What is an ectopic pregnancy?

What are the causes of an ectopic pregnancy?

There are many factors that increase the risk of an ectopic pregnancy, and they involve infection or injury that has altered the normal and highly complex function of the fallopian tubes.

• Pelvic inflammatory disease - untreated infection can contort, scar or block the tubes.
• Appendicitis and peritonitis where the appendix bursts can cause adhesions or scarring.
• Tubal surgery - any previous operation on the fallopian tubes - such as sterilisation and its reversal - makes an ectopic pregnancy more likely.
• Previous ectopic pregnancy - it is a sad fact that up to 20 per cent of the pregnancies that follow an ectopic will themselves become ectopic.
• Previous termination of pregnancy - increased risk of ectopic pregnancy among women who have had pregnancies terminated, especially if there has been an associated infection.
• IVF and fertility drugs - where the ovaries are being stimulated by a fertility drug, or where a test-tube fertilisation technique is being used to help an infertile couple, there is an increased risk that any resulting pregnancy will be ectopic.
• Advancing age - ectopic pregnancies are more common in the older woman.
• Intra-uterine contraceptive coil - if this method fails to prevent a pregnancy, there is a slightly increased risk of it being ectopic.
• Often, none of these increased risk factors are present.

How an ectopic pregnancy happens

• As an emergency - the woman might not even know she's pregnant, and may not experience the usual signs of nausea or breast tenderness, 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.

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