An ectopic pregnancy occurs when a fertilized ovum implants in an area outside of the womb, usually in one of the fallopian tubes. Since this space is not suitable for the baby to develop, the fertilized egg does not usually develop into a baby. If growth of an ectopic pregnancy is not prevented, the fallopian tube can rupture and cause dangerous internal bleeding that is life threatening to the mother.
Early stages of ectopic pregnancy
In the early stages of ectopic pregnancy, the patient is actively monitored. In many cases, the fertilized ovum dies and growth does not proceed. A medicine called methotrexate may also be used to stop the fertilized egg from developing any further. This medication kills the developing embryo and the pregnancy tissues are then absorbed into the woman’s body. Methotrexate is only a suitable treatment opinion if the embryo is no larger than 3.5 cm, has no heart beat, the serum hCG level is less than 1500 IU/litre and there is no chance of a concomitant pregnancy within the uterus (heterotropic pregnancy).
If monitoring suggests persistent development of the embryo or if the risk of fallopian tube rupture is high, keyhole surgery may be recommended to remove the ectopic pregnancy.
Follow up after an ectopic pregnancy
The loss of pregnancy can be devastating for those involved and women can require support and counselling to help with feelings of grief and bereavement. Women may also be concerned about trying for another baby and will need to consult their doctor about their specific individual circumstances. In general, women are advised to wait for several menstrual cycles before trying to conceive again, in order to allow their fallopian tubes time to recover. A woman’s chances of conceiving after they have experienced an ectopic pregnancy depends on the health of their fallopian tubes but it is estimated that 65% achieve a normal pregnancy 18 months after their ectopic has ended.
Reviewed by Sally Robertson, BSc