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Ectopic Pregnancy

What is an Ectopic Pregnancy

Normal pregnancy is supposed to develop inside the uterus.  Some women get pregnant but the pregnancy grows outside the uterus. A pregnancy which grows outside the uterus is called Ectopic Pregnancy. The most common place for such pregnancies to grow is in the fallopian tube.

Over time, ectopic pregnancy can become really dangerous. A woman can experience more and more pain, she may have internal bleeding, and she may need emergency surgery. While an ectopic pregnancy can not be prevented, it can be treated with medicine if the diagnosis is made early. The goal is early diagnosis and treatment, and avoiding surgery if possible.

Who’s at Risk

Women are considered at risk of ectopic pregnancy if they have already had:

  • an ectopic pregnancy
  • surgery to the fallopian tubes
  • surgery to the colon
  • a burst appendix
  • chlamydia or gonorrhea
  • PID (pelvic inflammatory disease)
  • surgery for endometriosis with lots of scar tissue

Whatever caused a first ectopic pregnancy can cause a second. The chance of ANY woman having an ectopic pregnancy is approximately 1 in 100. The chance of a woman getting a SECOND ectopic pregnancy is approximately 1 in 20, and maybe as high as 1 in 3. Women who have ever had an ectopic pregnancy must be carefully evaluated in the first seven weeks of all pregnancies that follow. It is essential that any woman who had already had an ectopic pregnancy, and is now pregnant, contacts her OB/GYN for early pregnancy blood tests and ultrasounds, to diagnose or exclude ectopic pregnancy.

Confirming an Ectopic Pregnancy

Normal pregnancy is confirmed with an ultrasound seeing a fetus with a heartbeat in the uterus. The earliest we can find these things is 5 ½ weeks after the last period. All normal pregnancies can be confirmed at 7 weeks, based on ultrasound measurements of the fetus. Similarly, the diagnosis of an ectopic pregnancy is based on blood pregnancy tests and an ultrasound.

We can make the diagnosis of an ectopic pregnancy IF:

  • we see a fetus in a sac outside of the uterus. This can be seen with ultrasound.
  • the blood pregnancy test is rising over time but it does not rise fast enough or high enough.
  • the blood pregnancy test is high enough, but an ultrasound doesn’t find a pregnancy in the uterus.

If You’re at Risk

Women at risk of ectopic pregnancy do extra home urine pregnancy tests IF:

  • she feels pregnant.
  • she does not have a period 5 – 6 weeks after the last period.
  • the periods are irregular, a test should be done every six weeks.

A woman at risk for ectopic pregnancy should CONTACT her OB/GYN IMMEDIATELY when a urine pregnancy test is positive.