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Ectopic Pregnancy

An ectopic pregnancy happens when a pregnancy develops outside of the uterus. Unfortunately, ectopic pregnancies can't develop to term like a normal pregnancy and require medical attention.

Ectopic pregnancies are rare and can become life-threatening if not treated in a timely manner.

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What Is an Ectopic Pregnancy?

Doctors define an ectopic pregnancy as a pregnancy that begins somewhere outside of the uterus, usually in the fallopian tubes. Because of this, they're also called a tubal pregnancy, although an ectopic pregnancy can happen in the cervix, ovaries, or abdomen, too.

Typically, a fertilized egg attaches itself to the wall of the uterus to begin growing into a full-term fetus. With an ectopic pregnancy, the fertilized egg doesn’t have the room or nutrients to grow properly. They can also rupture the fallopian tube and cause internal bleeding in the abdomen.

There isn’t a way to save an ectopic pregnancy, or a specific treatment to prevent one. Medication and surgery are options to remove the pregnancy before it becomes life-threatening.

How common is an ectopic pregnancy?

Ectopic pregnancies occur in less than 2% of all pregnancies in the United States.

What causes an ectopic pregnancy?

In many ectopic pregnancies, it's not clear why the fertilized egg didn't make it to the uterus before attaching. But for some people, scar tissue or an infection in the fallopian tubes may make it more challenging for the egg to move quickly to the uterus. So instead, it begins growing inside the tube.

What are ectopic pregnancy risk factors and complications? 

Ectopic pregnancy risk factors 

If you're between ages 35 and 44, you're more likely to have an ectopic pregnancy. Some health factors may also increase your risk.

These include:

  • Endometriosis.
  • Pelvic inflammatory disease (PID).
  • Previous fertility treatments.
  • Previous ectopic pregnancy.
  • Previous adnominal or pelvic surgery.
  • Becoming pregnant while using an intrauterine device (IUD).
  • Smoking history.

Complications of ectopic pregnancy 

If left untreated, an ectopic pregnancy can become life-threatening for the pregnant person. The organ where the egg attached could burst and cause severe bleeding, which can be fatal.

How can I prevent an ectopic pregnancy?

Unfortunately, there isn’t an easy way to prevent ectopic pregnancies from occurring. But you can take actions to control your risk factors.

For instance:

  • If you plan on becoming pregnant, stop smoking.
  • If you're at higher risk for this type of pregnancy, talk to your doctor about ways to minimize your risk, such as checking your hormone levels.

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What Are the Signs and Symptoms of an Ectopic Pregnancy?

An ectopic pregnancy doesn't always show symptoms and may only be diagnosed with an ultrasound.

The most common ectopic pregnancy symptoms include:

  • Abnormal vaginal bleeding.
  • Sharp or stabbing pain in the abdomen, pelvis, low back, or shoulder.
  • A missed period or other signs of pregnancy, such as nausea, fatigue, and frequent urination.

If an ectopic pregnancy progresses and ruptures an organ, you may look very pale and experience:

  • Severe pain in the abdomen or pelvis.
  • Severe shoulder pain (due to blood pooling under the diaphragm).
  • Weakness, dizziness, or fainting.

When should I see a doctor about my ectopic pregnancy symptoms?

You should seek medical attention immediately if you experience any of the above symptoms and think you may be pregnant. Since ectopic pregnancies can become life-threatening, you need to get medical help as quickly as possible.

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How Do You Diagnose an Ectopic Pregnancy? 

To diagnose an ectopic pregnancy, your provider will ask about your symptoms and do a pelvic exam. They may also run tests.

Tests to diagnose an ectopic pregnancy

To locate the source of your pain, your doctor may:

  • Use an ultrasound to determine a pregnancy in the uterus.
  • Measure your human chorionic gonadotropin (hCG) hormone levels. An ectopic pregnancy will have high hCG levels without a pregnancy in the uterus.

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How Do You Treat an Ectopic Pregnancy? 

Ectopic pregnancies rarely resolve on their own. Typically, a medication or surgery is necessary.

Medicine to treat an ectopic pregnancy

Some early ectopic pregnancies may be treated with intramuscular injections of a medicine called methotrexate. This drug allows the body to absorb the pregnancy tissue and can save the fallopian tubes. The healing process can take up to six weeks to fully resolve and requires hCG level monitoring and checkups with your doctor.

Surgery to treat an ectopic pregnancy

Ectopic pregnancies may also be treated with minimally invasive surgery. Usually, the entire fallopian tube with the ectopic pregnancy is removed to reduce the risk of another ectopic pregnancy. Other times, the ectopic pregnancy may be removed from the fallopian tube.

A ruptured ectopic pregnancy requires emergency surgery. This is typically with an abdominal incision in a procedure called a laparotomy.

Can I try for another baby after an ectopic pregnancy?

Many people who've had an ectopic pregnancy are able to have a successful pregnancy after treatment. But you should wait at least two to three months after medication or surgery before trying to get pregnant again. It’s also important to make sure you and your partner are ready physically and emotionally before starting again.

While the chance of another ectopic pregnancy does rise after having one, the risk is still small. If you do become pregnant again, talk to your doctor immediately to confirm a healthy pregnancy in the uterus.

Support after an ectopic pregnancy

Pregnancy loss can be very emotional and sensitive, and many people grieve the loss of an ectopic pregnancy. It's not uncommon to feel sadness or grief for several months. It's important to give yourself time and space and for you and your partner to take care of yourselves and each other.

Support groups and grief counseling are two ways to receive support after an ectopic pregnancy. Learn more about how UPMC can support you after pregnancy loss.


Last reviewed by a UPMC medical professional on 2024-09-05.