In the UK, around 1 in every 90 pregnancies is ectopic. We’re here to start the conversation to help raise awareness & understanding
What is an ectopic pregnancy?
An ectopic pregnancy develops when a fertilised egg implants itself outside of the womb. The most common area for an ectopic pregnancy to develop is in the fallopian tubes (the tubes connecting the ovaries to the womb) but can also be located in other areas, including the cervix. However, this is rare.
An egg will not develop into a baby if it gets stuck in the fallopian tubes and can put your health at risk if the pregnancy continues. Therefore, an early diagnosis is beneficial.
What are the signs & symptoms of an ectopic pregnancy?
Most symptoms of ectopic pregnancy tend to develop as early as the fourth week of pregnancy up to the twelfth week. For some, it can be longer.
Not all women will experience symptoms and an ectopic pregnancy may only be detected during a routine pregnancy scan.
Symptoms of an ectopic pregnancy can include:
• A missed or late period
• Vaginal bleeding (or brown watery discharge)
• Abdominal pain that’s usually located on one side of your tummy
• Shoulder tip pain (where your shoulder ends and your arm begins)
• Problems with your bladder or bowel, such as discomfort when peeing or pooing or diarrhoea
• Feeling lightheaded or faint. This can often be accompanied by sickness and your skin may look pale
If you’re experiencing any of the above symptoms try not to worry. They aren’t necessarily a tell-tale sign of a serious problem and sometimes they can be caused by another problem, like a stomach bug.
If you’re experiencing any of the above symptoms or if you’re not experiencing symptoms but your instinct is telling you that something doesn’t feel quite right, speak to your GP.
What causes an ectopic pregnancy?
Ovulation is a phase that occurs monthly during the menstrual cycle. One of the ovaries releases an egg that’s drawn into the end of the fallopian tubes before making its way towards the uterus. If intercourse occurs whilst the egg is making its way along the fallopian tube, it may encounter sperm, which can subsequently lead to the egg becoming fertilised. In an ectopic pregnancy, the egg doesn’t make it to the uterus and instead implants itself outside, most commonly in the fallopian tubes.
It’s thought that an ectopic pregnancy occurs when the fallopian tubes are either narrow or blocked. However, it can be difficult to detect the root cause of an ectopic pregnancy, leaving many cases unclear.
There are some factors that are thought to put people at an increased risk of ectopic pregnancy, including:
• Pelvic inflammatory disease (PID)
• If you’ve previously had an ectopic pregnancy
• Previous surgery that you may have had on your fallopian tubes
• Fertility treatment, like IVF as they require you to take medicine to stimulate the release of an egg
• Increasing age, particularly women over the age of 35
• Smoking. For support and advice for quitting smoking, visit the NHS Stop Smoking Service
• Becoming pregnant while using an intrauterine device (IUD) or intrauterine system (IUS) for contraception, also widely known as ‘the coil’. It’s rare to become pregnant if you use these but if you do fall pregnant your likelihood of having an ectopic pregnancy is increased
Preventing an ectopic pregnancy isn’t always possible but if you do fall pregnant again, it’s a good idea to let your GP know as soon as possible so early scans can be carried out to check everything is ok.
Can an ectopic pregnancy survive?
Unfortunately, an ectopic pregnancy cannot be moved or re-implanted into the uterus, meaning it’s not possible for the pregnancy to develop normally. The ectopic pregnancy usually has to be removed using medicine or an operation, leading us onto…
How is an ectopic pregnancy treated?
Treatment is required to remove the ectopic pregnancy before it grows too large. There are three main treatment options that your GP will discuss with you, including:
• Expectant management
• Medicine
• Surgery
Your GP will discuss the benefits and risks associated with each option before deciding which one is most suitable for you based on your symptoms and test results. Some of the treatments mentioned can affect your ability to conceive successfully in the future, although most women will be able to become pregnant again. Your doctor will discuss this with you.
Find out more information about each treatment option below.
Expectant management:
Rather than immediate treatment, you’ll be carefully monitored by your healthcare professional to determine whether treatment is necessary. This is usually suitable for those who have experienced little to no symptoms and the pregnancy is small or can’t be found and there’s a good chance that the pregnancy will dissolve by itself. One of the benefits of expectant management is you won’t experience any side effects associated with treatment.
