Ectopic Pregnancies Explained

Ectopic pregnancy is defined as an abnormal pregnancy that occurs outside the uterus (womb). This occurs when the baby begins to develop outside the uterus. The most common site for an ectopic pregnancy is within a fallopian tube. However, ectopic pregnancies can occur in the ovary, the stomach area, and the cervix. There is no doubt that the baby in these types of pregnancies cannot survive.

The incidence of ectopic pregnancy has been estimated to range from 10,221 to 77,129 cases per year and it continues to be the main cause of pregnancy related death in the first trimester. The early diagnosis and treatment of this condition effectively reduces maternal morbidity and mortality.

Most of these cases result from scarring caused by a past infection in the fallopian tubes, surgery of the fallopian tubes, or by a previous ectopic pregnancy. It is noteworthy to mention that up to 50% of women who develop ectopic pregnancies have had an inflammation of some sort weather be it in the fallopian tubes (salpingitis) or in the pelvis (pelvic inflammatory disease), the incidence increases as the number of infections increase.

Other causes include endometriosis, complications that result from a ruptured appendix or scarring caused by previous pelvic surgery, tubal ligation and reversal of tubal ligation and in some cases, the cause remains unknown.

Another little known fact women need to be aware of is that taking hormones such as estrogen and progesterone, which are the main components of birth control pills, can slow the normal movement of the fertilized egg through the fallopian tubes and lead to ectopic pregnancy. Finally, ectopic pregnancy is more likely to occur in adults versus adolescents and this is a trend has been noted in multiple studies.

Recognizing the Symptoms of an Ectopic Pregnancy:

•Lower abdominal or pelvic pain
•Mild cramping on one side of the pelvis
•Abnormal vaginal bleeding
•Low back pain

If the abnormal pregnancy ruptures and bleeds, symptoms will get worse:

•Severe, sharp, and sudden pain in the lower abdominal area
•Feeling light headed or actually fainting
•Referred pain to the shoulder area
•Internal bleeding due to a rupture of an ectopic pregnancy site may lead to shock which is the first symptom of nearly 20% of ectopic pregnancies.

85% of women who have had an ectopic pregnancy will be able to have a normal pregnancy later on. However, a recurrent ectopic pregnancy occurs in 10 - 20% of cases and while some women do not become pregnant again, others become pregnant and spontaneously abort during the first 3 months.

The rate in the United States of women who die as a result of an ectopic pregnancy has dropped in the last 30 years to less than 0.1%. (Ref: J Pediatr Adolesc Gynecol (2007) 20:181e185, Medline plus ecnyclopedia.)