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When you’re pregnant, the fertilized egg normally attaches to the wall of the uterus where it will grow. If the egg attaches elsewhere, you have an ectopic pregnancy. Most often, the egg situates itself in the fallopian tube but can happen in the ovary, abdominal cavity, or lower part of the uterus. Ectopic pregnancy symptoms can be subtle at first.
It’s important to pay attention to the symptoms because the pregnancy can’t continue if it is ectopic — the fertilized egg won’t be able to survive and there is just too much risk of bleeding that can occur if the pregnancy goes on too long.
What does an ectopic pregnancy feel like?
At the beginning, the ectopic pregnancy might not feel much different than any other pregnancy. You’ll have a missed period and experience breast tenderness and nausea. As time goes on, you’ll have light vaginal bleeding combined with pelvic pain. This is because the egg is trying to grow in a place not conducive to it maturing.
It is possible in some cases to feel shoulder pain or to feel as if you need to have a bowel movement. This is usually a more serious symptom of blood leaking from the fallopian tube. Your symptoms will vary and be contingent on exactly where the blood pools and what nerve endings it is pressing against.
When ectopic pregnancy symptoms start
It may not be easy to recognize an ectopic pregnancy when you first realize you are pregnant. The signs and symptoms will simply be signs and symptoms of being pregnant. You’ll skip a period and likely take a pregnancy test which will be positive. Your initial symptoms are really just the symptoms of being pregnant with hormonal changes occurring in your body.
As the pregnancy continues and the fertilized egg tries to develop, light bleeding will return. This is often six to eight weeks after your last normal menstruation. This is a considerable amount of time to pass before you realize there is a problem.
The timing of symptoms may only make the entire situation worse, as it did for Vicky Lynch. “I got a call on Sunday evening when I was hosting my inlaws (who we never told about the pregnancy because we were waiting for the end of the first trimester). My doctor told me to get to the ER immediately. I then had to tell everyone about the pregnancy, drop everything and head to the ER," she told Mom.com, about finding out she was having complications and then rushing to announce her pregnancy to her family.
"We were there for 8 hours until 2 in the morning. Despite tests and an ultrasound, they were unable to locate the pregnancy," Lynch continued. "It was so complicated telling everyone about the pregnancy after the fact and dealing with their questions and emotions that I wished I had just told them from the start before we knew the pregnancy wasn't viable.”
Risks of an ectopic pregnancy
There are those who are at a higher risk for an ectopic pregnancy than others. The risk factors include:
- Previous ectopic pregnancy: Someone who has experienced an ectopic pregnancy once is at a higher risk of having a second one.
- Inflammation and infection: Because sexually transmitted diseases such as gonorrhea and chlamydia lead to tubal inflammation, you become a higher risk for an ectopic pregnancy. “You can reduce your risk by getting an annual test for STI’s,” Sarah Yamaguchi, MD, FACOG told Mom.com.
- Fertility treatments: There is research suggesting that women who go through IVF treatments have a higher risk of an ectopic pregnancy. Some research also links infertility to ectopic pregnancies.
- Tubal surgery: If you have had surgery to correct a closed or damaged fallopian tube, you are at a higher risk of an ectopic pregnancy.
- Certain birth control: Women who become pregnant while an IUD is still in place are more likely to have an ectopic pregnancy. Tubal ligation also increases your risk.
- Smoking: Those who smoke are at a higher risk of an ectopic pregnancy and other pregnancy complications.
How to get rid of an ectopic pregnancy
Sadly, an ectopic pregnancy can’t be allowed to continue. The egg can’t develop normally unless it is in the uterus and your life is at risk to continue with the pregnancy.
When the ectopic pregnancy is caught early enough, it is often treated with a drug called methotrexate. This drug stops cell growth and dissolves existing cells. Your doctor will inject this into a muscle. In rare cases, you may need a subsequent injection a week or two after the first.
In some cases, one of two procedures may be utilized: a salpingostomy and a salpingectomy. For both procedures, a small incision is made in your abdomen near your belly button or in it. Your doctor will go in with a small tube that has a camera and light so he can see. The difference between the two procedures is that a salpingostomy only removes the ectopic pregnancy and allows the tube to heal where the salpingectomy removes the ectopic pregnancy and the tube.
If you are experiencing heavy or internal bleeding, a laparotomy may be done. This is an emergency procedure that removes the pregnancy, the tube, and stops the bleeding. It is rare to be able to save the fallopian tube in these cases.
