Ectopic pregnancy symptoms

An ectopic pregnancy is a potentially life threatening event, which occurs when a fertilized egg embeds outside your uterus. The most common place for it to implant is in your fallopian tube as it travels towards your uterus. It is surprisingly common and occurs in about one in 100 pregnancies.

The danger occurs if ectopic is undiagnosed. The fallopian tube may rupture, as the embryo grows too big, causing a major haemorrhage and collapse. It is often caused by damage or infection in your fallopian tubes, which narrows the tube and prevents the egg reaching your uterus.

What are the symptoms of ectopic pregnancy?

It is often difficult to diagnose in early pregnancy, however there are certain symptoms associated with ectopic pregnancy:

  • A late period, with a positive pregnancy test
  • Persistent, sometimes severe abdominal pain often felt on one side
  • Shoulder tip pain is often a good differential diagnosis for ectopic pregnancy
  • Abnormal bleeding which is often dark and watery, similar to ‘prune juice’
  • Digestive upsets with symptoms of diarrhoea and occasionally pain is also experienced opening your bowels
  • Dizzy spells or fainting may be experienced

Women more at risk of ectopic pregnancy

In theory, any sexually active woman capable of becoming pregnant is at risk. However there are some factors, which increase your risk:

  • A history of pelvic inflammatory disease (PID) most commonly caused by Chlamydia
  • Adhesions (scar tissue) in the pelvis caused by previous abdominal surgery
  • Certain types of contraception increase your risk including the coil (IUCD) or the mini pill (progesterone only)
  • Previous ectopic pregnancy
  • Smoking
  • IVF treatment for fertility

Diagnosis, treatment and follow up

An ectopic pregnancy is usually diagnosed by an internal transvaginal ultrasound scan, which provides a better view of your uterus, fallopian tubes and ovaries. Sometimes it may not be possible to confirm a diagnosis on scan, therefore blood tests may be performed instead.

The most common form of treatment is an operation to remove the ectopic pregnancy and often the fallopian tube too. Non-invasive treatment is by a drug called Methotrexate, which stops the pregnancy growing. Close follow up is needed to monitor its effects. Very rarely, no treatment is required, but again you will need close monitoring to make sure the pregnancy comes to a natural end.

In subsequent pregnancies you will require an early scan to confirm that your pregnancy has embedded in your uterus.

Conclusion

Sadly, Chlamydia one of the most common causes of PID (pelvic inflammatory disease) and salpingitis (inflammation of the fallopian tube) is difficult to diagnose as it is often asymptomatic. However, the side effects of this infection may have far reaching consequences for young women wishing to become pregnant as it increases their risk of infertility and ectopic pregnancy.

Photography: Alex @Flickr

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