Ectopic pregnancy

What is an ectopic pregnancy? 

Ectopic means “out of place.” An ectopic pregnancy is when an embryo grows in the wrong place outside the womb. An embryo is a fertilized egg that results when an egg and sperm combine.

Once an egg is fertilized, it usually travels down a fallopian tube and attaches to the lining of your uterus (also called the womb). Fallopian tubes are the tubes between your ovaries (where your eggs are stored) and the uterus. The uterus is the place inside you where your baby grows. 

In most ectopic pregnancies, the fertilized egg attaches to a fallopian tube before it reaches the uterus. Less often, it attaches to an ovary, the cervix or your abdomen (belly). The cervix is the opening to the uterus that sits at the top of the vagina. These areas don’t have enough space or the right tissue for a baby to grow. 

Without treatment, an ectopic pregnancy can cause the place where it’s attached to bleed heavily or burst. This can lead to serious bleeding and even death in the pregnant woman. An ectopic pregnancy always ends in pregnancy loss. About 1 in 50 pregnancies (2 percent) in the United States is ectopic. 

What are the signs and symptoms of an ectopic pregnancy?

Signs of a condition are things someone else can see or know about you, like you have a rash or you’re coughing. Symptoms are things you feel yourself that others can’t see, like having a sore throat or feeling dizzy.

An ectopic pregnancy may start out with usual signs and symptoms of pregnancy, like missing your period or having nausea (feeling sick to your stomach) and tender breasts. Or you may not have any signs or symptoms and not even know you’re pregnant. 

Call your health care provider right away if you have any of these signs and symptoms of ectopic pregnancy:  

• Bleeding from the vagina
• Feeling faint or dizzy. This can be caused by blood loss which can cause low blood pressure. Blood pressure is the force of blood that pushes against the walls of your arteries. Arteries are blood vessels that carry blood away from your heart to other parts of the body.
• Pain in your lower back or even your shoulder
• Pain in your pelvic area (the part of your body between the stomach and legs). The pain may be mainly on one side. It can come and go, start out mild and then become sharp and stabbing.

How is an ectopic pregnancy diagnosed?

Your provider may do these tests to look for an ectopic pregnancy:  

• A pelvic exam 
• Blood tests to measure the levels of a pregnancy hormone called human chorionic gonadotropin (hCG). An ectopic pregnancy can cause hCG levels to rise more slowly than a healthy pregnancy. 
• Ultrasound. This test uses sound waves and a computer screen to show a picture of your baby inside the womb. During an ultrasound, your health care provider uses a wand-like tool called a transducer on your belly (also called a transabdominal ultrasound) or inside the vagina (also called a transvaginal ultrasound). Providers often use transvaginal ultrasound to find an ectopic pregnancy because it can show a pregnancy earlier than a transabdominal ultrasound. 

Your provider may repeat these tests if he thinks you have an ectopic pregnancy but can’t see it. It’s hard to see a pregnancy less than 5 weeks after your last period. If you’re having heavy bleeding, your provider may need to do surgery to diagnose an ectopic pregnancy.

How is an ectopic pregnancy treated?

There are two treatments for ectopic pregnancy:  

1. Medicine. Your provider gives you an injection of medicine called methotrexate to stop the embryo from growing. This treatment works best if the embryo is small and in the fallopian tube.  
2. Surgery. Your provider removes the embryo with surgical instruments placed through very small cuts in the belly. This type of surgery is called laparoscopic surgery.  

After treatment, your provider regularly checks your hCG levels until they return to zero. This can take a few weeks. If your levels stay high, it may mean that you still have ectopic tissue in your body. If so, you may need more treatment with methotrexate or surgery to remove the tissue.

Who is at risk for having an ectopic pregnancy?

Any woman can have an ectopic pregnancy. But the risk is higher if you: 

• Are older than 35
• Smoke
• Have more than one sex partner. This can put you at risk for getting a sexually transmitted infection (also called STI). An STI is an infection you can get from having sex with someone who is infected. STIs can lead to pelvic inflammatory disease (also called PID), an infection that can damage the fallopian tubes, uterus and other organs. 

