1. ECTOPIC
PREGNANCY

2. DEFINITION
• Pregnancy begins with a fertilized egg. Normally, the fertilized egg
attaches itself to the lining of the uterus. With an ectopic pregnancy,
the fertilized egg implants somewhere outside the uterus.
• An ectopic pregnancy typically occurs in one of the tubes that carry
eggs from the ovaries to the uterus (fallopian tubes). This type of
ectopic pregnancy is known as a tubal pregnancy. In some cases,
however, an ectopic pregnancy occurs in the abdominal cavity, ovary
or cervix.
• It is life-threatening to the mother

3. LOCATIONS OF ECTOPIC
PREGNANCIES

4. LOCATIONS OF ECTOPIC
PREGNANCIES
75-90%
5-15%
5%
1-2%

5. SYMPTOMS
At first, an ectopic pregnancy might not cause any signs or symptoms. In
other cases, early signs and symptoms of an ectopic pregnancy might be
the same as those of any pregnancy — missed period, breast tenderness
and nausea. If you take a pregnancy test, the result will be positive. Still,
an ectopic pregnancy can't continue as normal.
Abdominal or pelvic pain and light vaginal bleeding are often the first
warning signs of an ectopic pregnancy. If blood leaks from the fallopian
tube, it's also possible to feel shoulder pain or an urge to have a bowel
movement — depending on where the blood pools or which nerves are
irritated. Heavy vaginal bleeding is unlikely, unless the ectopic pregnancy
occurs in the cervix.

6. SYMPTOMS
• Low back pain
• Mild cramping on one side of the pelvis
• No periods
• Pain in the lower belly or pelvic area
• Abnormal vaginal bleeding
If the area around the abnormal pregnancy ruptures:
• Fainting or feel faint
• Intense pressure in the rectum
• Low blood pressure
• Severe, sharp, and sudden pain in the lower abdomen

7. CAUSES/RISK FACTORS
The main cause of an ectopic pregnancy is a damaged fallopian tube that doesn't let a fertilized egg
into your uterus, so it implants in the fallopian tube or somewhere else. You might never know what
caused an ectopic pregnancy, but you are at a higher risk if you have:
• History of an ectopic pregnancy
• Use of an IUD
• History of pelvic inflammatory disease (PID)
• Sexually-transmitted diseases such as chlamydia and gonorrhea / multiple sexual partners
• Congenital abnormality of the fallopian tube
• History of pelvic surgery (because scarring may block the fertilized egg from leaving the fallopian
tube)
• Tubal ligation, unsuccessful tubal ligation or tubal ligation reversal
• Use of fertility drugs
• Infertility treatments such as in vitro fertilization (IVF)
• Conditions such as endometriosis and fibroids can narrow the fallopian tubes
• Smoking (dose-dependent) around the time of conception

8. TESTS & DIAGNOSIS
• Pelvic Exam – May show tenderness in the pelvic area
• Transvaginal Ultrasound
• Blood Test - Beta hCG

9. TREATMENT
Treatment options for ectopic pregnancy include observation,
laparoscopy, laparotomy, and medication. Selection of these
options is individualized. Some ectopic pregnancies will resolve on
their own without the need for any intervention, while others will
need urgent surgery due to life-threatening bleeding.
• Laparotomy / Laparoscopy
• Medication - Methotrexate

10. OUTLOOK
Most women who have an ectopic pregnancy have normal
pregnancies and births in the future, even if a fallopian
tube was removed. As long as you have one normally
working fallopian tube, you can get pregnant. If the
ectopic pregnancy was caused by a treatable illness, such
as a sexually transmitted disease, getting treated for it
can improve your chances of a successful pregnancy. Talk
with your doctor about how long to wait after an ectopic
pregnancy before trying to conceive again. Some doctors
suggest waiting 3 to 6 months.