Ectopic Pregnancy

An Ectopic Pregnancy occurs when the fertilised egg, which in a normal pregnancy implants in the womb, implants somewhere other than the womb.  The most common type of ectopic pregnancy is a tubal pregnancy, in which the fertilised egg implants in one of the fallopian tubes.  It is also possible, though, for it to implant elsewhere, for example in the cervix or even in the abdominal space.

The baby cannot survive an ectopic pregnancy, and it can be life threatening for the mother, if left untreated.  In the case of a tubal pregnancy, if the pregnancy is allowed to develop for long enough, the fallopian tube is at risk of rupturing and causing a massive bleed.

The treatment for an ectopic pregnancy varies, depending on how advanced the pregnancy is.  The most common treatment is surgery, to remove the embryo and placental tissue.  Depending on whether any damage has been caused to the fallopian tube, it may also need to be removed.  This would usually be done at the same time, so that the mother doesn’t have to undergo two surgeries, but the possibility of this happening will be explained beforehand.

If an ectopic pregnancy is diagnosed early enough, treatment can take the form of medicine called methotrexate. Methotrexate works by stopping the growth of the embryo cells. It does have side effects though, it can often cause side effects, such as abdominal pain, conjunctivitis and an upset stomach. If methotrexate is given, careful monitoring through regular blood tests will be necessary afterwards. Methotrexate is given as an injection. Another thing to note about this drug, is that reliable contraception must be used for three months after taking it as there is an increased risk of development problems in the next baby if a woman becomes pregnant after being given the medication. In addition there is still a 7% chance of having a ruptured ectopic pregnancy (when the fallopian tube splits) after medical treatment with methotrexate even if hCG levels are going down.

If symptoms are very mild with an ectopic pregnancy, doctors may decide to ‘wait and see’.  Often the pregnancy will end by itself without any need for medical intervention.

An ectopic pregnancy can be a very traumatic experience for a family, particularly if huge blood loss and life-saving surgery is involved.  There may also be the worry of the effect on future fertility if a fallopian tube is lost.  As well as this, the family will of course be grieving the loss of a much wanted baby that they already loved.