Medical conditions that increase your risk for having an ectopic pregnancy include: 

• You’ve had a previous ectopic pregnancy.
• You’ve had surgery on a fallopian tube, or you have problems, like a birth defect in a fallopian tube. A birth defect is a health condition that is present at birth. It can change the shape or function of one or more parts of the body. It can cause problems in overall health, in how the body develops, or in how the body works.
• You have scars inside the pelvic area from a (ruptured) burst appendix or from past surgeries. Your appendix is part of your digestive tract that helps you process the food you eat. 
• You’ve had endometriosis. This is when tissue from the uterus grows somewhere outside the uterus.
• You had trouble getting pregnant, or you had fertility treatment to help you get pregnant.
• You got pregnant while using an intrauterine device (also called IUD) or after tubal ligation (also called having your tubes tied). An IUD is a form of birth control that your provider places inside your uterus. Tubal ligation is surgery to close the fallopian tubes to prevent you from getting pregnant. 

If you’ve had an ectopic pregnancy before, can you go on to have a healthy pregnancy? 

Yes. About 1 in 3 women (33 percent) who have had one ectopic pregnancy go on to have a healthy pregnancy later. If you’ve had an ectopic pregnancy, you have about a 3 in 20 chance (15 percent) of having another. 

More information

Last reviewed: October, 2017

Symptoms, Causes, Treatments & Tests

Overview

What is Ectopic Pregnancy?

What is an ectopic pregnancy?

An ectopic pregnancy is a pregnancy that happens outside of the uterus. This happens when a fertilized egg implants in a structure that can’t support its growth. An ectopic pregnancy often happens in the fallopian tube (a pair of structures that connect the ovaries and uterus). In rare cases, an ectopic pregnancy can occur on an ovary or in the abdominal cavity.

This is a life-threatening condition. An ectopic pregnancy is not a pregnancy that can be carried to term (till birth) and can be dangerous for the mother if not treated right away.

Where does an ectopic pregnancy happen?

It’s considered an ectopic pregnancy whenever the fertilized egg implants outside of your uterus. The egg is meant to travel down the fallopian tubes and imbed itself into the wall of your uterus, where it can begin to develop. In an ectopic pregnancy, the egg implants in one of the structures along the way. The most common place this can happen is within the fallopian tubes. The majority of ectopic pregnancies happen here—called a tubal ectopic pregnancy. A fertilized egg can also implant on other organs in your abdominal cavity. This is a rarer form of ectopic pregnancy than one that happens in a fallopian tube.

How serious is an ectopic pregnancy?

An ectopic pregnancy is a medical emergency. The uterus is uniquely suited to hold a growing fetus. It’s an organ that can stretch and expand as the fetus grows. Your fallopian tubes aren’t as flexible. They can burst as the fertilized egg develops. When this happens, you can experience large amounts of internal bleeding. This is life threatening. An ectopic pregnancy needs to be treated right away to avoid injury to the fallopian tube, other organs in the abdominal cavity, internal bleeding and death.

Can my pregnancy continue after an ectopic pregnancy?

Unfortunately, an ectopic pregnancy is fatal for the fetus. It cannot survive outside of the uterus. Quick treatment for an ectopic pregnancy is important to protect the mother’s life. If the egg has implanted in the fallopian tube and the tube bursts, there can be severe internal bleeding. This can lead to maternal death.

Symptoms and Causes

What causes an ectopic pregnancy?

In most cases, an ectopic pregnancy is caused by conditions that slow down or block the movement of the egg down the fallopian tube and into the uterus.

How do I know if I’m at risk of an ectopic pregnancy?

There are several risk factors that could increase your chance of developing an ectopic pregnancy. A risk factor is a trait or behavior that increases your chance for developing a disease or condition. You may be at a higher risk of developing an ectopic pregnancy if you’ve had:

• A previous ectopic pregnancy.
• A history of pelvic inflammatory disease (PID), an infection that can cause scar tissue to form in your fallopian tubes, uterus, ovaries and cervix.
• Surgery on your fallopian tubes (including tubal ligation, also referred to as having your tubes tied) or on the other organs of your pelvic area.
• A history of infertility.
• Treatment for infertility with in vitro fertilization (IVF).
• Endometriosis.
• Sexually transmitted infections (STIs).
• An intrauterine device (IUD), a form of birth control, in place at the time of conception.
• A history of smoking.

Your risk can also increase as you get older. Women over age 35 are more at risk than younger women.

