Every month we will identify the 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.
I have chlamydia – are my chances of an ectopic pregnancy higher?
Chlamydia is a sexually transmitted disease which is recognised as an important cause of ectopic pregnancy infection. It may be asymptomatic with few symptoms presenting but it can result in severe tubal damage . It can cause scaring and adhesion to the Fallopian tubes. It may also damage the lining of the tube: the lining of the tube has cells which have fine hairs ( known as cilia ) which beat to facilitate the embryo to travel down the tube and into the uterine cavity . If damaged there is a slower transfer and thus a higher chance that the embryo will implant in the tube resulting in an ectopic pregnancy.
Even if you have no symptoms but have any concerns that you may have chlamydia, you should visit your nearest sexual health clinic to be screened. This involves having swabs taken – see the Risks of Ectopic Pregnancy section for more information)
How early can an ultrasound detect an ectopic pregnancy?
Ultrasound is mainly used to exclude an ectopic pregnancy. If an inter-uterine pregnancy has been confirmed then the chances of having an ectopic pregnancy as well (known as an heteroscopic pregnancy) is said to bee 1 in 40,000 cases . Transvaginal scan findings which are suggestive of an ectopic pregnancy include a thickened endometrium ( lining of the womb ), increased fluid behind the uterus (known as the pouch of Douglas) and a complex mass at the side of the uterus. It is rare to see a beating foetal heart beat outside the uterus.
Can an ectopic pregnancy ever go full term?
It is extremely unlikely that an ectopic pregnancy will go to term but in rare cases a secondary abdominal pregnancy has been reported. In theses case the placenta has grown in the bowel or intestine.
What happens during an ectopic pregnancy surgery?
Surgery for an ectopic pregnancy can be either preformed laparoscopically (key hole) which is the most common, or by open surgery, usually through a lower bakinan incision on the abdomen.
The decision on which procedure is undertaken depends on the clinical situation. Whichever approach is used the operation usually involves removal of the portion of the tube that contains the pregnancy (partial salpingectomy). In selective cases an incision is made over the pregnancy and is removed with conservation of the Fallopian tube. This is called a linear salpingectomy. (see surgical treatment of ectopic pregnancy and also surgical videos which contains graphic images of actual surgery which could be unsuitable for those under the age of 18).
When is an ectopic pregnancy dangerous?
Ectopic pregnancy is a pregnancy outside the uterine cavity ( the usual site of a pregnancy). The most common site for an ectopic pregnancy is in the Fallopian tube . As the pregnancy grows it stretches the tube leading to discomfort and then pain. As the pregnancy increases in volume the tube can rupture or the pregnancy can erode the arteries and veins causing bleeding into the abdomen. As the bleeding is internal it is not visible. The first signs maybe feeling light headed and feeling faint or actually fainting . Physical signs include a pail complexion, an increased pulse rate and low blood pressure. These are all signs of hypovolemic shock which left untreated by surgery can occur in death due to cardiac arrest.