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What is an Ectopic pregnancy?

What is an Ectopic pregnancy?

Ectopic pregnancy is a life-threatening condition that today, affects 1 in every 80 pregnancies.

Ectopic pregnancy occurs when a fertilized egg implants outside of the uterus. Ectopic pregnancy literally means "a pregnancy that is in an abnormal place or position."

The most common placement for an ectopic pregnancy is in the fallopian tube and tubal ectopics make up for approximately 80% of all types. Other places that ectopic pregnancy can occur in the ovary, cervix, c-section scar, interstitial (where fallopian tube meet uterus) and abdominal, although these types are considered quite rare, but some types are on the increase due to modern processes of fertility and previous delivery.

Some women are higher risk for ectopic than others. Women who smoke, or have previous experience of the following, a previous STD, tubal surgery,a previous ectopic or IVF treatment, although over 50% of women who have an ectopic pregnancy have none of these risk factors.

Due to the serious nature of an ectopic pregnancy it is important that any symptoms are reported to relevant healthcare professionals. The most common symptoms experienced are lower tummy pain and/or vaginal bleeding but other symptoms  can be, experiencing pain or pressure when going to the loo, shoulder tip pain, generally feeling unwell. If any of these symptoms are experienced then you should contact you GP or your Local Early Pregnancy Assessment Unit. If it is out of hours then you can also contact NHS Direct on 111or A & E if you suspect something is very wrong, trust your instincts.

Ectopic pregnancy can also be asymptomatic which means that they have no symptoms. Symptoms can be experienced later, sometimes up to 12 weeks gestation. 

 Diagnosis of an ectopic pregnancy

Ectopic pregnancy can be difficult to diagnose and on ultrasound unless a live ectopic is seen outside of the uterus and often cannot be identified (like many pregnancy related issues) with only one ultrasound scan alone. Sometimes, what is called an "adnexal mass" or lump of body tissue can be seen outside of the uterus and this would also offer some information that an ectopic could be present, but still it is not definite. Ectopic pregnancy can also show on an early pregnancy scan that there is fluid within the uterus resembling a gestation sac and this is called a pseudo sac, but until a yolk sac can be seen or there are clear distinguishable ultrasound markers to differentiate a true early gestation sac from that of a the pseudo sac of an ectopic pregnancy precaution should always be taken.

Other tests such as beta Hgc Testing is also required to ascertain whether the levels are increasing or decreasing or not rising as with a normal pregnancy, but if an empty uterus is seen on ultrasound there are a number of reasons that this could be. It could be that the pregnancy is simply too early to be seen on ultrasound or a miscarriage has already taken place. The beta Hgc test can offer clues to rule out an ectopic pregnancy but again cannot diagnose the location of a pregnancy. The information that you give also assists in the diagnosis and a medical history will also be taken into account. If someone with a suspected ectopic remains stable with normal blood pressure and presentation then watching and waiting for change to occur on an ultrasound would be a safe course of action, but if suspicion still remains high then you may be referred for a laparoscopy or keyhole surgery.

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