Many women who experience an ectopic pregnancy don’t have any of the above risk factors.

What are the symptoms of an ectopic pregnancy?

The early symptoms of an ectopic pregnancy can be very similar to typical pregnancy symptoms. However, you may experience additional symptoms during an ectopic pregnancy, including:

• Vaginal bleeding.
• Pain in your lower abdomen, pelvis and lower back.
• Dizziness or weakness.

If the fallopian tube ruptures, the pain and bleeding could be severe enough to cause additional symptoms. These can include:

When a tube bursts, you may feel sharp lower abdominal pain. This is a medical emergency and you will need to contact your healthcare provider or go to the emergency room immediately.

If you realize that you are pregnant and have an IUD (intrauterine device for contraception) in place, or have a history of a tubal ligation (having your tubes tied by surgery or at the time of a C-section), contact your healthcare provider right away. Ectopic pregnancy is more common in these situations.

Diagnosis and Tests

How is an ectopic pregnancy diagnosed?

An ectopic pregnancy is typically diagnosed during an appointment in your healthcare provider’s office. Your provider will perform several tests to first confirm a pregnancy, and then look for the ectopic pregnancy. These tests include:

• A urine test: This test involves either urinating on a test strip (typically shaped like a stick) or urinating into a cup in your provider’s office and then having a test strip dipped into the urine sample.
• A blood test: You provider may test your blood to see how much of the hormone human chorionic gonadotropin (hCG) you have in your body. This hormone is produced during pregnancy. You may also hear this called your serum beta-hCG level.
• An ultrasound exam: An imaging test, an ultrasound uses sound waves to create a picture of your body’s internal structures. Ultrasound is often used during pregnancy. Your provider will use this test to see where the fertilized egg has implanted.

Once your provider has confirmed the pregnancy and determined where the fertilized egg has implanted, a treatment plan will be created. Ectopic pregnancy is an emergency and treatment for this condition is very important.

If your fallopian tube ruptures, you will need to go to the emergency room and be treated immediately. In those cases, there’s no time to wait for an appointment.

How early in a pregnancy is an ectopic pregnancy detected?

Ectopic pregnancy is typically discovered very early in pregnancy. Most cases are found within the first trimester (the first three months). It usually is discovered by the eighth week of pregnancy.

Management and Treatment

How is an ectopic pregnancy treated?

There are several ways that an ectopic pregnancy can be treated. In some cases, your provider may suggest using a medication called methotrexate to stop the growth of the pregnancy. This will end your pregnancy. Methotrexate is given in an injection by your healthcare provider. This option is less invasive than surgery, but it does require follow-up appointments with your provider where you hCG levels will be monitored.

In severe cases, surgery is often used. Your provider will want to operate when your fallopian tube has ruptured or if you are at a risk of rupture. This is an emergency surgery and a life-saving treatment. The procedure is typically done laparoscopically (through several small incisions instead of one bigger cut). The surgeon may remove the entire fallopian tube with the egg still inside it or remove the egg from the tube if possible.

Prevention

Can I prevent an ectopic pregnancy?

An ectopic pregnancy cannot be prevented. But you can try to reduce your risk factors by following good lifestyle habits. These can include not smoking, maintaining a healthy weight and diet, and preventing any sexually transmitted infections (STIs). Talk to your healthcare provider about any risk factors you may have before trying to become pregnant.

Outlook / Prognosis

Can I get pregnant again after an ectopic pregnancy?

Most women who have had an ectopic pregnancy can go on to have future successful pregnancies. There is a higher risk of having future ectopic pregnancies after you have had one. It’s important to talk to your healthcare provider about the causes of your ectopic pregnancy and what risk factors you may have that could cause a future ectopic pregnancy.

How long should I wait before becoming pregnant again after an ectopic pregnancy?

You should talk to your healthcare provider about future pregnancies after being treated for an ectopic pregnancy. Although pregnancy may happen quickly after treatment, it’s often best to wait about three months. This allows your fallopian tube time to heal and decreases the risk of another ectopic pregnancy.

If my fallopian tube is removed, can I still have a baby?

