Ectopic pregnancy is any fertilized egg that is growing and developing outside of the uterus, or womb. The most common location for ectopic pregnancies to be found is in the fallopian tube, which carries the egg to the uterus after ovulation. Ectopic pregnancies can also be found on the ovary, in the cervix, or elsewhere in the abdominal cavity.
Ectopic pregnancies can be very dangerous because, as you might imagine, a baby is not meant to grow outside the uterus. In order for the pregnancy to start to grow, it must have access to a good blood supply. The developing placenta accomplishes this by invading whatever tissue the pregnancy has implanted on. This is normal in the uterus, but it can lead to dangerous bleeding if the pregnancy is outside the uterus. If the pregnancy is inside the fallopian tube, it can quickly grow too large for the tube and cause the tube to break open, which is another common cause of bleeding.
An ectopic pregnancy is diagnosed when a patient presents for the initial obstetric visit and has a positive pregnancy test with no pregnancy visible in the uterus during ultrasound exam. Sometimes she will have pain that brings her in for an exam or to the ER. If she is bleeding in her abdomen, she will require immediate surgery to stop the bleeding, which also leads to ending of the pregnancy. There is not currently any way to “move” an ectopic pregnancy into the uterus. If the ectopic is found early and the patient is stable, she can sometimes use a medication called methotrexate, which is a type of chemotherapy, to stop the pregnancy from growing. Her body will then absorb it and she can usually avoid surgery.
In the past, ectopic pregnancies were a common cause of maternal mortality due to internal bleeding. They can still be very dangerous even with modern medical technology to assist in early diagnosis and treatment.
Dr. Carrie Kaufman, OBGYN, practices at Austin Regional Clinic. Dr. Kaufman served as Chief Resident, Obstetrics and Gynecology, and as Residency Association President during her residency at UT Southwestern.