Ectopic Pregnancy

One of the scariest things to discover early in the first trimester is an ectopic pregnancy. This complication, also known is a tubal pregnancy, occurs when the newly conceived baby implants somewhere outside the uterus.

This is most often in one of the two fallopian tubes (thus the name "tubal pregnancy"). An ectopic pregnancy can also occur in other places as well, such as the abdominal cavity or even the cervix.

How do I Know if I'm Experiencing an Ectopic Pregnancy?

It is not always obvious that a pregnancy is ectopic. Some women do not even realize they are pregnant. The pregnancy hormone HCG, or human chorionic gonadotropin normally rises in a predictable pattern throughout the early weeks of pregnancy. This hormone is what a pregnancy test picks up and reads. When a pregnancy is ectopic, HCG may not rise normally and cause a pregnancy test to come back negative.

If a pregnancy test is positive but a tubal pregnancy is suspected careful monitoring of HCG levels is important. Often, however, a woman will not have any reason to suspsect ectopic pregnancy unless she has had one before. The first warning signs may be bleeding and abdominal pain.

Ultrasound can be used to detect an ectopic pregnancy at around 5-6 weeks after conception. Sometimes a laparoscopy, or a tiny camera inserted into the abdomen through an incision, is used to get a clearer look. If a gestational sac is not detected in the uterus there will be a careful examination of the fallopian tubes and the rest of the abdomen to find where the pregnancy has implanted.

If it is not diagnosed and treated an ectopic pregnancy can cause the fallopian tube to rupture, resulting in large amounts of internal bleeding. Ectopic pregnancy is life threatening. If you suspect it, get to the hospital immediately.

How is it Treated?

Sadly the baby cannot be saved if a pregnancy is ectopic. It is a heart-wrenching situation. The pregnancy must end in order to save the life of the mother. About 25% of all tubal pregnancies will end in a miscarriage. They may never even be detected.

Those that do not miscarry will need to be ended with the help of a doctor. Sometimes surgery is called for. If the ectopic pregnancy is in the fallopian tube the tube will have to be removed. It is still possible to become pregnant through the other tube, should you choose to try to conceive in the future.

There is also a drug that can end a tubal pregnancy chemically. This drug, called Methotrexate, prevents cells from dividing. Ending the pregnancy chemically may be safer for the mother and it also leaves a greater chance of the fallopian tubes remaining intact. However, it doesn't always work and some mothers may find it a very hard choice to make.

In very rare instances a hysterectomy is required. This happens only when the pregnancy is embedded deeply on the wrong part of the uterus. Most ectopic pregnancies can be resolved without such extreme measures.

How Can I Prevent Ectopic Pregnancy?

Sometimes it cannot be prevented, but there are things you can do to lessen the chance of ectopic pregnancy. If you've had one in the past your risk is higher, but many women go on to have a healthy pregnancy even after a loss from ectopic pregnancy.

First avoid risky sexual behavior. Sexually transmitted disease account for a large percentage of ectopic pregnancies.

It seems counter-intuitive, but if you think that you may possibly want to become pregnant ever again, do not have a tubal ligation. Having one increases your chances of ectopic pregnancy and having it reversed increases your chances.

Do not smoke. Smoking can damage the ampulla of the of the fallopian tubes. These important little "fingers" help push the fertilized egg down into the uterus.

Do not have an IUD put in. An IUD will not cause an ectopic pregnancy, but it does prevent an egg from implanting in the uterus. This could lead it to implant elsewhere in the body.

Note that some forms of assisted reproductive technology increase the risk of ectopic pregnancy. Those where the egg is fertilized outside of the body carry a slightly increased risk. Drugs that induce massive ovulation also carry some risk.

Another suggestion is to take the time to make sure your hormones are balanced before you try to conceive. This increases the odds that everything occurs as it should with implantation. You may wish to seek the help of a doctor or midwife experienced in helping women regulate their hormonal cycles.

If You've Had an Ectopic Pregnancy

If you have had a tubal pregnancy you have suffered a loss. Your baby may have been very real to you and was very wanted. You should not feel ashamed or bad for taking the time that you need to grieve your child.

You may also be going through a physical recovery yourself, especially if you needed surgery. Be sure to take the time to truly recover. Don't push yourself too hard or expect to much from yourself. Your partner may also be grieving but may not show it as readily as you. Remember that he was probably first scared that he would lose you, and needs time to process that. His grief may come in time, even if you don't see it right away.

It is normal and natural to grieve, but if you feel overwhelmed by your emotions you can always seek help. Talk to a trusted friend or family member. Or seek a clergyman or counselor experienced in helping women work through pregnancy loss.

Even if you have had an ectopic pregnancy loss, you will probably be able to go on to have another baby. It is still OK to mourn your loss of this baby, however. Take the time that you need to heal and then make your choice about trying to conceive when you feel physically and emotionally ready.

Natural Birth and Baby Care.com