An ectopic pregnancy is a pregnancy that occurs outside the womb (uterus). It is a life-threatening condition to the mother. The baby (fetus) cannot survive.
An ectopic pregnancy is often caused by a condition that blocks or slows the movement of a fertilized egg through the fallopian tube to the uterus. Such causes include:
The following also increase your risk for an ectopic pregnancy:
Sometimes the cause is unknown. Hormones may play a role.
Ectopic pregnancies occur in 1 in every 40 to 1 in every 100 pregnancies.
The most common site for an ectopic pregnancy is within one of the tubes through which the egg passes from the ovary to the uterus. However, in rare cases, ectopic pregnancies can occur in the ovary, stomach area, or cervix.
If the area around the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include:
The health care provider will do a pelvic exam, which may show tenderness in the pelvic area.
A pregnancy test and vaginal ultrasound will be done.
HCG is a hormone normally produced during pregnancy. Checking blood levels of this hormone (quantitative HCG blood test) can diagnose pregnancy. A rise in quantitative HCG levels over 1 to 2 days may help tell a normal pregnancy from an ectopic pregnancy.
Ectopic pregnancies is a life-threatening condition. The pregnancy cannot continue to birth (term). The developing cells must be removed to save the mother's life.
You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to shock, an emergency condition. Treatment for shock may include:
If there is a rupture, surgery (laparotomy) is done to stop blood loss. This surgery is also done to:
In some cases, the doctor may have to remove the fallopian tube.
If the ectopic pregnancy has not ruptured, treatment may include:
One-third of women who have had one ectopic pregnancy are later able to have a baby. A repeated ectopic pregnancy may occur in one-third of women. Some women do not become pregnant again.
The likelihood of a successful pregnancy after an ectopic pregnancy depends on:
The most common complication is rupture with internal bleeding that leads to shock. Death from rupture is rare.
Call your doctor or nurse if you have:
An ectopic pregnancy can occur even if you use birth control.
Most forms of ectopic pregnancy that occur outside the fallopian tubes are probably not preventable. However, a tubal pregnancy (the most common type of ectopic pregnancy) may be prevented in some cases by avoiding conditions that might scar the fallopian tubes.
The following may reduce your risk:
Tubal pregnancy; Cervical pregnancy
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Lobo RA. Ectopic pregnancy: Etiology, pathology, diagnosis, management, fertility prognosis. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 17.
Barnhart KT. Ectopic pregnancy. N Engl J Med. 2009;361:379-387.
ACOG Practice Bulletin Committee. ACOG Practice Bulletin No.94: Medical management of ectopic pregnancy. Obstet Gynecol. 2008;111:1479–1485.
Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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