Ectopic pregnancy is a common, potentially life-threatening, condition affecting one in 100 pregnancies.
An ectopic pregnancy occurs when the fertilised egg implants outside the cavity of the womb, usually in the fallopian tube. As the pregnancy grows, the fallopian tube stretches causing pain. If not treated quickly enough, the tube can burst, causing internal bleeding, which can lead to collapse and even death.
What to do if you suspect you have an ectopic pregnancy
An Ectopic pregnancy is a medical emergency. If you suspect you have an ectopic pregnancy you should seek immediate medical attention without delay. This may be either at your General Practitioner’s surgery or at hospital setting. If you see your GP, they will take a history, assess the situation possibly urine pregnancy test.
If they have any doubt whatsoever, you will be referred without delay to the hospital. Once you are in the hospital, history will be taken about your symptoms and risk factors for ectopic pregnancy. Examination may include pulse and blood pressure, abdominal palpation and possibly a vaginal examination.
Depending on the findings, further specialist investigations will be undertaken. You would usually have a cannula inserted into your arm ( a drip ) this is in case you need to be given fluids should your blood pressure be low.
The blood tests would include a full blood count, a blood group and a blood pregnancy test which gives a number rather than yes /no answer. You will then probably have a vaginal ultrasound scan to assess the pelvis. The scan will be looking for an evidence of an intrauterine pregnancy and also will be looking for masses around the ovaries and fallopian tubes and fluid (blood) behind the uterus.
If viable intrauterine pregnancy is seen, it virtually excludes an ectopic pregnancy. It is very unusual to actually see an ectopic pregnancy.
With the results of the examination and investigations depending on the clinical situation including woman’s condition a decision will be made on your management depending on the hospital guidelines. The management options can include, in a clinically stable patient conservative management with very close follow up with blood pregnancy test (b-hcg), to look at the changing levels. Other managements may include use of methotrexate and subsequent close follow up.
Diagnostic laparoscopy and laparoscopic surgery for an ectopic pregnancy would be an appropriate management in selected patients.