The questions have been translated by a number of different individuals who speak that language as their first, but not all of the translators are medically qualified. The Ectopic Pregnancy Foundation cannot take responsibility for any inaccuracies that may have occurred during the translation.
1. Will it happen again?
Once you have had an ectopic pregnancy, your risk of having another ectopic pregnancy is increased. The actual risk is increased about 10%. Overall, in the general population the risk is 1 to 2%. It is important to note however that your chance of having a normal pregnancy after an ectopic pregnancy is far better. It varies from 50 to 80%.
2. What are my chances of having a normal pregnancy?
Overall, the chances of having a normal pregnancy vary from 50% to 80%. If you have had IVF treatment your chance is slightly lower, simply because the risk of ectopic pregnancy and miscarriage in this group of patients is greater. The risk of an ectopic pregnancy after IVF is increased four fold. Once the pregnancy is well established, usually after the first trimester, your chance of carrying to term is as good as anyone else's. Your risk of ectopic pregnancy does not make your pregnancy, labour or delivery any more complicated. There is no need to routinely see an obstetrician just because you have had an ectopic pregnancy
3. When will I stop bleeding?
Bleeding following an ectopic pregnancy is normal. It is caused by shedding of the lining of the womb. This should last no more than the duration of a period. It is however possible that your bleeding may go on a little longer than usual. If you are concerned for any reason then please see your doctor.
4. When can I try again for another pregnancy?
There is no good evidence to suggest that getting pregnant too early puts you at a greater risk for another ectopic pregnancy. If you had been treated with Methotrexate, it is advisable to wait at least three months because this chemotherapeutic agent is known to harm the growing baby in the very early stages of its development. It is therefore advisable to use a secure form of contraception while you wait.
5. I was told by doctors that I had a salpingostomy, what is this?
A salpingostomy is where a small cut is made over the fallopian tube and the ectopic pregnancy removed. None of the tube is removed, and the defect is left open to heal. This procedure is recommended if the other tube is abnormal.
6. When I had my operation the whole of the left tube was removed.
If only part of the tube had been removed, would my chances of a subsequent pregnancy be increased?
The evidence suggests that the ‘take home baby rate' is the same whether part or all of the tube is removed.
7. As my ectopic pregnancy had burst, I had an abdominal operation rather than keyhole surgery. Would this affect my chance of becoming pregnant again?
Laparoscopic ‘key hole' surgery has the benefit of a smaller incision on the abdomen, and a shorter hospital stay, plus, quicker recovery time and return to work. There is no evidence that either operation is superior in terms of subsequent pregnancy rates.
8. When will my periods return?
If you had normal periods before you got pregnant then you can expect to have your periods returned in 4 to 6 weeks. If you had irregular periods before you were pregnant then this may vary. If you are planning another pregnancy and your periods have not returned in this time then you should see your doctor.
9. What if I am rhesus negative?
If this is your first pregnancy then you should have anti-D given. This should be within 3 days of treatment, as an intramuscular injection. If you are not sure of your blood group, you should ask the doctors treating you. Your blood group is checked routinely when managing an ectopic pregnancy.
10. Is there anything I can do to prevent another ectopic pregnancy?
There is nothing you can do to prevent another ectopic pregnancy. No known medication is of proven benefit, neither is removing your tubes. The best thing you can do is to avoid falling pregnant by using contraceptives. You can also reduce your risk by using a condom. If you think you may have an infection contact your doctor immediately to have it treated. If you do get pregnant it is important is to remember that you are at slightly increased risk of another ectopic pregnancy. Early recognition and prompt treatment is important.
11. Can I have an IUCD?
It is safe to use an intrauterine contraceptive device (IUCD) if you have had an ectopic pregnancy. Both the copper coil and the Mirena are safe. There is no good evidence to say that they cause ectopic pregnancies. If however the coil fails and you do get pregnant then your chances of an ectopic pregnancy is slightly increased.
12. Will my next baby be abnormal?
Having an ectopic pregnancy does not put you at risk of having an abnormal pregnancy the next time. If you have been treated with Methotrexate you should wait for at least 3 months before getting pregnant. If you do get pregnant within 3 months of being treated with Methotrexate, you should have your doctor refer you to a specialist for further tests. You may discuss with the specialist the tests available and the management options available to you.
13. What should I do if the pregnancy test is positive?
It is very important that you seek medical advice at about 5 weeks. You can do this by visiting your doctor. He may refer you to the local hospital for an early ultrasound scan. Having a diagnosis of an intrauterine pregnancy (ie in the womb) can be reassuring. If however the pregnancy is of unknown location after clinical investigations, then follow up will be arranged.
14. Will I have to have a caesarean section?
There is no evidence to support routine caesarean section in patients who have had an ectopic pregnancy. If you choose to have a caesarean section, your risk of having an ectopic pregnancy in future may increase slightly. This is because the risk of postnatal infection is slightly greater than that of a normal pregnancy.