About 2 percent of all pregnancies develop outside the uterus, called an ectopic pregnancy. These are nearly always in the fallopian tube. Rarely, an ectopic pregnancy will be located in an ovary or in the cervix, or even in the abdomen. Ectopic pregnancy is more common in women with the following conditions:
When the embryo implants in the fallopian tube, usually there is not enough blood flow to keep the embryo healthy and it dies.
The tube may begin to expel some of the tissues or bleed. Some embryos do continue to grow and may become large enough to break through the fallopian tube (rupture). This can cause severe bleeding, hemorrhage, and shock.
Women with an ectopic pregnancy may have irregular bleeding and often have pelvic or abdominal pain, especially one-sided pain. Tests to detect ectopic pregnancy include the level of a hormone in the blood called human chorionic gonadotrophin (hCG), which may not increase as it normally would. Ultrasound examination (a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs) can show a fetus or other tissue in or near the fallopian tube, or blood collecting in the mother's pelvis. Usually, ultrasound can determine there is not an ectopic pregnancy if there is a fetus inside the uterus. Laparoscopy may also be used to diagnose ectopic pregnancy. This is surgery that uses a lighted tube inserted into the mother's abdomen to examine inside her pelvis and often provides the most accurate diagnosis.
Specific treatment for ectopic pregnancy will be determined by your doctor based on:
Ectopic pregnancy may be treated in several ways depending on whether the fallopian tube has ruptured or not, the development level of the pregnancy, and the mother's hormone levels. Treatments may include:
In rare cases, a laparotomy may be necessary. This is a surgical procedure in which an incision is made in the mother's abdomen to remove the ectopic pregnancy or damaged fallopian tube.
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