Ectopic Pregnancies. Why Do They Happen?

• An ectopic pregnancy occurs when an egg implants outside the womb, for example in the fallopian tube.
• 1% of women can experience an ectopic pregnancy.
• There are various risk factors including medical conditions, age and lifestyle but often the cause is unknown.
• Early detection can sometimes save the fallopian tube from permanent damage.
• Whilst risk of another ectopic pregnancy can increase, most woman are able to have a healthy pregnancy after an ectopic.

What is are ectopic pregnancies?

An ectopic pregnancy is a distressing and potentially life-threatening experience in which a fertilised egg implants outside the womb, sometimes attaching to an ovary but more often developing in a fallopian tube. 

Early detection can prevent permanent damage to the fallopian tubes and the risk of serious health complications for the mother. Sadly, an ectopic pregnancy isn’t viable for mother or baby and fetal survival is very rare.

What causes an ectopic pregnancy? Are there any obvious risk factors to be aware of? 

An ectopic pregnancy affects 1 in 100 women and can happen to any woman. According to UK charity Tommy’s around a third of women who have an ectopic pregnancy have no known risk factors. That said, your risk may be increased by any of the following:

• A previous ectopic pregnancy
• Damaged fallopian tubes or previous surgery on your fallopian tubes
• Scarring in your pelvic region from a ruptured appendix or surgery
• Pelvic inflammatory disease
• Endometriosis
• IVF or other fertility treatment
• Becoming pregnant while using an intrauterine device (IUD)
• A maternal age above 35
• Being a smoker

Are there obvious signs a pregnancy is ectopic? What should you look out for? 

An ectopic pregnancy will feel like a healthy pregnancy at the start with a missed period, sore and swollen breasts, positive pregnancy test and morning sickness. While it doesn’t always cause symptoms, the UK’s National Health Service (NHS) recommends contacting your doctor as soon as possible if you notice any of the following signs during your first trimester (up to 12 weeks’ gestation):

• Vaginal bleeding
• Intermittent or persistent abdominal cramps or pelvic pain, possibly down one side
• Shoulder tip pain, where the shoulder meets the arm (this could be a sign of internal bleeding)
• Discomfort going to the toilet (urinating or passing stools)

In around 15% of ectopic pregnancies the fallopian tube ruptures. This is a medical emergency and if you experience sudden and intense pain in your stomach, sharp shoulder pain, or feel faint or nauseous you should call emergency or go to your closest emergency department immediately. 

Can I conceive again after an ectopic pregnancy?

An ectopic pregnancy can be an extremely painful and upsetting experience and it’s natural to wonder whether you’ll be able to get pregnant safely again. 

According to Mayo Clinic most women who have had an ectopic pregnancy are able to have a future, healthy pregnancy. Your risk does increase by around 10% if you have had a previous ectopic pregnancy, so it is important to seek your healthcare team’s advice and attend any scans and blood tests they recommend.

Find out more here.

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Sources

Better Health “Ectopic Pregnancy” https://www.betterhealth.vic.gov.au/health/healthyliving/ectopic-pregnancy#symptoms-of-ectopic-pregnancy

Mayo Clinic “Ectopic Pregnancy” https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/diagnosis-treatment/drc-20372093

NHS “Ectopic Pregnancy” https://www.nhs.uk/conditions/ectopic-pregnancy/

Tommy’s “Ectopic pregnancy information and support” https://www.tommys.org/baby-loss-support/ectopic-pregnancy-information-support