It’s likely that you’ll have regular blood tests to monitor the level of human chorionic gonadotropin hCG (sometimes known as the pregnancy hormone) in your blood. These tests will continue until the hormone is no longer found in your body.
Further treatment will be required if the hormone level doesn’t decrease or if it increases. If you start to develop more severe symptoms, your doctor will give you advice and support on what to do moving forward.
Medicine:
When close monitoring isn’t suitable, your healthcare professional may recommend a medicine called methotrexate. This is a powerful medicine administered through a single injection in the buttocks and works by stopping the pregnancy from growing.
Like expectant management, you’ll be required to attend regular blood tests to check if the treatment is working. If it’s not working, you may need a second dose or surgery might be an option that your doctor recommends.
Your doctor will make you aware of the side effects associated with the treatment alongside advice on the steps you should follow after treatment to look after your health, including avoiding alcohol until you’re told that it’s safe to do so.
Surgery:
Keyhole surgery (laparoscopy) is performed to remove an ectopic pregnancy. During the surgery, you’ll be put to sleep with the help of a general anaesthetic.
To remove the fertilised egg, small incisions will be made in your tummy before a thin viewing tube (laparoscope) is inserted. The entire fallopian tube is removed unless your healthcare professional thinks your other fallopian tube doesn’t look healthy. In that case, they may attempt to remove the pregnancy without removing the whole tube.
Removing the affected fallopian tube is the most effective treatment and isn’t thought to reduce your chances of becoming pregnant again. It can take four to six weeks to fully recover from the surgery with most women leaving the hospital after a few days. Your doctor will talk you through all the relevant aftercare advice to assist your recovery.
Support after an ectopic pregnancy
We understand that losing a pregnancy can be a difficult time for anyone. If you or your partner feel a sense of grief during this time, you’re not alone. If you’re struggling to come to terms with your loss, there are many places and people you can turn to, to get the support and advice you need.
Try not to feel guilty about taking time to grieve. It can take some people longer than others and eventually, with the right guidance and support, your feelings can start to improve over time. Professional support or counselling can be a helpful aid during this time. If you do feel like you’d benefit from speaking to somebody about your experience with ectopic pregnancy, don’t hesitate to reach out to your GP.
Alternatively, if you’d prefer to talk to someone from the comfort of your own home, there’s the Boots Online Doctor Depression and Anxiety Treatment Service.* After filling out a quick online consultation, one of our clinicians will assess you and plan the tailored treatment to give you and your partner the support you need to help you feel like yourself again.
You can also read the Boots Health Hub for mental health for further guidance, support and advice. It also signposts you to various mental health services, including Support Room.** This is a service that provides on-demand therapy in just one click, while allowing you to communicate with a therapist, coach or mentor via in-app messaging, voice messages, video messages and one-to-one 30-minute video sessions.
There are also plenty of support groups where those who have been affected by loss of a pregnancy can come together and share their experiences, speaking openly about the challenges they’ve faced. Support groups can be a valuable resource for many, giving you a safe space to open up about your feelings while meeting new people along the way. Below are some examples of the support groups that are readily available:
• Ectopic Pregnancy Foundation
Trying for another baby
It’s important to do what’s best for you and your partner. When you both feel physically and emotionally ready, you may be ready to try for another baby. Your healthcare professional will be able to advise you on the best time to do this.
Usually, you’ll be advised to wait three months if you’ve been treated with the medicine methotrexate, or until you’ve had two full periods after treatment. The first full bleed you’ll experience in your first week after treatment doesn’t count as your first period. This is usually your body responding to the fall in hormones. If you have any questions, don’t hesitate to speak to your GP. However, they should go through all of this with you.
Understandably, you may worry that your ability to conceive has been affected by ectopic pregnancy. Thankfully, even if you’ve had a fallopian tube removed during treatment, it’s possible to get pregnant again.
Consult your GP if you do become pregnant again. The earlier you can let them know the better as they can monitor you to check that your pregnancy is developing normally. You may be asked to go for an early scan but try not to worry, this is normal procedure.
Alternatively, you can also turn to your GP for support and advice if you’re struggling to conceive. They can talk you through your options, such as fertility treatment like IVF. You can also read our tips for when you’re trying for a baby for additional support and advice.
