancy and an ectopic pregnancy is suspected, further blood testing or ultrasound is needed to diagnose an ectopic pregnancy.

In most cases, an ectopic pregnancy is treated right away to avoid rupture and severe blood loss. The decision about which treatment to use depends on how early the pregnancy is detected and your overall condition. For an early ectopic pregnancy that is not causing bleeding, you may have a choice between using medicine or surgery to end the pregnancy.

Using methotrexate to end an ectopic pregnancy spares you from an incision and general anesthesia. But it does cause side effects and can take several weeks of hormone blood-level testing to make sure that treatment has worked. Methotrexate is most likely to work:. If you have an ectopic pregnancy that is causing severe symptoms, bleeding, or high hCG levels, surgery is usually needed.

This is because medicine is less likely to work and a rupture becomes more likely as time passes. When possible, laparoscopic surgery that uses a small incision is done. For a ruptured ectopic pregnancy , emergency surgery is needed. For an early ectopic pregnancy that appears to be naturally miscarrying aborting on its own, you may not need treatment. Your doctor will regularly test your blood to make sure that your pregnancy hormone hCG, or human chorionic gonadotropin levels are dropping.

This is called expectant management. Ectopic pregnancies can be resistant to treatment. If your blood type is Rh-negative , Rh immunoglobulin may be used to protect any future pregnancies against Rh sensitization.

For more information, see the topic Rh Sensitization During Pregnancy. Surgery may be your only treatment option if you have internal bleeding. You cannot prevent ectopic pregnancy, but you can prevent serious complications with early diagnosis and treatment. If you have one or more risk factors for ectopic pregnancy, you and your doctor can closely monitor your first weeks of a pregnancy. If you smoke, quit to lower your risk of ectopic pregnancy. Women who smoke or who used to smoke have higher rates of ectopic pregnancy.

Using safer sex practices, such as using a male condom or a female condom every time you have sex helps protect you from sexually transmitted infections STIs that can lead to pelvic inflammatory disease PID. PID is a common cause of scar tissue in the fallopian tubes, which can cause ectopic pregnancy. If you are at risk for having an ectopic pregnancy and you think you may be pregnant, use a home pregnancy test.

If it is positive, be sure to have a confirmation test done by a doctor, especially if you are concerned about having an ectopic pregnancy. If you are receiving methotrexate treatment to end an ectopic pregnancy, you may experience side effects from the medicine.

See these tips for managing methotrexate treatment to minimize these side effects. If you experience an ectopic pregnancy loss, no matter how early in a pregnancy, expect that you and your partner will need time to grieve. It is also possible to develop depression from the hormonal changes after a pregnancy loss.

If you have symptoms of depression that last for more than a couple of weeks, be sure to call your doctor or a psychologist, clinical social worker, or licensed mental health counsellor. You can contact a support group, read about the experiences of other women, and talk to friends, a counsellor, or a member of the clergy.

These things may help you and your family deal with a pregnancy loss. If you have had an ectopic pregnancy, you may worry about your chances of having a healthy or ectopic pregnancy in the future. Your risk factors and any fallopian tube damage you may have will impact your future risk and your ability to become pregnant.

Your doctor can answer your questions based on your risk factors. Medicine can only be used for early ectopic pregnancies that have not ruptured. Depending on where the ectopic growth is and what type of surgery would otherwise be used, medicine may be less likely than surgical treatment to cause fallopian tube damage.

Medicine is most likely to work when an early ectopic pregnancy is not causing bleeding and:. For an ectopic pregnancy that is more developed, surgery is a safer and more dependable treatment. Methotrexate is used to stop the growth of an early ectopic pregnancy. It can also be used after surgical ectopic treatment to ensure that all ectopic cell growth has stopped. Methotrexate treatment is usually the first choice for ending an early ectopic pregnancy.

If the pregnancy is further along, surgery is safer and more likely than medicine to be effective. Routine follow-up blood tests are needed for days to weeks after the medicine is injected. Methotrexate can cause unpleasant side effects, such as nausea, indigestion, and diarrhea.

