An ectopic pregnancy is a condition that happens when a fertilised egg attaches itself somewhere outside the uterus. Show
BreadcrumbHome Baby loss support Ectopic pregnancy In an ectopic pregnancy, a fertilised egg starts to grow somewhere other than in the normal lining of the womb, usually in 1 of the fallopian tubes. Ectopic pregnancy affects around 1 in 100 pregnancies. An ectopic pregnancy creates a potentially life-threatening situation for the mother, so it is very important that it is treated quickly. Unfortunately, it is not possible to save the pregnancy if it is ectopic. This can be difficult to come to terms with. You can talk to a Tommy’s midwife about what you’re going through for free. You can call them on 0800 0147 800 (Monday-Friday, 9am-5pm) or email them at [email protected] All our midwives are trained in bereavement support. Any woman can have an ectopic pregnancy. In fact, about a third of women who experience an ectopic pregnancy have no known risk factors. But there are some things that may increase your risk of having an ectopic pregnancy. These include: Contact your GP or call NHS 111 if you have a combination of any of the below symptoms and you think you might be pregnant, even if you haven't had a positive pregnancy test. Symptoms of an ectopic pregnancy usually develop between the 4th and 12th week of pregnancy. Vaginal bleeding in pregnancy tends to be a bit different to your regular period. It often starts and stops, and may be watery and dark brown in colour. Vaginal bleeding in pregnancy can be common and isn't necessarily a sign of a serious problem, but you should always get medical advice if you have it. Stomach painYou may have stomach pain, typically low down on 1 side. It can develop suddenly or gradually, and may be persistent or come and go. Any stomach pain may just be caused by a stomach bug, trapped wind or something unknown. But it is important to get medical advice if you have it. Shoulder tip painShoulder tip pain is an unusual pain felt where your shoulder ends and your arm begins. You should get medical advice right away if you experience this. We don’t fully understand why this pain happens. It is thought to be linked to the presence of fluid or blood leaking into the pelvis or lower abdomen, which happens in an ectopic pregnancy. There are nerves in this area that are linked to your shoulder. Irritation of these nerves can lead to shoulder tip pain. Discomfort when going to the toiletYou may have pain when going for a wee or poo. You may also have diarrhoea or constipation. Some changes to your normal bladder and bowel patterns are normal during pregnancy. These symptoms can be caused by urinary tract infections and stomach bugs. But it's still a good idea to get medical advice. Symptoms of a ruptureIn some cases, an ectopic pregnancy can grow large enough to split open the fallopian tube. This is known as a rupture. Ruptures are very serious. Surgery to repair the fallopian tube needs to be carried out as soon as possible. Signs of a rupture include a combination of:
A rupture can be life threatening, but fortunately they are uncommon and treatable, if dealt with quickly. Deaths from ruptures are extremely rare in the UK. How is ectopic pregnancy treated?Unfortunately, the only way to treat an ectopic pregnancy is to end the pregnancy. This can be very distressing, and you may need support afterwards to come to terms with what has happened. Your healthcare team will talk to you about your options and what this means for you. Not all these options will be suitable and will depend on:
It’s important that you understand all your options and what this may mean for you and your ability to get pregnant again (if you want to). Don’t be afraid to ask as many questions as you need to and raise any concerns you have about what is happening. There are 3 treatment options for an ectopic pregnancy. Expectant managementExpectant management means waiting for the pregnancy to end by itself naturally (miscarriage), without treatment. It is usually only possible when the pregnancy is still in the early stages and when you have a few or no symptoms. Your doctor will need to check your hCG levels (pregnancy hormones) every few days until they go back to normal. This is to make sure that the pregnancy has completely ended. You may need more ultrasound scans. Find out more about expectant management. MedicationYou will be given medication as an injection. This stops the pregnancy from developing and it will gradually disappear. If you are given medication, your fallopian tube is not removed. You may need to stay in hospital overnight. Many women are in some pain for the first few days, but this should settle if you take paracetamol. You will need to go back to hospital in the first week and then once a week to check your hCG levels. It may take a few weeks make sure the pregnancy has completely ended and you may need further ultrasound scans. During this time, you should not have sex. You should also avoid getting pregnant by using reliable contraception for at least 3 months. Some women who take medication may still need surgery. SurgeryThe aim of surgery is to remove the ectopic pregnancy. The surgery will be either be a laparoscopy (a type of keyhole surgery) or a laparotomy (open surgery). It may take longer to recover if you have open surgery. You may have your fallopian tube removed (known as a salpingectomy). This will reduce the risk of having another ectopic pregnancy next time. If you only have 1 tube or your other tube does not look healthy, you may be advised to have a salpingotomy. This operation aims to remove the pregnancy without removing the tube. This means that you have a higher risk of another ectopic pregnancy, but you will still be able to get pregnant naturally. You may be offered a follow-up appointment with your gynaecologist, particularly if you have had an emergency operation. If you have not had your fallopian tube removed, you will need to have your hCG levels checked until they are back to normal. In an emergencyIf the fallopian tube has ruptured, you will need emergency surgery to remove the ruptured tube and pregnancy. Your doctors will need to act quickly, so they may have to decide to operate for you. Will I still be able to have a baby in the future?For most women, an ectopic pregnancy is a ‘one off’ event and does not happen again. Even if you have only one fallopian tube, your chance of getting pregnant again is only slightly reduced. If you do get pregnant again, you may be offered an ultrasound scan at 6 to 8 weeks to confirm that the pregnancy is developing in the womb. Talk to your GP if you do not want to become pregnant again. Some forms of contraception may be more suitable after an ectopic pregnancy. How you may feel about an ectopic pregnancyHaving an ectopic pregnancy can have a huge impact on your mental health. Everyone is different but you’ll likely have lots of feelings and emotions and may need time to come to terms with the loss of a baby. Some women might also need time to accept that they could also have lost their life. You may eventually want to try for another baby. Try to remember that the possibility of a normal pregnancy next time is much greater than the possibility of having another ectopic pregnancy. You may find it helpful to:
The Tommy's Miscarriage Support Tool If you have miscarried before, it's understandable to feel anxious about trying again. The Tommy's Miscarriage Support Tool can give you a percentage chance of your next pregnancy being successful and gives personalised support and information. Get started Back to baby loss information and support Sources NICE (2019). Ectopic pregnancy and miscarriage: diagnosis and initial management. National Institute for health and care excellence https://www.nice.org.uk/guidance/ng126 Clinical Knowledge Summaries. Ectopic pregnancy https://cks.nice.org.uk/ectopic-pregnancy (Last reviewed: May 2018 Next review due: December 2023) NHS Choices. Ectopic pregnancy https://www.nhs.uk/conditions/ectopic-pregnancy/ (Page last reviewed: 27/11/2018 Next review due: 27/11/2021) Royal College of Obstetricians and Gynaecologists (2010) An ectopic pregnancy https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-an-ectopic-pregnancy.pdf |
Signs of ectopic pregnancy at 8 weeks
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