Ectopic pregnancy

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Pelvic laparoscopy

Ultrasound in pregnancy

Female reproductive anatomy

Uterus

Ultrasound, normal fetus - foot

Ectopic pregnancy

Alternative Names:

Tubal pregnancy; Cervical pregnancy; Abdominal pregnancy
Treatment:

In the event that pelvic organ rupture has occurred because of the ectopic pregnancy, internal bleeding or hemorrhage may lead to shock. This is the first symptom of nearly 20% of ectopic pregnancies.

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Shock is an emergency condition. Initial treatment may be keeping the woman warm, elevating her legs, and administering oxygen. Treatment with intravenous fluids and sometimes a blood transfusion is performed as soon as possible.

Surgical laparotomy is performed to stop the immediate loss of blood (in cases in which rupture has already occurred), or to confirm the diagnosis of ectopic pregnancy, remove the products of conception, and repair surrounding tissue damage. In some cases, removal of the involved fallopian tube may be necessary.

In non-emergency cases, mini-laparotomy or laparoscopy are the most common surgical treatments. Such procedures have similar outcomes. However, they are less invasive and are available at a lower cost because they require minimal hospitalization or outpatient treatment.

Non-surgical (medical) management for ectopic pregnancies without suspected immediate danger of rupture is being implemented in many medical centers . In such cases, methotrexate is administered with careful outpatient monitoring of the woman and serial quantitative HCGs, CBCs, and liver function tests.

Ectopic pregnancies cannot continue to term (birth), so removal of the developing cells is necessary to save the life of the mother.
Expectations (prognosis):

About 85% of the women who have experienced one ectopic pregnancy are later able to achieve a normal pregnancy. A subsequent ectopic pregnancy may occur in 10 to 20% of cases. Some women fail to become pregnant again, while others become pregnant and spontaneously abort during the first trimester.

The maternal death rate from ectopic pregnancy in the U.S. has decreased in the last 30 years to less than 0.1%.

Complications:

Rupture, with resulting hemorrhage leading to shock and the need for blood transfusion, is the most common complication. Death from rupture is rare.
Infertility occurs in 10 to 15% of women who have experienced an ectopic pregnancy.

Calling your health care provider:

A woman who has an early pregnancy, or who thinks she might be pregnant and has symptoms (especially lower abdominal pain or abnormal vaginal bleeding) should notify her health care provider. Ectopic pregnancy can occur in any woman who is fertile and sexually active, regardless of contraceptive use.