In most cases, you can still have a baby if you have had one of your fallopian tubes removed. You have a pair of fallopian tubes and eggs can still travel down your remaining tube. There are also assisted fertility procedures where the egg is extracted from the ovary, fertilized outside of the body and placed in the uterus for implantation. This is called in vitro fertilization (IVF).

Have an open conversation about your thoughts on future pregnancies with your healthcare provider. Together, you can form a plan and discuss ways to decrease any risk factors you may have.

Ectopic Pregnancy (for Parents) – Nemours KidsHealth

What Is an Ectopic Pregnancy?

In a normal pregnancy, the fertilized egg implants and develops in the uterus. In an ectopic pregnancy, the egg implants somewhere other than the uterus — often, in the fallopian tubes. This is why ectopic pregnancies are commonly called “tubal pregnancies.” The egg also can implant in the ovary, abdomen, or the cervix.

None of these areas has the right space or nurturing tissue for a pregnancy to develop. As the fetus grows, it will eventually burst the organ that contains it. This can cause severe bleeding and endanger the mother’s life. A classical ectopic pregnancy does not develop into a live birth.

What Are the Signs & Symptoms of an Ectopic Pregnancy?

Ectopic pregnancy can be hard to diagnose because symptoms often are like those of a normal early pregnancy. These can include missed periods, breast tenderness, nausea, vomiting, tiredness, or frequent urination (peeing).

Often, the first warning signs of an ectopic pregnancy are pain or vaginal bleeding. There might be pain in the pelvis, abdomen, or even the shoulder or neck (if blood from a ruptured ectopic pregnancy builds up and irritates certain nerves). The pain can range from mild and dull to severe and sharp. It might be felt on just one side of the pelvis or all over.

These symptoms also might happen with an ectopic pregnancy:

• vaginal spotting
• dizziness or fainting (caused by blood loss)
• low blood pressure (also caused by blood loss)
• lower back pain

What Causes an Ectopic Pregnancy?

An ectopic pregnancy usually happens because a fertilized egg couldn’t quickly move down the fallopian tube into the uterus. The tube can get blocked from an infection or inflammation. The tube can get blocked from:

• pelvic inflammatory disease (PID)
• endometriosis, when cells from the lining of the uterus implant and grow elsewhere in the body
• scar tissue from previous abdominal or fallopian surgeries
• rarely, birth defects that changed the shape of the tube

How Is an Ectopic Pregnancy Diagnosed?

If a woman might have an ectopic pregnancy, her doctor may do an ultrasound to see where the developing fetus is. Often, pregnancies are too small to see on ultrasound until more than 5 or 6 weeks after a woman’s last menstrual period. If an external ultrasound can’t show the pregnancy, the doctor might do the test with a wand-like device in the vagina.

A woman might need testing every few days if the first tests can’t confirm or rule out an ectopic pregnancy.

How Is an Ectopic Pregnancy Treated?

How doctors treat an ectopic pregnancy depends on things like the size and location of the pregnancy.

Sometimes they can treat an early ectopic pregnancy with an injection of methotrexate, which stops the growth of the embryo. The tissue usually is then absorbed by the woman’s body.

If the pregnancy is farther along, doctors usually need to do surgery to remove the abnormal pregnancy.

Whatever treatment she gets, a woman will see her doctor regularly afterward to make sure her pregnancy hormone levels return to zero. This may take several weeks. An elevated level could mean that some ectopic tissue was missed. If so, she might need more methotrexate or surgery.

What About Future Pregnancies?

Most women who have had an ectopic pregnancy can have normal pregnancies in the future. Having had one ectopic pregnancy does increase a woman’s risk of having another one.

What Else Should I Know?

Any woman can have an ectopic pregnancy. But the risk is higher for women who are older than 35 and those who have had:

• PID
• a previous ectopic pregnancy
• surgery on a fallopian tube
• infertility problems or medicine to stimulate ovulation

Some birth control methods also can affect a woman’s risk of ectopic pregnancy. Those who become pregnant while using an intrauterine device (IUD) might be more likely to have an ectopic pregnancy. Smoking and having multiple sexual partners also increase the risk of an ectopic pregnancy.

When Should I Call the Doctor?

If you believe you’re at risk for an ectopic pregnancy, meet with your doctor to talk about your options before you become pregnant. If you are pregnant and have any concerns about the pregnancy being ectopic, talk to your doctor — it’s important to find it early. Your doctor might want to check your hormone levels or schedule an early ultrasound to ensure that your pregnancy is developing normally.

