What is an ectopic pregnancy?
An ectopic pregnancy happens when a fertilised egg implants outside the womb (uterus), most often in a fallopian tube. It cannot continue normally and can cause serious internal bleeding if it ruptures. It is also called an extrauterine pregnancy.
Where it can implant
Site | Note |
Fallopian tube (tubal) | The most common site |
Ovary | Less common |
Cervix | Less common |
Caesarean scar | Implants in the scar from a past caesarean |
Cornual or interstitial | Where the tube meets the womb |
Abdominal | Rare |
Heterotopic | Rare: a normal pregnancy in the womb and an ectopic pregnancy at the same time |
Also Read: What Is a Cryptic Pregnancy? Causes, Signs & Risk
Ectopic pregnancy is also known as:
- Extrauterine pregnancy (EUP)
- Tubal pregnancy
- Cornual pregnancy
- Ovarian ectopic pregnancy
- Interstitial pregnancy
- Heterotopic pregnancy
The other Sites of Ectopic Pregnancy
As you know, ectopic pregnancy generally happens in the fallopian tube, but there are other regions where it can also happen, such as:
- Ovary
- Cervix (parts of the uterus that open into the vagina)
- Cesarean scar (an egg can implant in the scar from a past cesarean section)
- Cornua uteri (happens in the region where the fallopian tubes meet the uterine cavity)
- Heterotopic pregnancy (a normal pregnancy and an ectopic pregnancy in another place can happen at the same time).
What are the causes of Ectopic Pregnancy ?
The main reason behind ectopic pregnancy is the conditions that hinder or block the movement of the egg down your fallopian tube. Meaning these conditions do not let eggs pass from the fallopian tubes to the uterus or womb.
Also Read: Molar Pregnancy: Causes, Symptoms, and Treatment Explained
Here are some common reasons:
Pelvic Inflammatory Disease
Pelvic Inflammatory Disease (PID) or infections such as chlamydia or gonorrhea can block the fallopian tubes. This makes it challenging for an egg to reach the uterus , causing it to grow in the tube instead.
History of Ectopic Pregnancy
A history of ectopic pregnancy before may increase the risk of another time, because the tubes may already be damaged from the past incident.
Surgeries such as sterilization or tube repairs may leave scars or alter the shape of the tubes. This causes an egg to get stuck, and implantation may happen outside the womb.
It is a condition in which cells similar to the lining of the womb, or endometrium, develop outside the uterus (possibly on or near the tubes). This can block or affect regular egg movement.
Use of an Intrauterine Device (IUD)
It is a rare scenario; however, if a pregnancy occurs with an IUD in place, it’s more likely to be ectopic. Because an IUD can make it difficult for the egg to implant in the womb.
Fertility procedures like IVF can increase the likelihood of eggs entering the tube instead of the womb. This could happen, especially when many embryos are transferred at once.
Smoking can damage the small hair-like cells in the tubes that help move the egg. This slows the egg movement and increases the risk of it implanting in the wrong place.
Birth Defects of the Tube
Some women are born with congenital tubal abnormalities (abnormally shaped fallopian tubes). This causes an egg to get stuck on its journey to the destination (womb).
The Ectopic Pregnancy Symptoms
The symptoms can be very similar to normal pregnancy, but additional signs can be there, which is why regular doctors visits are so important.
Symptoms of an ectopic pregnancy generally develop between the 4th and 12th weeks of pregnancy.
Some of the signs of ectopic pregnancyare:
- Vaginal bleeding (a bit different from your regular period)
- Tummy pain (low down on one side)
- Shoulder tip pain
- Discomfort when peeing
- Symptoms of a fallopian tube rupture (sharp, sudden, and intense pain in your tummy, low blood pressure, bowel problems)
Note: Vaginal bleeding during pregnancy is generally common and isn’t necessarily a sign of a serious issue. Hence, go to your doctor for a proper diagnosis.
How common is Ectopic Pregnancy?
Ectopic pregnancies are rare scenarios that may occur in about 2% of all pregnancies.
The Ectopic Pregnancy treatments
Sadly, the developing embryo or fetus cannot be saved in an ectopic pregnancy. The treatment aims to remove the pregnancy before it grows too large.
The primary treatment options are:
If the pregnancy is very small and hormone levels are dropping, the healthcare professional may just observe and wait with regular blood tests and ultrasounds. They hope that the pregnancy will dissolve by itself on its own without treatment.
If an ectopic pregnancy is diagnosed early, but active monitoring isn’t possible. A medicine known as methotrexate is administered as an injection. This stops the pregnancy cells from growing and lets the body reabsorb the tissue naturally over time. There is no need for surgery if this works.
If the pregnancy becomes too large, your doctor may consider surgery known as keyhole surgery (laparoscopy). This open surgery helps remove the ectopic pregnancy and sometimes the damaged portion of the fallopian tube.
Where to get help in Singapore
- Emergency: call 995 or go to the nearest A&E.
- Early Pregnancy Assessment Units:KKH's EPAU offers same-day appointments for mild symptoms. SGH's Early Pregnancy Assessment Unit assesses bleeding or pain in the first 14 weeks and accepts self-referrals. Call to confirm current hours and referral rules.
- Non-urgent concerns: your own obstetrician or GP.
Trying again after an ectopic pregnancy
An ectopic pregnancy does not always mean you cannot conceive again. If your tubes were kept, there is a reasonable chance of a healthy pregnancy later, but the risk of another ectopic pregnancy is slightly higher, so see your doctor early in your next pregnancy. Ask your doctor how long to wait before trying again.
Planning ahead? Read about natural family planning. Once your doctor has confirmed a healthy pregnancy, you can also learn about cord blood banking in Singapore.
Conclusion
Ectopic pregnancy can be life-threatening if not detected and treated immediately. It may lead to many complications, including severe bleeding. Yes, pregnancy is a beautiful journey, and to enjoy it to the fullest, regular monitoring and following your doctor’s advice are necessary. Some of the preventive measures that are in your hands are getting infection treatment, quitting smoking, and getting early scans and checkups if you have risk factors or symptoms.
FAQs
When does ectopic pregnancy pain start?
Symptoms usually start between weeks 4 and 12. The pain is typically in the lower tummy and gets worse over time. See a doctor early, and go to A&E if the pain is severe.
What are the signs of an ectopic pregnancy?
A missed period, spotting or bleeding, one-sided lower tummy pain, shoulder-tip pain and dizziness. Some women have no symptoms, so see a doctor early if you have risk factors.
Is an ectopic pregnancy a miscarriage?
No. A miscarriage is a pregnancy in the womb that ends early. In an ectopic pregnancy the pregnancy is outside the womb. Both can cause bleeding and pain, so see a doctor for either.
Can an ectopic pregnancy be saved?
No. It cannot continue normally. Treatment protects your health.
Can I get pregnant again after an ectopic pregnancy?
Often yes, especially if your tubes were kept. The risk of another ectopic pregnancy is slightly higher, so see your doctor early in your next pregnancy.
When should I go to A&E?
If you are pregnant, or could be, and have severe pain, heavy bleeding, dizziness or fainting, call 995 or go to the nearest A&E.
