Ectopic Pregnancy – Flashcards

An ectopic pregnancy is when a fertilised egg implants itself outside of the womb, usually in one of the fallopian tubes.

This means the egg will not develop into a baby, which can be devastating to the pregnant woman.

Occasionally, an ectopic pregnancy doesn't cause any noticeable symptoms and is only detected during routine pregnancy testing. However, most women do have symptoms.

these usually become apparent between week 5 and week 14 of pregnancy.

They include: •abnormal vaginal bleeding •abdominal pain, typically just in one side, which can range from mild to severe •an absent period (amenorrhoea), and other symptoms of pregnancy

If an ectopic pregnancy is detected at an early stage, a medication called methotrexate is sometimes needed to stop the egg developing. The pregnancy tissue is then absorbed into the woman's body.

No, methotrexate is not always needed - in around half of cases, the egg dies before it can grow.

Ectopic pregnancies detected at a more advanced stage will require surgery to remove the egg.

If an ectopic pregnancy is left to develop, there is a risk that the fertilised egg could continue to grow and cause the fallopian tube to split open (rupture), which can cause life-threatening internal bleeding.

Signs of a ruptured fallopian tube are: •sudden, severe, sharp pain •feeling faint and dizzy •feeling or being sick •diarrhoea •shoulder tip pain

In a normal pregnancy an egg is fertilised by sperm in one of the fallopian tubes, which connect the ovaries to the womb. The fertilised egg then moves into the womb and implants itself into the womb lining (endometrium), where it grows and develops.

An ectopic pregnancy occurs when a fertilised egg implants itself outside the womb. It most commonly occurs in a fallopian tube (this is known as a tubal pregnancy), usually as the result of damage to the fallopian tube or the tube not working properly.

Less commonly (in around 2 in 100 cases), an ectopic pregnancy can occur in an ovary, in the abdominal space or in the cervix (neck of the womb).

Things that increase your risk of ectopic pregnancy include: •pelvic inflammatory disease (PID) - an infection of the female reproductive system, typically caused by chlamydia •smoking •having a previous history of other ectopic pregnancies In around half of all cases, there are no obvious risk factors.

In most cases it is recommended that you wait for at least two full menstrual cycles before trying for another pregnancy, as this will allow time for your fallopian tubes to recover. However, if you were treated with methotrexate, it is usually recommended that you wait at least three months.

Some women who have an ectopic pregnancy do not have any symptoms. They may not find out it is ectopic until an early scan shows the problem or a woman's fallopian tube has ruptured. If there are symptoms, they usually appear between weeks 5 and 14 of the pregnancy.

One-sided abdominal pain You may experience pain, typically on one side of your abdomen (tummy), which can be persistent and severe.

Vaginal bleeding Vaginal bleeding is a different type of bleeding from your regular period. It often starts and stops, and can be bright or dark red in colour. Some women mistake this bleeding for a regular period and do not realise they are pregnant.

Shoulder tip pain Shoulder tip pain is felt where your shoulder ends and your arm begins. It's not known exactly why shoulder tip pain occurs, but it usually happens when you're lying down and is a sign that the ectopic pregnancy is causing internal bleeding. The bleeding is thought to irritate the phrenic nerve, which is found in your diaphragm (the muscle used during breathing that separates your chest cavity from your abdomen). Irritation of the phrenic nerve causes referred pain (pain that is felt elsewhere) in the shoulder blade.

Bowel pain You may experience pain when passing urine or stools.

Diarrhoea and vomiting An ectopic pregnancy can cause similar symptoms to a gastrointestinal disease and is often associated with diarrhoea and vomiting.

The most serious symptom of an ectopic pregnancy is known as "collapse". This occurs when an ectopic pregnancy has split open the fallopian tubes (tubal rupture) and is causing dangerous internal bleeding.

People who have experienced collapse describe feeling lightheaded (dizzy) and faint. You may also: •experience a sharp, sudden, intense abdominal pain •feel sick •have an increased heart rate •look pale •have diarrhoea

In rare cases, a ruptured fallopian tube can be fatal. However, this is very uncommon and in most cases, the fallopian tube can be successfully repaired or removed.

Yes, a pregnancy test can sometimes provide a positive result, even if the pregnancy is ectopic.