top of page

About Ectopic Pregnancy

Smiling Nurse_edited.png

An ectopic pregnancy can't proceed normally. The fertilized egg can't survive, and the growing tissue may cause life-threatening bleeding, if left untreated.

Therefore, you are advised to take an ultrasound exam at the first signs of pregnancy and if detected, terminate the ectopic pregnancy at the earliest possible. 

What is an Ectopic Pregnancy?

O..jpg

Pregnancy begins with a fertilized egg. Normally, the fertilized egg attaches to the lining of the uterus. An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus.

​

An ectopic pregnancy most often occurs in a fallopian tube, which carries eggs from the ovaries to the uterus. This type of ectopic pregnancy is called a tubal pregnancy. Sometimes, an ectopic pregnancy occurs in other areas of the body, such as the ovary, abdominal cavity or the lower part of the uterus (cervix), which connects to the vagina.

Why Does it Happen?

While the exact cause for ectopic pregnancy remains uncertain, there are a few risk factors. These include:

  • Salpingitis (infection of the fallopian tube)

  • Previous ectopic pregnancy

  • Prior fallopian tube surgery

  • Endometriosis

  • Fertility treatments such as IVF/ ICSI

  • Extensive smoking

P..jpg

Symptoms

  • You may not notice any symptoms at first.

  • However, some women who have an ectopic pregnancy have the usual early signs or symptoms of pregnancy — a missed period, breast tenderness and nausea.

  • If you take a pregnancy test, the result will be positive. Still, an ectopic pregnancy can't continue as normal.

  • As the fertilized egg grows in the improper place, signs and symptoms become more noticeable.

Early warning of ectopic pregnancy

  • Often, the first warning signs of an ectopic pregnancy are light vaginal bleeding and pelvic pain. If blood leaks from the fallopian tube, you may feel shoulder pain or an urge to have a bowel movement. Your specific symptoms depend on where the blood collects and which nerves are irritated.

  • Emergency symptoms:

  • If the fertilized egg continues to grow in the fallopian tube, it can cause the tube to rupture. Heavy bleeding inside the abdomen is likely. Symptoms of this life-threatening event include extreme lightheadedness, fainting and shock.

Types of Ectopic Pregnancy:

Q..jpg
Fallopian Ectopic
R..jpg
Ovarian Ectopic
R..jpg
Abdominal Ectopic
R..jpg
Cervical Ectopic

DIAGNOSIS

  • Transvaginal ultrasound (in the early 6 weeks of pregnancy)

  • Abdominal ultrasound (later than 6 weeks of pregnancy)

 

Procedure: Both transvaginal and abdominal ultrasounds are simple, 7-10 minutes imaging tests, that is,  the tests that provide an internal image of the body organ using high-frequency sound waves. 

 

However, as the name suggests, transvaginal ultrasound is done by inserting the sound wave device through the transvaginal cavity, whereas the abdominal ultrasound is done through the abdominal surface. Since the sound wave device is closer in transvaginal ultrasound, it can help pick up the type of pregnancy earlier and is more accurate than through the results of an abdominal ultrasound. 

 

Confirmation: The location of the fetus confirms the type of pregnancy. 

  • In uterus: Normal pregnancy 

  • In fallopian tubes: Tubal ectopic pregnancy

  • On the ovaries: Ovarian ectopic pregnancy

  • On the peritoneum: Abdominal ectopic pregnancy

  • At the cervix: Cervical ectopic pregnancy

Risk factors

  • Some things that make you more likely to have an ectopic pregnancy are:

  • Previous ectopic pregnancy. If you've had this type of pregnancy before, you're more likely to have another.

  • Inflammation or infection. Sexually transmitted infections, such as gonorrhea or chlamydia, can cause inflammation in the tubes and other nearby organs, and increase your risk of an ectopic pregnancy.

  • Fertility treatments. Some research suggests that women who have in vitro fertilization (IVF) or similar treatments are more likely to have an ectopic pregnancy. Infertility itself may also raise your risk.

  • Tubal surgery. Surgery to correct a closed or damaged fallopian tube can increase the risk of an ectopic pregnancy.

  • Choice of birth control. The chance of getting pregnant while using an intrauterine device (IUD) is rare. However, if you do get pregnant with an IUD in place, it's more likely to be ectopic. Tubal ligation, a permanent method of birth control commonly known as "having your tubes tied," also raises your risk, if you become pregnant after this procedure.

  • Smoking. Cigarette smoking just before you get pregnant can increase the risk of an ectopic pregnancy. The more you smoke, the greater the risk.

Risks & Complications if left untreated:

  • Removal of ectopic pregnancy is a must. Else, if it ruptures, it poses life-threatening risks to the mother’s life. Some of the symptoms and complications include-

  • Acute pain at the site of rupture (fallopian tube/ ovaries/ abdomen etc.)

  • Pain the shoulder (dependent on the site of rupture and the nerves it triggers)

  • Life-threatening bleeding 

Ectopic Pregnancy SPECIALISTS DOCTORS

Dr. ABCD
MBBS,
10 yrs of experience

Dr. ABCD
MBBS,
10 yrs of experience

Dr. ABCD
MBBS,
10 yrs of experience

Medical Termination

While termination of ectopic pregnancy is possible through medicines, it is not commonly preferred because of the longer treatment method, continuous need of monitoring, and repeated follow-ups. The medical management also runs the elevated risks of repeat ectopic pregnancy. 

 

However, if the ectopic pregnancy is detected earlier in the cycle, and the patient favors medical management, the following may be employed:

 

Medicine: Methotrexate

 

Procedure: Methotrexate is given directly by an injection in one dose. hCG levels are monitored before and after the procedure. If the levels do not decrease after the first dose, a second dose may be needed. Confirmation of termination is taken through ultrasound. 

 

Side effects: Some of the side effects include- 

  • Abdominal pain 

  • Vaginal bleeding

  • Nausea

  • Vomiting

  • Diarrhea

  • Dizziness

S..jpg
T..jpg

Surgical Termination

The surgical treatment for removing ectopic pregnancy depends on the particular type of ectopic pregnancy. Some of the common surgical methods include:

 

  • Fallopian ectopic pregnancy: 

  • Salpingectomy: A nick is made at the fallopian tube via laparoscopy, the fetus is removed and the incision is stitched back. 

  • Salpingostomy: A nick is made at the fallopian tube via laparoscopy, the fetus is removed, while the incision is left open to heal naturally.  

  • Salpingectomy: The whole fallopian tube is removed along with the fetus via laparoscopy. 

 

All cost an average of Rs. 60,000- Rs. 80,000 in India. 

  • Ovarian ectopic pregnancy:

  • The fetus is removed from the respective ovary through a laparoscopic procedure. On average, it costs anywhere between Rs. 60,000- Rs. 80,000 in India. 

 

  • Abdominal ectopic pregnancy:

  • The fetus is removed from the respective cavity in the abdomen through a laparoscopic procedure. On average, it costs anywhere between Rs. 60,000- Rs. 80,000 in India. 

 

  • Cervical ectopic pregnancy: 

  • The fetus or its remaining tissues are curetted from the cervix via D&C procedure (dilation and curettage). On average, the cost ranges between 20,000 to Rs. 25,000 in India.

bottom of page