Welcome to Laurie’s Big Blog – October 2021

Every month we will identify the 6 most commonly asked questions about ectopic pregnancy and answer them. If you have any further questions which you cannot find answers to on the website, please can you contact us. 

Does my ethnicity affect my chances of having an ectopic pregnancy?

Black women and other minority races are at an increased risk of developing an ectopic pregnancy. In a paper written by myself and published in a peer reviewed medical journal we reported a significantly higher rate in women with an Afro Caribbean heritage – 56.8% compared to 34.5 % in a control group (see the publication on the website).

What are the symptoms of a caesarean scar ectopic pregnancy?

Scar ectopic pregnancy is the least common site of ectopic pregnancy and can present challenges in both diagnosis and treatment. The main reason for a scar on the uterus is from a previous Caesarean section, however this maybe after a myomectomy. The symptoms of a scar ectopic pregnancy are varied and up to 37% of women are asymptomatic. Light vaginal bleeding occurs in 39% and mild or moderate lower abdominal discomfort or pain in 16% . Treatment depends on the clinical picture and could include treatment with methotrexate or surgery.

How can I help raise awareness of ectopic pregnancy?

To improve the outcome of an ectopic pregnancy it is important to raise awareness of this increasing common and serious condition, this should be to the general public and health care professionals. With increased awareness, the diagnosis could be made early and this possibly treated medically with the drug methotrexate, thus reducing the need for hospital admission and surgery.
The ectopic pregnancy foundation was established in 2002 to raise awareness and information to both the public and health care professionals . The Ectopic Pregnancy Foundation website provides information on ectopic pregnancy symptoms and a tab on what to do if you think that you may have an ectopic pregnancy can be found on the home page. We also have a section on frequently asked questions in 32 languages and a 24 hours-a-day patient help line, manned by health care professionals, and charged at local rates.

For health care professionals we provide information on diagnosis and treatment of this condition and also an educational section.
The ectopic pregnancy foundation receives no central funding and relies on donations from the general public. It would be very helpful if you would donate online or run fundraising events.

What does it mean if I have shoulder pain but no other symptoms of ectopic pregnancy?

Various musculoskeletal aches may occur in early pregnancy and are self limiting. When an ectopic pregnancy causes bleeding into the abdomen, when the woman lies flat, blood tracks up under the diaphragm and causes referred pain typically called shoulder tip pain.

What are the chances of having a second ectopic pregnancy?

After a first ectopic pregnancy subsequent pregnancies are inter-uterine, and the recurrent rate is quoted at about 18%. As this is the case, it is important in a subsequent pregnancy to be seen by health care professionals and a vaginal scan may be undertaken to locate the site of the pregnancy.

Polycyclic ovarian syndrome

Polycystic ovarian syndrome (PCOS) is a common gynaecological condition affecting between 5 to 20% of women. The diagnosis is made by the appearance of the ovaries at trans-vaginal scan and also by blood tests. PCOS is associated with infertility problems, and early pregnancy issues including early pregnancy loss and ectopic pregnancy. In a study of woman with the diagnosis of PCOS who were undergoing assisted  fertility treatment (which in itself is a risk factor for an ectopic pregnancy) it was found that these women had a three fold increase in ectopic pregnancy.