An “ectopic pregnancy” occurs when the fertilized embryo implants outside of the uterus; most commonly in fallopian tube. When attached to the fallopian tube, this is referred to as a “tubal pregnancy.” Approximately 16%1 of women seeking emergency medical attention due to cramping and/or vaginal bleeding in the first trimester are diagnosed as having an ectopic pregnancy. Overall, ectopic pregnancies are rare, occurring in 1%-2%2 of all pregnancies. As the embryo grows, it can cause the tube to rupture (burst), which can cause major internal bleeding. This can be life threatening3 and/or cause future fertility issues if not discovered early.
Bleeding and cramping are the most common symptoms of an ectopic or tubal pregnancy. Women who are pregnant or may be pregnant should seek immediate medical attention for a possible ectopic pregnancy if they experience any or all of the following symptoms:
Cramping pain in the lower abdomen that may worsen with coughing, moving, or bowel strain
Sharp, steady pelvic pain
Nausea and vomiting
Dizziness or weakness
Feeling of pressure in the rectum
Risk factors leading to a greater risk for an ectopic pregnancy include: previous tubal surgery, sterilization, previous ectopic pregnancy, current use of an intrauterine device (IUD), history of pelvic inflammatory disease (PID), infertility for two years or longer, women over the age of 35 years, and smoking.
When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination and imaging with transvaginal ultrasound can usually confirm the diagnosis. In some cases, a blood test may also be used to determine diagnosis.2 The ultrasound is performed to check where the embryo implanted, if not found in the uterus. An ultrasound is one of the best methods to determine where the embryo may have implanted and alert if there are other health concerns to be aware of.
Since ectopic pregnancies may be life threatening, they must be treated as an emergency situation and the doctor will determine how best to end the pregnancy, as the embryo cannot be transplanted into the uterus. Many cases of ectopic pregnancy, if caught early enough, can be treated with medicine and not surgery. Early detection may help preserve the fallopian tube for future pregnancy attempts.
In all cases of suspected tubal pregnancies, the Support Circle technician or nurse will immediately refer the woman to the emergency room. If you have questions, Support Circle staff at our three Bay Area clinics are available.