Call your doctor right away if you’re pregnant and having any pain, bleeding, or other symptoms of ectopic pregnancy.

Ectopic Pregnancy | ACOG

Assisted Reproductive Technology: A group of infertility treatments in which an egg is fertilized with a sperm outside the body; the fertilized egg then is transferred to the uterus.

Endometriosis: A condition in which tissue that lines the uterus is found outside of the uterus, usually on the ovaries, fallopian tubes, and other pelvic structures.

Fallopian Tube: Tube through which an egg travels from the ovary to the uterus.

General Anesthesia: The use of drugs that produce a sleep-like state to prevent pain during surgery.

Hormone: A substance made in the body by cells or organs that controls the function of cells or organs.

In Vitro Fertilization (IVF): A procedure in which an egg is removed from a woman’s ovary, fertilized in a laboratory with the man’s sperm, and then transferred to the woman’s uterus to achieve a pregnancy.

Laparoscopy: A surgical procedure in which an instrument called a laparoscope is inserted into the pelvic cavity through a small incision. The laparoscope is used to view the pelvic organs. Other instruments can be used with it to perform surgery.

Obstetrician–Gynecologist (Ob-Gyn): A physician with special skills, training, and education in women’s health.

Pelvic Inflammatory Disease: An infection of the uterus, fallopian tubes, and nearby pelvic structures.

Sexually Transmitted Infections (STIs): Infections that are spread by sexual contact, including chlamydia, gonorrhea, human papillomavirus (HPV), herpes, syphilis, and human immunodeficiency virus (HIV, the cause of acquired immunodeficiency syndrome [AIDS]).

Ultrasound Exam: A test in which sound waves are used to examine internal structures. During pregnancy, it can be used to examine the fetus.

Uterus: A muscular organ located in the female pelvis that contains and nourishes the developing fetus during pregnancy.

Miracle baby was carried outside mother’s womb

When doctors told Nicky Soto that her baby was growing outside her womb, the Arizona mom was stunned and scared. Soto was told that her life would be at risk if she opted to continue with the ectopic pregnancy — and no one held out much hope that the baby would survive.

But Soto, 27, had struggled for five years to become pregnant. After some soul searching, she decided to take the risk, fearing that this might be her last chance.

On Monday her gamble paid off: Soto gave birth though Caesarean section to a healthy, albeit small, baby boy named Azelan Cruz Perfecto. Her doctors say they’ve never seen or heard anything like this miracle birth.

Soto got the disturbing news about her ectopic pregnancy when she was 18 weeks along. She’d been referred to a specialist when her regular physician detected a problem. On ultrasound images it was clear that Soto was carrying a boy, but that the baby was not in the normal spot. What the specialist couldn’t tell was exactly where baby was growing. If the baby’s placenta was attached to a vital organ, that would be extremely dangerous.

“It was really scary,” Soto remembered tearfully. “Just because we didn’t know where the baby was and what he was attached to and what could happen.”

Still, Soto figured it was now or never.

“There was the fact that this was maybe my only chance to carry another child,” she told TODAY’S Meredith Vieria. “If this didn’t go right and we had to remove the uterus, I wouldn’t be able to carry again. I was hoping for the best.”

Specialists told Soto that serious complications – or even death – might be the result if she continued the pregnancy.

“Our biggest concern was what it would be attached to and where the blood supply came from,” Dr. Curtis Cook, Soto’s surgeon explained on TODAY.

Even with MRI scans, it was impossible to see whether any of Soto’s vital organs or blood vessels were wrapped up in the placenta,  said Cook, a physician at Banner Good Samaritan Medical Center in Phoenix.

To keep an eye on Soto and the pregnancy, doctors advised her to stay at the hospital till they delivered the baby. She’s been there since March.

Though she tried to stay in good spirits, sometimes Soto worried about what would happen to her 7-year-old son if she died trying to give him a brother.

“Every day the concern was in my mind: Is everything going to go well like I’m telling myself it will?” she told Vieria. “It was concerning, but I took the risk. I just stayed in the hospital and I tried to stay as safe as I could.”

She kept those concerns under control until Monday morning, the time doctors had scheduled for her surgery to deliver the baby at 32 weeks.

