Experiencing an ectopic pregnancy is one of the most devastating events in a woman’s life because even if the pregnancy was not planned or confirmed, the shock of what has happened can leave a lasting emotional impact. Statistics suggest that as many as one in 90 women experience an ectopic pregnancy – and some may not even know, as the egg can die and be reabsorbed by the body before the pregnancy is confirmed. However, for women whose ectopic pregnancy is detected, even though the egg will be at a very early stage of development, the sense of loss can be extremely traumatic.
Ectopic pregnancies occur when the fertilised egg fails to attach itself to the wall of the uterus – which usually happens around seven days after it has been fertilised in the fallopian tube. In ectopic pregnancies, the egg usually begins to develop in one of the fallopian tubes, or may develop outside the uterus, such as in the cervix. If the pregnancy has already been confirmed by a pregnancy test, discovering the pregnancy is ectopic at a first scan can be devastating.
Sadly, however, not all pregnancies are successful and in the case of an ectopic pregnancy the earlier a diagnosis is made, the better the outcome for the mother as the egg will not be viable. The symptoms of ectopic pregnancy include pain which may be concentrated on one side of the abdomen and may be mild or severe; as well as vaginal bleeding, which also may be severe.
If very severe or chronic symptoms are experienced, it is essential to get medical help, as an ectopic pregnancy in which the egg is lodged in a fallopian tube may cause the fallopian tube to rupture. This can cause serious internal bleeding and be fatal if not treated.If a woman of child bearing age appears to be experiencing severe abdominal pain and is bleeding heavily, always call the emergency services, even if a pregnancy has not been confirmed.
The usual symptoms of a ruptured fallopian tube are:
- Abdominal pain and cramps
- Dizziness or fainting
- Nausea or vomiting
- Shoulder pain.
It is easy to confuse the above symptoms with a gastrointestinal infection or food poisoning bug, but severe vaginal bleeding should be referred to a doctor even if the individual does not know or suspect she is pregnant. There are also thought to be certain risk factors for ectopic pregnancy – although no woman who experiences an ectopic pregnancy should ever blame herself or feel guilty, however great the sense of loss she feels.
Chlamydia is a sexually transmitted infection which can cause infertility and usually produces no symptoms and some researchers have linked it to a higher risk for ectopic pregnancy. Pelvic inflammatory disease (PID) is also thought to carry a higher risk for ectopic pregnancy as the effects of this bacterial infection can spread to the womb and fallopian tubes. Smoking and a history of ectopic pregnancy may also increase risk.
However sometimes the egg can fail to develop properly for a multitude of reasons and some medical professionals even believe first or early pregnancies can carry a higher risk of miscarriage or ectopic pregnancy as the mother’s womb and body prepares itself for pregnancy – almost like a practise run or two before a successful pregnancy.
Once an ectopic pregnancy has been diagnosed, there are usually two treatment options – one involves prescribing the drug methotrexate and the other is surgery, depending on how developed the egg is and how great the risk to the woman. Many ectopic pregnancies actually resolve themselves, with the egg failing to develop at all and being naturally absorbed back into the body’s tissues. Some women actually experience an ectopic pregnancy without being aware of it when this happens.
Methotrexate can be prescribed, however, to make sure this happens. The drug works by inhibiting the action of the vitamin folate, which is essential in pregnancy to enable cells to multiply successfully. Methotrexate is a powerful drug which should only be used under medical supervision – it is prescribed for other conditions and diseases which involve abnormal cell division, such as cancers, psoriasis and auto-immune diseases like rheumatoid arthritis.
Methotrexate prevents the egg from growing and it is slowly reabsorbed back into the body. This in itself can be a distressing and traumatic experience for the patient, and counselling may be needed to help a woman through the sense of shock and grief, even if the pregnancy was unexpected or not planned.
In some ectopic pregnancies surgery may be the best option if the woman’s health is at risk or the egg has grown. The egg will still be at an early stage of development, but this can still be traumatic.
If you are planning to get pregnant again soon after the ectopic pregnancy, it is necessary to wait or at least three months if you have been treated with methotrexate. It is also important to understand that an ectopic pregnancy does not necessarily mean you will not be able to have a baby successfully in the future.
The Ectopic Pregnancy Trust offers online advice about coping with ectopic pregnancy – as well as information about treatments for ectopic pregnancy.