How can a woman know if she has an ectopic pregnancy? What should be done about it?

During a normal pregnancy, a fertilized egg moves down into the uterus, and implants into the uterine lining, and begins to grow. But in an ectopic pregnancy, the egg settles in the fallopian tube or in other abdominal structures sometimes totally outside of the uterus. And this is what makes it an ectopic pregnancy. This can potentially be life-threatening to the mother, because if it starts to grow, it will cause the organ that it's growing in to burst, and sometimes this can also involve a lot of bleeding, so the mother is losing a lot of blood. So the earlier an ectopic pregnancy is caught, the better the outcome will be. It's hard to tell if a woman has an ectopic pregnancy or not though in the beginning. She's probably just going to feel like she's pregnant, and you may very well see a positive result, and be really excited about being pregnant, and have all the normal symptoms - you're nauseous, you may or may not throw up, you feel like you have to pee all the time, you might have breast tenderness. And then as things progress, you may start to have abdominal pain or vaginal bleeding, and so if you have pain or bleeding, call your doctor. And that may also be due to a miscarriage or to pelvic organ problems, but an ectopic pregnancy does need to be ruled out.

Noticeable symptoms of an ectopic pregnancy include vaginal bleeding or spotting, abdominal pain that might just be on one side or the other (or it could just be generalized and all over), you might have low back pain, you could possible feel dizzy (that can be caused by low blood pressure if the woman is losing a lot of blood). And another weird symptom that most people wouldn't associate with this is shoulder pain. If a woman's abdomen is starting to fill up with blood, then it stimulates certain nerves and can make her feel shoulder pain. So all of these things are reasons to call your doctor over and to let them know that you're feeling them.

The doctor will ask you more specific questions about what you've been experiencing. They may want to draw blood levels to see what human chorionic gonadotropin (or HCG) levels are doing. That's a hormone that your body starts to release early in pregnancy and levels rise exponentially until they peak around 8 to 11 weeks. But when the pregnancy isn't progressing like it should, then we don't see those levels rise, or they plateau and start to fall, and that's an indication that there's a problem like miscarriage or ectopic pregnancy. The doctor may also want to do an ultrasound, and this may involve an abdominal ultrasound like you traditionally think of on your belly. And sometimes they have to do a vaginal ultrasound, and that's like a long wand they put up inside and the can get better images early in pregnancy to actually diagnose an ectopic pregnancy.

So if it is diagnosed, then there's a couple of different things that they can do, and the treatment is going to depend on how severe it is, where the pregnancy is developing. If it's caught early on, then sometimes they can give the woman a shot called methotrexate, and this stops the growth of the tissue. And over the next couple of months, the doctor will just want to test the woman to make sure HCG levels are dropping and that her body is returning back to a normal fertile state later. It can have future implications though, so talk with your doctor about methotrexate (if they want to give it to you) about how long afterwards they would want you to wait before you try conceiving again.

Another possible treatment is surgery. Sometimes they're so severe that they have to actually go remove the ectopic pregnancy and the affected organs, and drain the abdomen of blood. And so, again, it definitely depends on the severity of the case, and the earlier it's caught, the better the outcome. If you suspect that you might be having complications with your pregnancy, call your doctor. And after asking you more specific questions, they'll decide if any of this investigation needs to be done and if an ectopic pregnancy might be the cause. If you have more questions for me in the future, feel free to ask them on our Facebook page at http://www.facebook.com/IntermountainMoms, and recommend us to your friends and family too.

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