Pregnancy loss

Ectopic pregnancy

An ectopic pregnancy is one located outside the uterus, usually in one of the fallopian tubes. If a tube is damaged in any way, the fertilised egg may never complete its journey to the uterus. Ectopic pregnancies rarely last past eight weeks.

Common symptoms are lower abdominal pain, often on one side at the beginning, light bleeding, nausea and vomiting, dizziness or weakness, and/or pain in the shoulder or rectum. If the fallopian tube ruptures, the pain and/or internal bleeding can be severe enough to cause fainting. Ectopic pregnancy is a life-threatening condition.

Although recognised by physicians since at least the tenth century, ectopic pregnancies can be difficult to diagnose, and sometimes an evaluation is made with an ultrasound or laparoscopy. If you suspect that you have an ectopic pregnancy see your doctor immediately, as this problem goes from bad to worse quickly. Treatment varies from drugs to surgery.

The rate of ectopic pregnancies increased more than fourfold between 1970 and 1990, partly because of damage to women's reproductive systems caused by sexually transmitted diseases, in particular chlamydia and gonorrhoea, as well as pelvic inflammatory disease, which is often, but not always, sexually transmitted.

Other causes of an ectopic pregnancy include a previous ectopic pregnancy, the use of an intrauterine device (IUD), congenital abnormality of the fallopian tubes, prior pelvic or abdominal surgery and a failed tubal sterilisation. Other risk factors associated with an ectopic pregnancy are smoking, regular douching, fertility drugs, in vitro fertilisation and/or GIFT (gamete intrafallopian transfer).

Maternal age, number of children, abortion and miscarriage history are not known factors. The consequences of an ectopic pregnancy depend on many factors and range from no damage to your reproductive organs to the complete removal of a ruptured fallopian tube. Overall, women who have had one ectopic pregnancy have a greater chance of a subsequent ectopic pregnancy, and a 20 to 40% chance of infertility.