Jay Goldberg (Obstetrician/Gynecologist, Cedars-Sinai Medical Center) gives expert video advice on: What are my chances of having a normal pregnancy after an ectopic pregnancy? and more...
What is an "ectopic pregnancy"?
An ectopic pregnancy is by definition, any pregnancy that is not within the uterus. Most commonly ectopic pregnancies occur in the fallopian tube, but they can occur in the abdomen, the ovary, the cervix, they can occur anywhere outside of the uterus.
What causes an ectopic pregnancy?
Ectopic pregnancies occur because there has probably been some sort of damage to the fallopian tube. Most ectopic pregnancies are in the fallopian tube and prior surgery, prior infection, most commonly a chlamydia infection, can result in tubal damage or kinking of the fallopian tube that wouldn't allow an embryo, or the sperm and the egg once they've met to sufficiently travel into the uterus. They get stuck along the way. They get stuck, they make a home there and they start to grow. Once they get to a certain point, the tube can't sustain it anymore. The fallopian tube is not strong enough to hold it there.
What are the symptoms of an ectopic pregnancy?
The first symptom of an ectopic pregnancy is absence of a period. If you miss a period, then you're pregnant. If you've then had pain, that is not uncommon in an early pregnancy in a normal early pregnancy. But if you go to the doctor at six to seven weeks of pregnancy and they do an ultrasound and there's no visible pregnancy within the uterus, then most likely your doctor will draw blood tests to see if you truly are six to seven weeks pregnant or if you maybe earlier or if you are six to seven weeks and there's nothing in the uterus, then the doctor will then follow you for an ectopic pregnancy. Now an ectopic pregnancy symptom could be significant amount of pain, light headed, dizzy, faint, passing out, because if the pregnancy were outside the uterus and it ruptured where it was growing, where there'd be in the fallopian tube or elsewhere, it will then result in bleeding and sometimes there is a minimal amount of pain until you've lost a significant amount of blood or you become dehydrated, you become dizzy, lightheaded and such.
How is an ectopic pregnancy treated?
There are three ways to treat an ectopic pregnancy. The first is conservative management, that you actually just follow it. If it seems to be resolving on it's own, if it seems to be in a location where it's already discontinued growing and is resolving on it's own, then it can simply be observed. And sometimes these will completely go away on their own. The body resorbs the tissue. Life goes back to normal. A second is a non-surgical intervention in which you use a medication called methotrexate, and your physician can discuss that in more detail with you. But it is a medication that can be administered, it's a shot that will cause the ectopic pregnancy to begin to resorb. And there are certain criteria that need to be met, and your doctor will be familiar with this. If those criteria are met then you will be qualified for this shot. And then the third method is surgical management. And surgical management most often nowadays is laparoscopic. It's the procedure where they will insert a camera into your belly button and then use various instrumentation to remove the ectopic pregnancy. Depending on where it is will depend on the extensiveness of the surgery and whether or not they can do it laparoscopically, or they may have to do an open surgery which is called a laparotomy.
What are my chances of having a normal pregnancy after an ectopic pregnancy?
If you had an ectopic pregnancy in the past and are trying to conceive again, you are at an increased risk for another ectopic pregnancy, simply because the ectopic pregnancy, if it were to have occurred in the fallopian tube, may have damaged that fallopian tube, thus potentially increasing your risk of another ectopic pregnancy. But minus that, your chances of becoming pregnant at all after an ectopic pregnancy, because you've conceived once, are good.