What Is an Ectopic Pregnancy?
An ectopic pregnancy (also known as a tubal pregnancy) is one in which the fertilized egg implants somewhere other than in the uterus. Most often this happens in the fallopian tubes but sometimes elsewhere in the abdominal cavity. These pregnancies are not viable and pose grave danger to the health and future fertility of the pregnant person until they are diagnosed and treated. If the pregnancy continues, the developing fetus will cause the tube to stretch and sometimes rupture, leading to potentially life-threatening internal bleeding. Typically, there is poor blood supply to the fetus inhibiting its growth. Also, there is no way to move the fetus to the uterus. This is why ectopic pregnancies can not be saved. Learn more about ectopic pregnancies and what it means to be not viable.
Risk Factors for Ectopic Pregnancy
Ectopic pregnancies affect about 1% to 2% of all pregnancies. Often, there is no known cause. However, a history of infections or injury to the fallopian tube makes having an ectopic pregnancy much more likely. Other risk factors include previous ectopic pregnancy, endometriosis, or pelvic inflammatory disease (PID), a condition that often develops after an infection such as chlamydia. Smoking, a history of fallopian tube, abdominal, or pelvic surgery, a history of infertility, and assisted reproduction are also known to increase the chance of tubal pregnancy.
Signs and Symptoms of Ectopic Pregnancy
Up to 30% of ectopic pregnancies have no medical signs or symptoms in the early stages of development when the embryo is still very small. When present, signs and symptoms typically appear before the tenth week and may include:
Cramping on one side of the pelvisShoulder painSudden onset of abdominal or pelvic painTender cervixVaginal bleeding
Diagnosis of Ectopic Pregnancy
Sometimes, an ectopic pregnancy is diagnosed when the pregnant person seeks care due to signs of a problem, such as pelvic pain or vaginal bleeding. Other times, it is discovered via ultrasound exams that show the embryo developing outside of the uterus. In cases of heavy bleeding, the pregnancy may initially be diagnosed as a miscarriage. It is typically at this stage that an ultrasound will reveal the issue to be an ectopic pregnancy. Elevated hCG levels in the blood can further support the diagnosis (since miscarriage usually results in a drop in hCG). Once an ectopic pregnancy is diagnosed, termination is needed to protect the life of the pregnant person.
Why Ectopic Pregnancies Not Viable
The vast majority of ectopic pregnancies implant in the fallopian tubes. This is why they are also called tubal pregnancies. If left unchecked, fetal growth will involve larger amounts of tissue and vascular structures. Eventually, the fetus will become too large for the fallopian tube and can not survive. It is at this point that the pregnancy can become dangerous with any rupture likely to cause a massive bleed—and the fetus without a space to grow. When the implantation is in the abdominal cavity, it also presents grave risks of hemorrhage and fetal malformation. Additionally, it’s important to note that an ectopic pregnancy can not develop appropriately outside the uterus—and it can’t be moved. Sadly, no medical technology exists to successfully transplant the fetus and implant it in the uterus. Since fetal death is certain and the risk to the pregnant person is extremely high, termination is required, either through surgery or abortive medications. Since an ectopic pregnancy is not an established, viable pregnancy (because it has not successfully implanted in the uterus), its termination is not an abortion. Terminating an ectopic pregnancy is standard medical care and legal in all 50 states.
A Word From Verywell
Unfortunately, an ectopic pregnancy can not be saved. Treatment is required to avoid serious complications, such as hemorrhaging and impairment of future fertility. Additionally, if left untreated ectopic pregnancy can become a medical emergency for the pregnant person.