“Up until Monday morning I was fine,” Soto told Vieria. “That’s when I started panicking.”

But ultimately, there was some good luck in Soto’s bad fortune. The placenta, it turns out, wasn’t attached to any organs after all. It was attached to the outside of the uterus.

Still, Curtis and others in the 25-member team that delivered Soto’s son are amazed at how well everything turned out. Baby Azelan is considered low-birth weight, but has no major complications.

For her part, Soto is deeply grateful to everyone who helped.

“I’m so thankful for all their hard work,” she told Vieria. “They didn’t give up on my son. They followed my wishes to continue the pregnancy even though it was risky. It was something we all had to go through together.”

Related: Medical marvel: Baby Macie Hope was born twice

Related: 4-titude: Four sets of quadruplets born at same hospital

Follow TODAY Health on Facebook.

Linda Carroll is a health and science writer living in New Jersey. Her work has appeared in The New York Times, Newsday, Health magazine and SmartMoney. She is co-author of the forthcoming book, “The Concussion Crisis: Anatomy of a Silent Epidemic.”

Ectopic Pregnancy | Cedars-Sinai

Not what you’re looking for?

What is an ectopic pregnancy?

A pregnancy that develops outside
the uterus is called an ectopic pregnancy. It almost always happens in a fallopian
tube.
Because of this, it’s often called a tubal pregnancy. In rare cases, an ectopic
pregnancy will happen in an ovary, in the cervix, or the belly (abdomen).

What causes an ectopic pregnancy?

A fertilized egg normally moves down a fallopian tube and into the uterus. But the
egg can get stuck in the tube if the tube is blocked. This might be from an infection
or scar tissue. If the fertilized egg can’t reach the uterus, it begins to develop
in the tube.

Who is at risk for an ectopic pregnancy?

Ectopic pregnancy is more common in women who:

• Have had trouble getting pregnant (infertility)
• Have endometriosis. This is when uterine tissue grows in other areas of the pelvis.
• Have a sexually transmitted disease. This can cause infection and scarring in the
  pelvis.
• Had tubal surgery
• Use an IUD
• Had an ectopic pregnancy in the past
• Have multiple sex partners
• Smoke
• Are older

What are the symptoms of an ectopic pregnancy?

Women with an ectopic pregnancy may
have irregular bleeding and pelvic or belly (abdominal) pain. The pain is often just
on
1 side. Symptoms often happen 6 to 8 weeks after the last normal menstrual period.
If
the ectopic pregnancy is not in the fallopian tube, symptoms may happen later. The
classic symptoms of an ectopic pregnancy are:

• Belly (abdominal) pain
• No recent period
• Vaginal bleeding not related to a period

How is an ectopic pregnancy diagnosed?

Your healthcare provider will
measure the level of the hormone hCG (human chorionic gonadotropin) in your blood.
They
will use ultrasound to check the uterus for a fetus or other pregnancy tissue. In
some
cases, your healthcare provider will use laparoscopy to diagnose and treat an ectopic
pregnancy. This is surgery that uses a lighted tube inserted into your abdomen to
check
inside the pelvis. It often gives the most accurate diagnosis.

How is an ectopic pregnancy treated?

Ectopic pregnancy may be treated in several ways. This depends on whether the fallopian
tube has broken open (ruptured), how far along the pregnancy is, and your hormone
levels. Treatments may include:

• Letting the ectopic pregnancy heal and the body absorb it on its own. This is only
  for certain cases.
• Using the medicine methotrexate to stop the pregnancy from growing further
• Using surgery (usually laparoscopy) to make a small opening in the fallopian tube.
  The surgeon removes the pregnancy and sometimes the tube.

In rare cases, healthcare providers must make a larger incision in the abdomen to
remove the ectopic pregnancy or damaged fallopian tube.

What are possible complications of an ectopic pregnancy?

When the embryo implants in the fallopian tube, it does not have enough room to grow
or enough blood flow to keep it healthy, so it dies.

The tube may start to let out some of the tissues or bleed. Some embryos do keep growing
and may become large enough to burst the fallopian tube. This can cause severe bleeding
and shock.

Ectopic pregnancy is the leading cause of pregnancy-related deaths during the first
3 months of pregnancy in the U.S.

