How do ectopic pregnancies happen

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. This may improve your chances of getting pregnant in the future. Author: Healthwise Staff. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.

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Topic Overview What is an ectopic pregnancy? What causes an ectopic pregnancy? Things that make you more likely to have fallopian tube damage and an ectopic pregnancy include: Smoking. The more you smoke, the higher your risk of an ectopic pregnancy.

Pelvic inflammatory disease PID. This is often the result of an infection such as chlamydia or gonorrhea. Endometriosis , which can cause scar tissue in or around the fallopian tubes. Being exposed to the chemical DES before you were born. These include: Surgery on the fallopian tubes or in the pelvic area. Fertility treatments such as in vitro fertilization. What are the symptoms? The key signs of an ectopic pregnancy are: Pelvic or belly pain. It may be sharp on one side at first and then spread through your belly.

It may be worse when you move or strain. Vaginal bleeding. How is an ectopic pregnancy diagnosed? To find out if you have an ectopic pregnancy, your doctor will likely do: A pelvic examination to check the size of your uterus and feel for growths or tenderness in your belly.

A blood test that checks the level of the pregnancy hormone hCG. This test is repeated 2 days later. During early pregnancy, the level of this hormone doubles every 2 days. Low levels suggest a problem, such as ectopic pregnancy. An ultrasound. This test can show pictures of what is inside your belly. With ultrasound, a doctor can usually see a pregnancy in the uterus 6 weeks after your last menstrual period.

How is it treated? What can you expect after an ectopic pregnancy? But it does mean that: You may have trouble getting pregnant. You are more likely to have another ectopic pregnancy. Cause Fallopian tube damage is a common cause of ectopic pregnancy. Common causes of fallopian tube damage that may lead to an ectopic pregnancy include: Smoking.

Smoking is thought to damage the fallopian tubes' ability to move the fertilized egg toward the uterus. Pelvic inflammatory disease PID , such as from a chlamydia or gonorrhea infection. PID can create scar tissue in the fallopian tubes. Fallopian tube surgery, often used to reverse a tubal ligation or to repair a scarred or blocked tube. A previous ectopic pregnancy in a fallopian tube. Symptoms An early ectopic pregnancy often feels like a normal pregnancy. A woman with an ectopic pregnancy may experience common signs of early pregnancy, such as: A missed menstrual period.

Tender breasts. Increased urination. First signs of an ectopic pregnancy may include: Vaginal bleeding, which may be light. Abdominal belly pain or pelvic pain, usually 6 to 8 weeks after a missed period. As an ectopic pregnancy progresses, though, other symptoms may develop, including: Belly pain or pelvic pain that may get worse with movement or straining. It may occur sharply on one side at first and then spread throughout the pelvic region.

Heavy or severe vaginal bleeding. Pain with intercourse or during a pelvic examination. Dizziness, light-headedness, or fainting syncope caused by internal bleeding. Signs of shock. Shoulder pain caused by bleeding into the abdomen under the diaphragm. The bleeding irritates the diaphragm and is experienced as shoulder pain. What Happens Normally, at the beginning of a pregnancy, the fertilized egg travels from the fallopian tube to the uterus , where it implants and grows.

In rare cases: The egg attaches and grows in an ovary, the cervix, or the abdominal cavity outside of the reproductive system.

One or more eggs grow in the uterus, and one or more grow in a fallopian tube, the cervix, or the abdominal cavity. This is called a heterotopic pregnancy.

Complications of ectopic pregnancy Ectopic pregnancy can damage the fallopian tube, which can make it difficult to become pregnant in the future. What Increases Your Risk Things that can increase your risk of having an ectopic pregnancy include: A previous ectopic pregnancy.

Past or present cigarette smoking. The more you smoke, the higher the risk. Experts suspect that smoking affects fallopian tube function. A history of pelvic inflammatory disease PID , often caused by chlamydia or gonorrhea. Exposure to the chemical DES diethylstilbestrol before you were born. Medical treatments and procedures that can increase your risk of having an ectopic pregnancy include: Previous fallopian tube surgery to treat infertility or to reverse a tubal ligation.

