What is it about ?
In the case of an ectopic pregnancy, the fertilized egg does not grow inside, but outside the uterus. It grows in the wrong place which can lead to a tear between the 10e and the 12e week of pregnancy. This results in bleeding in the mother’s womb, which can be life threatening.
Some women have a higher risk of developing an ectopic pregnancy:
- women who have had inflammation (of the cervix) of the uterus or fallopian tubes in the past (a pelvic inflammatory disease, especially at Chlamydia);
- women who have had surgery in the region of the small pelvis;
- women who have had an ectopic pregnancy in the past;
- women who have fertility problems ;
- women who suffer fromendometriosis (overgrowth of womb lining outside the womb);
- women who suffer from irritable bowel syndrome ;
- smokers.
Where and how often?
For every 1000 pregnancies, there are 15 to 20 ectopic pregnancies. Most of these pregnancies develop in women between the ages of 25 and 34. In about 95-98% of cases, the fertilized egg implants in the fallopian tube. Other possible (but rare) places are the cervix, ovaries and abdominal cavity.
How to recognize it?
If you are a young woman of childbearing age and have abnormal (vaginal) bleeding and / or sudden pain in the lower abdomen, you should always think about the possibility of an ectopic pregnancy.
A negative result in the urine pregnancy test does not completely exclude the presence of an ectopic pregnancy: in case of doubt, a blood test will be taken by a doctor.
An ectopic pregnancy can sometimes go almost unnoticed, but it can also be accompanied by very serious symptoms. In one, the bleeding resembles the usual rules; in the other, an abdominal hemorrhage or a tear in the fallopian tube can cause very severe stomach aches, a throbbing pain in the shoulder, or even fainting.
How is the diagnosis made?
The doctor will think of an ectopic pregnancy when a woman of childbearing age suffers from abnormal vaginal bleeding and / or recurrent pain in only one side of the lower abdomen.
In this situation, he will first take a blood test for a pregnancy test and a measurement of the level of the pregnancy hormone (hCG). The most reliable tests can confirm pregnancy from one week before your period is due (i.e. when your period has not yet started).
If the doctor suspects pregnancy, he will perform a transvaginal ultrasound, inserting a probe into the vagina. This is the only way to tell if there is an embryo in the uterus. In principle, this examination is painless, like a usual pelvic examination.
If the ultrasound does not show an embryo inside the uterus and the blood level of the pregnancy hormone indicates pregnancy, there is a high chance that the pregnancy is ectopic.
What can your doctor do?
In some situations, the doctor will simply monitor the situation with blood tests. This will be the case in particular if the blood test shows a small quantity (max. 2000 units) of pregnancy hormone (hCG) and the embryo is not yet very large. In this case, the embryo usually dies spontaneously.
Sometimes it is indicated to administer drugs to destroy embryonic tissue. This is only possible when the embryonic tissue is young, the pregnancy hormone concentration is relatively low (max. 5000 units) and the woman’s liver and kidney tests are good. If so, methotrexate is given by injection into the buttock muscle. Often (7 to 9 times out of 10), a single injection is sufficient. Three in four women experience stomach pain after the injection.
If the situation is serious and it is necessary to act very quickly, a surgical intervention is necessary. If you still want to have children afterwards, the procedure will aim to open the fallopian tube, if technically possible of course. But usually, unfortunately, the fallopian tube will have to be removed. You can try to get pregnant again after your next period.
When diagnosing an ectopic pregnancy, the doctor follows the situation closely:
- by blood tests (measurement of the concentration of pregnancy hormone);
- in women with rh negative blood group, it will administer anti-D immunoglobulins;
- in a subsequent pregnancy, he will have to check early on that the fertilized egg is developing, this time inside the uterus. After an ectopic pregnancy, the risk of recurrence is around a 1 in 10 chance.
Want to know more?
- Methotrexate – CBIP – Belgian Center for Pharmacotherapeutic Information
- Anti-D immunoglobulins – CBIP – Belgian Center for Pharmacotherapeutic Information
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