What is an ectopic pregnancy?

• As an emergency - the woman might not even know she's pregnant, and none of the usual signs of nausea or breast tenderness will be apparent, but she'll feel unwell and may collapse suddenly, needing emergency admission to hospital.
• Many women miss a period, have a positive pregnancy test, some lower abdominal pain, and some irregular vaginal bleeding - which may be red or brown. The woman may feel faint or generally unwell. This usually occurs around 6-10 weeks of pregnancy because the fallopian tube contracts in response to the stretching caused by the growing embryo. Bleeding will occur into the abdominal cavity if the tube ruptures and this will result in severe abdominal pain.

There are various tests, and the first of these is a pregnancy test itself. There are, nowadays, fairly sensitive urine tests available, which can give an answer quickly. This can be followed up by a blood test. Vaginal ultrasound scanning can demonstrate a normally positioned womb pregnancy and therefore exclude an ectopic pregnancy in a tube.

Sometimes, because of the early stage of development, a pregnancy test may be positive but the position of the pregnancy cannot be seen with ultrasound scanning. In this case, a woman needs to be carefully monitored and this may mean staying in hospital. The changing blood levels of the pregnancy hormone are noted, and together with other features, can indicate a normal or an ectopic pregnancy growth. Sometimes women have a laparoscopic examination (where a small telescope tube is placed into the abdomen). This will then give a definitive diagnosis.

What treatments are possible?

Once an ectopic pregnancy is diagnosed, there are several different treatments possible -unfortunately, these do not include the transplantation of this pregnancy into the womb.

• A small number of ectopics do not cause the fallopian to rupture because the development stops and a miscarriage occurs.
• In a few other cases, an injection may be possible to shrink the ectopic pregnancy.
• Laparoscopic surgery, where either the tube is opened, or the tube itself removed, may also be a possibility.
• In most cases, open, lower abdominal surgery is performed in order to operate on the affected fallopian tube.