A tubal ligation failure. In rare cases when pregnancy happens after a sterilization surgery, there is a higher-than-usual risk that the pregnancy is ectopic. A progestin-only birth control failure, such as progestin-only pills, or a pregnancy that happens with an intrauterine device IUD in place. This may result from the passing of the fertilized egg into a fallopian tube after it is transferred to the uterus. Infection after any kind of surgery done on the uterus or fallopian tubes.

This can lead to scar tissue. It often starts and stops, and can be bright or dark red in colour. Some women mistake this bleeding for a regular period and do not realise they are pregnant. Shoulder tip pain — shoulder tip pain is felt where your shoulder ends and your arm begins.

It is not known exactly why shoulder tip pain occurs, but it usually occurs when you are lying down and is a sign that the ectopic pregnancy is causing internal bleeding.

The bleeding is thought to irritate the phrenic nerve, which is found in your diaphragm the muscle used during breathing that separates your chest cavity from your abdomen.

The irritation to the phrenic nerve causes referred pain pain that is felt elsewhere in the shoulder blade. Diarrhoea and vomiting — an ectopic pregnancy can cause similar symptoms to a gastrointestinal disease and is often associated with diarrhoea and vomiting.

It can be difficult to diagnose an ectopic pregnancy from the symptoms alone, as they can be similar to other conditions. If an ectopic pregnancy is detected at an early stage, a medication called methotrexate is sometimes needed to stop the egg developing. The pregnancy tissue is then absorbed into the woman's body. Methotrexate is not always needed, as in around half of cases the egg dies before it can grow larger. Ectopic pregnancies detected at a more advanced stage will require surgery to remove the pregnancy sac.

If an ectopic pregnancy is left to develop, there is a risk that the fertilised egg could continue to grow and cause the fallopian tube to split open rupture , which can cause life-threatening internal bleeding.

A ruptured fallopian tube is a medical emergency. If you think that you or someone in your care has experienced this complication, call and ask for an ambulance. In a normal pregnancy an egg is fertilised by sperm in one of the fallopian tubes, which connect the ovaries to the womb.

The fertilised egg then moves into the womb and implants itself into the womb lining endometrium , where it grows and develops. An ectopic pregnancy occurs when a fertilised egg implants itself outside the womb.

It most commonly occurs in a fallopian tube this is known as a tubal pregnancy , often as the result of damage to the fallopian tube or the tube not working properly. Less commonly in around 2 in cases , an ectopic pregnancy can occur in an ovary, in the abdominal space or in the cervix neck of the womb. In many cases, it's not clear why a woman has an ectopic pregnancy. Sometimes it happens when there's a problem with the fallopian tubes, such as them being narrow or blocked.

The loss of your pregnancy at any stage can have a huge impact on you and your partner. One day you are pregnant and planning your future life with your child, and then within a short time, your pregnancy ends. The ending of an ectopic pregnancy is a form of miscarriage — and the feelings that a woman and her partner may experience can be similarly difficult. It is not uncommon for feelings of grief and bereavement to last for 6 to 12 months, although these feelings usually improve with time.

Pregnancy, Birth and Baby offers free and confidential support and counselling to women, their partners, friends and relatives. Call on Many women affected by a miscarriage benefit from counselling.

SANDS miscarriage, stillborn and neonatal death support provide support groups for parents and their family whose baby has died through stillbirth , miscarriage , ectopic pregnancy and medically advised termination.

It is normally recommended that you wait for at least 2 menstrual cycles before trying for another pregnancy, as this will allow time for your fallopian tubes to recover if treated with methotrexate, you will need to wait at least 3 to 4 months. Always notify your doctor if your pain increases or you feel something is out of the ordinary. 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. Here's what to watch for. Blocked fallopian tubes can affect fertility, but with treatment, some women can go on to have healthy pregnancies. Learn how to cope with the depression associated with miscarriage. A new study finds that epidurals do not affect child development in their later years. A fetal arrhythmia is an irregular heart rate — too fast, too slow, or otherwise outside the norm.

It's often benign.