An ectopic pregnancy, also known as extrauterine pregnancy, occurs when a fertilized egg implants itself outside the womb (uterus). The most common location is the fallopian tube, the passage connecting the ovary to the uterus. However, implantation can also happen in other areas like the ovary, cervix (lower part of the uterus), or even the abdominal cavity.

Ectopic pregnancies are a leading cause of pregnancy-related deaths in the first trimester, highlighting the importance of early diagnosis and treatment. In the United States, estimates suggest ectopic pregnancies occur in 1-2% of pregnancies, with ruptured ectopic pregnancies contributing to 2.7% of pregnancy- related deaths.

While symptoms can vary, some common early signs of an ectopic pregnancy include: nausea and vomiting, sharp abdominal cramps (often on one side), dizziness or fainting, pain in the shoulder, neck, or rectum, and vaginal bleeding.

If the fertilized egg grows and ruptures, severe bleeding can occur, presenting a life-threatening situation. Additional symptoms in such cases may include fainting and low blood pressure.

A definitive diagnosis of an ectopic pregnancy relies on ultrasound visualization of a yolk sac or embryo outside the uterus. However, this stage may not be reached before symptoms appear. Doctors often combine patient symptoms with serial ultrasounds and monitoring of beta human chorionic gonadotropin (hCG) levels, a hormone produced during pregnancy, to make an accurate diagnosis.

Several factors can hinder the fertilized egg’s movement through the fallopian tube, leading to an ectopic pregnancy. These include: Scarring or adhesions from previous pelvic surgery or infections, Congenital abnormalities or growths within the fallopian tubes, and Pelvic inflammatory disease (PID) caused by sexually transmitted infections (STIs).

Certain conditions that increase the likelihood of an ectopic pregnancy include: previous ectopic pregnancy, pelvic inflammation (infections like chlamydia or gonorrhea can cause inflammation in the reproductive organs, increasing the risk), fertility treatments and history of infertility,

tubal surgery (any surgery on the fallopian tubes can create scar tissue or blockages, potentially leading to ectopic pregnancy), birth control methods (while uncommon, pregnancy with an IUD in place is more likely to be ectopic.), tubal ligation (permanent sterilization) also carries a risk if pregnancy occurs afterwards and smoking (cigarette smoking can increase the risk of ectopic pregnancy endometriosis).

Ectopic pregnancies cannot be relocated to the uterus and require prompt treatment. Two main treatment methods exist: medication (this is typically an option when the pregnancy is diagnosed early and hasn’t grown significantly), and surgery (surgery is often necessary, especially for ruptured ectopic pregnancies or those where medication is not suitable. Different surgical approaches exist depending on the location of the ectopic pregnancy and the patient’s condition).

Following treatment, close follow-up care is crucial for several weeks to ensure complete resolution of the ectopic pregnancy and monitor for any complications.