An ectopic pregnancy is any pregnancy where the fertilized egg attaches and begins to grow outside of the uterus or womb. In a normal pregnancy, a fertilized egg develops into a fetus in the lining of the uterus. In an ectopic pregnancy, the fertilized egg implants elsewhere within the female reproductive system. Over 95% of the time, an ectopic pregnancy implants in the fallopian tubes, the tubes that run from the ovaries to the uterus. However, in rare cases, an ectopic pregnancy may occur in the cervix, intra-abdominal area, or another location.
The fertilized egg cannot grow appropriately in an ectopic pregnancy, and ectopic pregnancy may endanger the health of the mother. In the United States, ectopic pregnancies occur in 1 out of 50 pregnancies. This problem is the chief cause of pregnancy-related maternal deaths in the first trimester. As the fertilized egg grows outside the uterus, it can rupture internal structures and cause hemorrhaging.
As you can see, an ectopic pregnancy is a potentially serious condition. Here is information on causes of ectopic pregnancy and ways you can help prevent them from occurring.
Ectopic Pregnancy Causes
According to the American College of Obstetricians and Gynecologists (ACOG), the majority of women with an ectopic pregnancy have no known risk factors. However, doctors have identified several situations that increase the likelihood of experiencing an ectopic pregnancy. These include:
- Previous ectopic pregnancy
- Maternal age over 35 years
- A history of pelvic inflammatory disease
- Fallopian tube surgery history
- Previous infertility or fertility treatments
- Conception with an intrauterine device (IUD) in place
Women who have had a previous ectopic pregnancy have about a 10% chance of having another ectopic pregnancy, on top of any other risk factors. As for maternal age, women over 35 have a greater likelihood of experiencing many types of pregnancy complications, including ectopic pregnancy. A history of smoking also increases the risk of ectopic pregnancy.
Another risk factor for ectopic pregnancy is pelvic inflammatory disease (PID). PID is a bacterial infection of the reproductive organs and is usually caused by gonorrhea and/or chlamydia, sexually transmitted diseases. Some PID cases are accompanied by no obvious symptoms, but signs can include pelvic pain, pain during sexual intercourse, and burning when urinating. Fortunately, treatment with specific antibiotics is usually successful against PID.
You also stand a greater chance of developing an ectopic pregnancy if you’ve had surgery on your fallopian tubes – a tubal ligation (tubes tied), for example. Furthermore, getting pregnant with an IUD in place is extremely rare, but this occurrence dramatically raises the likelihood of ectopic pregnancy. Up to 53% of pregnancies that happen in the presence of an IUD are ectopic pregnancies.
Finally, a history of female fertility problems is a risk factor for ectopic pregnancies, particularly if you have received medical or surgical treatments for the issues. Such treatments include fertility drugs, hormonal therapy, in vitro fertilization (IVF), and other treatments using assisted reproductive technologies.
Lowering the Risk of an Ectopic Pregnancy
Although it is not possible to totally eliminate the chance of an ectopic pregnancy, there are ways to lower your risk. You can decrease your chances of developing PID by limiting your number of sexual partners and using condoms to protect against sexually transmitted infections.
Detection of an ectopic pregnancy is paramount so that your OB-GYN can treat the condition and avoid the possibility of rupture. While pelvic pain and vaginal bleeding may occur, many ectopic pregnancies produce no symptoms. For this reason, it is important that you visit your OB-GYN as soon as you suspect you are pregnant. Even better, schedule an appointment with your OB-GYN as soon as you decide to try to become pregnant.
A transvaginal ultrasound, which is a specialized imaging procedure, is usually required to diagnose an ectopic pregnancy. Your doctor may also use blood tests to aid in diagnosis. Some ectopic pregnancies can be addressed with medication, while others require surgical treatment.
Even if you have no risk factors for ectopic pregnancy, early prenatal care is crucial. Schedule an appointment with your OB-GYN, and give them a complete and honest account of your medical history, habits, family medical history, and more. Ectopic pregnancy may not be completely avoidable, but together with your doctor, you can maximize your chances of a healthy pregnancy.
About the Connecticut OBGYN Practice
Dr. John Garofalo, M.D., is a CT OBGYN based in Fairfield County, providing care for Norwalk, Darien, New Canaan, Weston, Rowaytan and the surrounding areas. He has more than 20 years of practice and surgical experience covering many facets of obstetrics and gynecology.
Laury Berkwitt, APRN, is a nurse practitioner specializing in women’s health in Fairfield County, Connecticut. Laury has a passion for providing quality women’s health care in a safe and comfortable manner by creating a trusting patient-practitioner relationship. She has been in practice for more than 10 years, caring for women of all ages.
John Garofalo, MD, and Laury Berkwitt, APRN, can be reached for personal consultations and well-woman exams by calling 203.803.1098.