For information about how to minimize side effects, see these tips for managing methotrexate treatment. If your ectopic pregnancy is not too far advanced and has not ruptured, methotrexate may be a treatment option for you. Successful methotrexate treatment of an early ectopic pregnancy avoids the risks of surgery, may be less likely to damage the fallopian tube than surgery, and is more likely to preserve your fertility. If you are not concerned with preserving fertility, surgery for an ectopic pregnancy is faster than methotrexate treatment and will likely cause less bleeding.

When possible, surgery is done through a small incision using laparoscopy. This type of surgery usually has a short recovery period. An ectopic pregnancy can be removed from a fallopian tube by using salpingostomy or salpingectomy. Both salpingostomy and salpingectomy can be done either through a small incision using laparoscopy or through a larger open abdominal incision laparotomy. Laparoscopy takes less time than laparotomy. And the hospital stay is shorter.

But for an abdominal ectopic pregnancy or an emergency tubal ectopic removal, a laparotomy is usually required. When an ectopic pregnancy is located in an unruptured fallopian tube, every attempt is made to remove the pregnancy without removing or damaging the tube.

Emergency surgery is needed for a ruptured ectopic pregnancy. Your future fertility and your risk of having another ectopic pregnancy will be affected by your own risk factors. These can include smoking, use of assisted reproductive technology ART to get pregnant, and how much fallopian tube damage you have.

As long as you have one healthy fallopian tube, salpingostomy small tubal slit and salpingectomy part of a tube removed have about the same effect on your future fertility. But if your other tube is damaged, your doctor may try to do a salpingostomy. You may be able to reduce your risk through good reproductive health maintenance. Have your partner wear a condom during sex and limit your number of sexual partners.

Maintain regular visits with your doctor, including regular gynecological exams and regular STD screenings. Taking steps to improve your personal health, such as quitting smoking, is also a good preventive strategy. The long-term outlook after an ectopic pregnancy depends on whether it caused any physical damage.

Most people who have ectopic pregnancies go on to have healthy pregnancies. If both fallopian tubes are still intact, or even just one, the egg can be fertilized as normal. However, if you have a preexisting reproductive problem, that can affect your future fertility and increase your risk of future ectopic pregnancy.

This is especially the case if the preexisting reproductive problem has previously led to an ectopic pregnancy. Surgery may scar the fallopian tubes, and it can make future ectopic pregnancies more likely. If the removal of one or both fallopian tubes is necessary, speak to your doctor about possible fertility treatments. An example is in vitro fertilization that involves implanting a fertilized egg into the uterus.

Pregnancy loss, no matter how early, can be devastating. You can ask your doctor if there are available support groups in the area to provide further support after loss. Take care of yourself after this loss through rest, eating healthy foods, and exercising when possible. Give yourself time to grieve. Remember that many women go on to have healthy pregnancies and babies.

False positives and negatives can occur for a…. If you miss your period but get a negative pregnancy test, there are a number of possible explanations. Here's what might be going on. If you've undergone a tubal ligation procedure, it's unlikely but still possible that you'll become pregnant. Sperm can reach deep inside via the one-sided uterus that is in contact with the vagina, but the opposite Fallopian tube may pick up the fertilised egg and transport it into the rudimentary horn.

Because the rudimentary horn often has a thick muscular wall, these pregnancies may advance into the second or even third trimester before they cause catastrophic rupture. The thick wall also makes them more difficult to diagnose, as the rudimentary horn may be assumed to be a normal uterus during an ultrasound scan. Treatment is to terminate the pregnancy by surgically removing the rudimentary horn and its Fallopian tube. If the pregnancy is advanced, this is sometimes difficult to do without also removing the ovary on the same side.

A pregnancy in the uterine portion of the Fallopian tube of a uterus that forms as expected is called an interstitial pregnancy. This should not be confused with a cornual pregnancy.

