You might not have heard of ectopic pregnancies – some people haven’t until it happens to them – but they’re pretty common. In fact, an estimated one in 50 pregnancies in the US is ectopic. Read on to find out what that means, and what to do if it happens to you.
What is an ectopic pregnancy, exactly?
An ectopic pregnancy happens when sperm fertilizes an egg, but that egg gets stuck on its way to the uterus, and so the pregnancy starts to grow somewhere else – occasionally in the abdomen cavity or cervix but most often in the fallopian tube (which is why it’s sometimes called a tubal pregnancy).
Because the egg isn’t growing inside the uterus, the pregnancy isn’t viable. Cruelly, though, if you take a home test in the first few weeks, your hormone levels will rise in the same way as a regular pregnancy, so it can take some time to diagnose. It might be spotted at your first scan, or you might experience symptoms that signal something isn’t right.
What are the symptoms of an ectopic pregnancy?
It usually takes between one and three months for symptoms to develop, and they can include:
- Vaginal spotting or bleeding (often thinner than a period)
- Pain in the lower abdomen
- Pain when going to the toilet, perhaps combined with diarrhea
If you have any of all of these, you should get checked out by your doctor as soon as possible, because if you do have an ectopic pregnancy, there’s a risk that your fallopian tube could burst – usually referred to as a rupture.
What are the symptoms of a fallopian tube rupture?
- Sudden, sharp waves of pain in the abdomen, rectum, neck or shoulder (caused by internal bleeding putting pressure on the nerves)
- Fainting or feeling lightheaded
If you experience any of these, you should go to an emergency room, stat. In the vast majority of cases, it can be treated successfully, but the bleeding caused by ectopic pregnancies can be fatal, so it needs to be taken seriously.
How is it treated?
If an ectopic pregnancy becomes an emergency, surgery is usually the best option. This might mean simply removing the ectopic pregnancy or taking out the entire fallopian tube.
If it’s spotted early, there’s a possibility it might resolve on its own, so your doctor may recommend just monitoring it at first, to see if your body reabsorbs the egg.
Most often, it’s treated with Methotrexate, a drug that slows down cell growth. This involves injections over several weeks, with blood tests in between to ensure the ectopic growth is shrinking. This is usually effective, but isn’t pleasant: it causes bleeding and cramping, similar to a miscarriage.
Can you have a baby after an ectopic pregnancy?
Yes, if it’s caught in time.
If the egg and fallopian tube need to be surgically removed, this will make it harder to become pregnant as you’ll release eggs less often, and there’s also a risk that one or both tubes could be scarred by the surgery, but many people who’ve had an ectopic pregnancy go on to have a healthy baby. Unfortunately, though, if you’ve had one ectopic pregnancy, you have an increased risk of another.
If you want to try again, you’ll need to wait at least two months after surgery and three if you were treated with Methotrexate, as it’s such strong medication.
What causes it?
The cause is rarely clear. It can be linked to an existing issue with the fallopian tubes (due to a previous gynecological surgery or just how you were born), pelvic inflammatory disease triggered by a sexually transmitted infection, or fertility treatment (as it stimulates the body to produce more eggs). They’re more likely if you’ve over 35 and up to 20 times more likely if you smoke. If you get pregnant while using an IUD you have a higher chance of it being an ectopic pregnancy – so you might want to check for that as soon as possible. Otherwise, there isn’t much you can do, but regular STI screenings and putting away the cigarettes wouldn’t hurt.