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Ectopic Pregnancy

By Janelle Green, CNM, MSN

Ectopic Pregnancy

Perhaps you’ve heard the term ectopic pregnancy but are unsure what it is.

Ectopic pregnancy (EP) can be physically and emotionally devastating. So understanding your risks and knowing the symptoms could be more important than you thought—early treatment could save your life and your fertility.

An ectopic pregnancy occurs outside of your uterus, most commonly in the fallopian tubes but could also occur in the ovaries, abdomen or cervix. Though this seems hard to imagine, it’s possible for a baby to grow outside of the uterus but it can’t survive there.

EP is a medical emergency since it can be life-threatening. If you experience an EP, it should be treated immediately.

Risks of ectopic pregnancy

An EP can burst or rupture, creating blood loss and sending you into shock. You’re at greater risk than most women for EP if you’ve had previous infections in your fallopian tubes (such as pelvic inflammatory disease from chlamydia or gonorrhea) or had tubal surgery. If you’ve used assisted reproduction technologies, are a woman of color, or age 35 or older, you’re also at greater risk. If you become pregnant while using an IUD for birth control, it’s more likely to be an EP.

The most common symptoms are irregular vaginal bleeding and abdominal pain but some women don’t experience any symptoms. Typically, bleeding occurs either during an early pregnancy, or may be very light or spotty. Severe abdominal pain or shoulder pain combined with bleeding and feelings of dizziness or fainting may mean that an EP has ruptured. In this case seek emergency care immediately.

Depending on where the EP is, and if caught early enough, it may only require intense monitoring via blood work or ultrasound. Most commonly a chemotherapy medication called Methotrexate is given. This medicine causes fetal death and allows the pregnancy to pass just as a miscarriage would. Surgery may be needed if the pregnancy is further advanced or if Methotrexate treatment fails.

Dealing with an ectopic pregnancy

EP can be very sad and scary. It’s a pregnancy loss that threatens your life as well. Typically, women who experience EP may already have had a hard time getting pregnant, making it even more devastating.

If you experience EP, you’ll be asked to make decisions quickly to ensure the best possible outcomes. This will include ending your pregnancy. Unfortunately there is no other option. Additionally, treatment can be physically difficult to handle and could drag on for some time.

Reach out to your healthcare provider, your partner or family and community resources for support. Give yourself time to process your feelings of grief or loss. When caught in time, normal future pregnancies are often possible for women with a past ectopic pregnancy.

Janelle Green, CNM, MSN, is a midwife and mom in Central California. She is also an expert advisor to Healthy Mom&Baby magazine and Health4Mom.org.

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