This can mean that ovarian pregnancies are often not diagnosed until surgery. The ovary is a highly vascular structure. An ectopic pregnancy located on or in the ovary will usually require surgery involving either the partial or complete removal of the ovary due to bleeding. If the ovary is partially removed, it may recover and continue to produce eggs as before.

However, even if it no longer produces eggs or is removed completely, the other ovary is perfectly capable of producing an egg every cycle, enabling the ability to conceive naturally in the future. These pregnancies are thought to occur when the uterus has been scarred by previous surgery or a condition called adenomyosis. Again, they can be difficult to diagnose as it can be hard to see the cavity as separate to the pregnancy.

The pregnancies are also inaccessible, which makes them difficult to treat by removing the pregnancy. Methotrexate may be advised. Abdominal pregnancies, in most instances, are thought to have begun in the Fallopian tube and then separated from the wall of the fallopian tube, floating into the abdominal cavity to then reattach to one of the structures in the abdomen.

The pregnancy can progress and may go undetected until many weeks into the pregnancy. There are some accounts of abdominal pregnancies surviving to be delivered with an abdominal operation but these are incredibly rare. Heterotopic pregnancy is the term where there is the co-existence of an intrauterine pregnancy with an ectopic pregnancy. Although it is rare, it is possible to have a twin pregnancy with one embryo to implant in the uterus and another elsewhere.

Some studies suggest that the live birth rate of a surviving pregnancy may even be higher if it is in the uterus and developing as expected at the time of diagnosis.

Are you experiencing symptoms that you think may be an ectopic pregnancy? Click here to find out more. This section aims to help you make sense of some of the thoughts, feelings, and reactions you may be experiencing.

There could also be problems with the tube walls, which should normally tighten and carry the fertilised egg into the uterus.

In many cases of ectopic pregnancy, the fertilised egg dies quickly and is broken down by your system before you miss your period or after you experience some slight pain and bleeding. In these cases an ectopic pregnancy is rarely diagnosed and it is assumed to be a miscarriage. Nothing needs to be done in these circumstances.

If the fertilised egg continues to grow, the thin wall of your fallopian tube will stretch, causing you pain in your lower abdomen. You may also experience vaginal bleeding. As the egg grows, the tube may rupture, causing you severe abdominal stomach pain, internal bleeding and possible collapse. Women who experience an ectopic pregnancy have all the signs of a normal pregnancy, in the beginning. Most symptoms of an ectopic pregnancy occur between the fourth and tenth week of pregnancy. These include:.

If you experience these symptoms you should see your doctor or visit your local hospital immediately. If an ectopic pregnancy is suspected, your doctor will perform an ultrasound scan and a pregnancy test. If the ultrasound scan shows an empty uterus but the pregnancy test comes back positive, then it is likely you have an ectopic pregnancy.

These signs may also indicate that you are in very early stages of pregnancy or that you have already miscarried. While an ultrasound using a transvaginal probe provides the best quality scan, it is not always possible to see an ectopic pregnancy. If you are well and not in severe pain, you may have a blood hormone test each day for up to 2 to 3 days to help diagnose if you have an ectopic pregnancy.

Your doctor will discuss the most appropriate one for you, however, your doctor may also find it necessary to proceed from one method to another. A telescopic device the laparoscope is inserted through a small cut below your navel belly button. To help identify your organs, carbon dioxide gas is blown into your stomach through a needle. A couple of small incisions are also made in your lower abdomen to manipulate and if necessary remove the ectopic pregnancy tissue.

The surgery may involve removing your fallopian tube salpingectomy or opening your fallopian tube salpingostomy to remove the ectopic pregnancy tissue. If the pregnancy is advanced or there has been significant associated haemorrhaging bleeding then your doctor may perform a laparotomy, a type of surgery involving a much larger incision.

A medication called methotrexate is used to dissolve the pregnancy tissue. It is given by injection in the leg or bottom and is suitable for women without pain or those with minimal pain.