Ectopic pregnancy Health Article

Symptoms

• Abnormal vaginal bleeding
• Amenorrhea
• Breast tenderness
• Low back pain
• Mild cramping on one side of the pelvis
• Nausea
• Pain in the lower abdomen or pelvic area

If the area of the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include:

• Feeling faint or actually fainting
• Pain that is felt in the shoulder area
• Severe, sharp, and sudden pain in the lower abdomen

Internal bleeding due to a rupture may lead to shock. Shock is the first symptom of almost 20% of ectopic pregnancies.

Signs and tests

The health care provider will do a pelvic exam, which may show tenderness in the pelvic area.

Tests that may be done include:

• Culdocentesis
• Hematocrit
• Pregnancy test
• Quantitative HCG blood test
• Transvaginal ultrasound or pregnancy ultrasound
• White blood count

A rise in quantitative HCG levels may help tell a normal (intrauterine) pregnancy from an ectopic pregnancy. Women with high levels should have a vaginal ultrasound to identify a normal pregnancy.

Other tests may be used to confirm the diagnosis, such as:

• D and C
• Laparoscopy
• Laparotomy

An ectopic pregnancy may affect the results of a serum progesterone test.

Treatment

Ectopic pregnancies cannot continue to birth (term). The developing cells must be removed to save the mother's life.

You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to shock, an emergency condition. Treatment for shock may include:

• Blood transfusion
• Fluids given through a vein
• Keeping warm
• Oxygen
• Raising the legs

If there is a rupture, surgery (laparotomy) is done to stop blood loss. This surgery is also done to:

• Confirm an ectopic pregnancy
• Remove the abnormal pregnancy
• Repair any tissue damage

In some cases, the doctor may have to remove the fallopian tube.

A mini-laparotomy and laparoscopy are the most common surgical treatments for an ectopic pregnancy that has not ruptured. If the doctor does not think a rupture will occur, you may be given a medicine called methotrexate and monitored. You may have blood tests and liver function tests.