Ectopic Pregnancy: Causes, Symptoms and Risks

The good news is that ectopic pregnancies are rare. However, if they do occur, they require medical attention, so it’s helpful to know about them, just in case. Learn more about what an ectopic pregnancy is, and what an ectopic pregnancy can feel like.

What Happens in an Ectopic Pregnancy?

In a typical pregnancy that develops normally, a fertilised egg moves through the fallopian tube toward the uterus, where it implants and starts to grow. But in an ectopic pregnancy, the fertilised egg implants outside of the uterus, usually attaching itself to the fallopian tube (but occasionally to the ovary, cervix, or other places in the abdomen). These cannot hold a growing embryo, so the pregnancy cannot progress. The chance of an ectopic pregnancy occurring is relatively low. In the UK, around 1 in every 80-90 pregnancies is ectopic.

An ectopic pregnancy must be treated, and your GP will discuss and recommend the best options for you. Following are some of the causes, risks, symptoms, and treatments for this condition.

Causes of an Ectopic Pregnancy

It’s unclear what causes of an ectopic pregnancy but it can occur when there is a problem with the fallopian tubes, like when they are too narrow or are blocked. There are also risk factors for an ectopic pregnancy that can increase the chances. The following are associated with an increased risk:

You have Pelvic inflammatory disease (PID). Having an infected or inflamed fallopian tube, which is usually caused by a sexually transmitted infection (STI), can mean it becomes partially or entirely blocked so the fertilised egg can’t proceed along the tube.
You’ve had a previous surgery on your fallopian tubes. An unsuccessful female sterilisation, for example, could heighten the risk of an ectopic pregnancy.
You’ve already had an ectopic pregnancy. This can increase the risk of having another ectopic pregnancy to around 10 percent.
You’re on fertility treatments, like IVF. If you’re taking medication that stimulates ovulation, this can increase the risk of an ectopic pregnancy.
Getting pregnant while using an IUD or IUS. While it’s highly unlikely you’ll get pregnant using an intrauterine device (IUD) or intrauterine system (IUS) for contraception, in the rare instance you do, you’re more likely to have an ectopic pregnancy.
You smoke.
You’re over 35. The risk is highest for women who are aged 35-40.

Signs and Symptoms of an Ectopic Pregnancy

You might be wondering how to tell if you have an ectopic pregnancy, particularly because some of the signs of an ectopic pregnancy are also normal signs of a healthy pregnancy that you might experience in the first trimester. Keep in mind that ectopic pregnancies are rare, and your GP or doctor is the appropriate person to make this diagnosis.

Some women don’t experience any symptoms at all. However, if you do develop symptoms, you will likely notice these signs of an ectopic pregnancy between the 4th and 12th weeks of pregnancy. These can include:

A tummy pain that comes in low down on one side. Ectopic pregnancy pain usually manifests as a tummy pain, and is typically low down on one side of your body. It can develop suddenly or gradually. It may come and go or persists.
Vaginal bleeding. This tends to be heavier or lighter than your normal period. Remember, bleeding in early pregnancy could also be implantation bleeding, so consult your doctor.
Discomfort when peeing or pooping. You may experience pain when you’re going for a pee or a poo, and you may even have diarrhoea.
Pain in the shoulder. You may feel an unusual pain where your shoulder ends and your arm begins. While the causes are not known, it can signal that an ectopic pregnancy is causing internal bleeding.
Weakness, dizziness, or fainting.

These symptoms can start very early in your pregnancy, at a time when you might not know you are pregnant yet or have had a positive pregnancy test.

In some cases, signs of an ectopic pregnancy will first be recognised by your healthcare provider during your first pregnancy scan.

Contact your doctor right away if you notice sharp pains that last more than a few minutes, or if you have any bleeding. Go to the hospital ASAP if you have vaginal bleeding along with abdominal or shoulder pain or weakness, dizziness, or fainting.

Diagnosis

Your GP can make an ectopic pregnancy diagnosis by undertaking these kinds of examinations:

A vaginal ultrasound. A transvaginal ultrasound scan will often show whether the fertilised egg has become implanted in one of the fallopian tubes.
A blood test to measure hCG levels. If the level of this pregnancy hormone is lower than expected, it could be due to an ectopic pregnancy.
Keyhole surgery. If it’s unclear whether you have an ectopic pregnancy or the location of the implanted fertilised egg is uncertain, then a laparoscopy, a type of keyhole surgery, must be carried out on your tummy. Via a small cut, a tube called a laparoscope is used to examine the womb and fallopian tubes directly.

What Are the Treatment Options?

Treatment for an ectopic pregnancy involves ending the pregnancy either by surgery or by medication and aims to restore the affected fallopian tube. Your doctor will talk you through the options, which can include:

Medication for ectopic pregnancy called methotrexate, which helps your body absorb the pregnancy tissue.
Minimally invasive surgery is used to remove the ectopic pregnancy tissue, usually while removing the affected fallopian tube.
Removal of all or part of the fallopian tube may be suggested if the tube is stretched or has ruptured during the ectopic pregnancy, and can be a life-saving emergency procedure.

You might be wondering what to expect after ectopic pregnancy surgery. Your doctor will closely monitor your recovery after an ectopic pregnancy and any surgery, including rechecking your hCG level to make sure the ectopic tissue has been completely removed.

Can I Get Pregnant After an Ectopic Pregnancy?

If you're wondering if you can have a healthy pregnancy after an ectopic pregnancy, your best bet is to speak with your GP, who will be able to provide you with specific guidance based on your medical history.

Ectopic pregnancies are relatively rare and treatable, but if you notice any symptoms that worry you, consult your GP for reassurance and advice.