When should I call the healthcare provider?

Don’t ignore symptoms of ectopic pregnancy. Call your healthcare provider if you have
any bleeding or pain in pregnancy.

Key points about ectopic pregnancy

• Pregnancy that develops outside the uterus is called ectopic pregnancy.
• Women with an ectopic pregnancy may have irregular bleeding and pelvic or abdominal
  pain, often on one side.
• Symptoms most often appear 6 to 8 weeks after the last normal menstrual period.
• Ectopic pregnancy may be treated in several ways, depending on whether the fallopian
  tube has burst.
• Don’t ignore symptoms of ectopic pregnancy. Call your healthcare provider if you have
  any bleeding or pain in pregnancy.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells
  you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
  or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also
  know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that
  visit.
• Know how you can contact your provider if you have questions.

Medical Reviewer: Irina Burd MD PhD

Medical Reviewer: Donna Freeborn PhD CNM FNP

Medical Reviewer: Heather M Trevino BSN RNC

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Not what you’re looking for?

Ectopic pregnancy information and support

What is an ectopic pregnancy?

In an ectopic pregnancy, a fertilised egg starts to grow somewhere other than in the normal lining of the womb, usually in 1 of the fallopian tubes. Ectopic pregnancy affects around 1 in 100 pregnancies.

An ectopic pregnancy creates a potentially life-threatening situation for the mother, so it is very important that it is treated quickly. Unfortunately, it is not possible to save the pregnancy if it is ectopic. This can be difficult to come to terms with. You can talk to a Tommy’s midwife about what you’re going through for free. You can call them on 0800 0147 800 (Monday-Friday, 9am-5pm) or email them at [email protected] All our midwives are trained in bereavement support.

What causes ectopic pregnancy?

Any woman can have an ectopic pregnancy. In fact, about a third of women who experience an ectopic pregnancy have no known risk factors. But there are some things that may increase your risk of having an ectopic pregnancy. These include:

• pelvic inflammatory disease (inflammation of the female reproductive system, usually caused by a sexually transmitted infection)
• previous ectopic pregnancy (the risk of having another ectopic pregnancy is around 10%)
• previous surgery on your fallopian tubes, such as unsuccessful female sterilisation
• fertility treatment, such as IVF 
• getting pregnant while using contraception such as an intrauterine device (IUD) or intrauterine system (IUS) for contraception 
• smoking
• age (the risk is highest for pregnant women aged 35 to 40).

What are the signs and symptoms of an ectopic pregnancy?

Contact your GP or call NHS 111 if you have a combination of any of the below symptoms and you think you might be pregnant, even if you haven’t had a positive pregnancy test.

Symptoms of an ectopic pregnancy usually develop between the 4th and 12th week of pregnancy.

Vaginal bleeding

Vaginal bleeding in pregnancy tends to be a bit different to your regular period. It often starts and stops, and may be watery and dark brown in colour.

Vaginal bleeding in pregnancy can be common and isn’t necessarily a sign of a serious problem, but you should always get medical advice if you have it.

Stomach pain

You may have stomach pain, typically low down on 1 side. It can develop suddenly or gradually, and may be persistent or come and go.

Any stomach pain may just be caused by a stomach bug, trapped wind or something unknown. But it is important to get medical advice if you have it.

Shoulder tip pain

Shoulder tip pain is an unusual pain felt where your shoulder ends and your arm begins. You should get medical advice right away if you experience this.

We don’t fully understand why this pain happens. It is thought to be linked to the presence of fluid or blood leaking into the pelvis or lower abdomen, which happens in an ectopic pregnancy. There are nerves in this area that are linked to your shoulder. Irritation of these nerves can lead to shoulder tip pain.

Discomfort when going to the toilet

You may have pain when going for a wee or poo. You may also have diarrhoea or constipation.

Some changes to your normal bladder and bowel patterns are normal during pregnancy. These symptoms can be caused by urinary tract infections and stomach bugs. But it’s still a good idea to get medical advice.

Symptoms of a rupture

In some cases, an ectopic pregnancy can grow large enough to split open the fallopian tube. This is known as a rupture.

Ruptures are very serious. Surgery to repair the fallopian tube needs to be carried out as soon as possible.

Signs of a rupture include a combination of:

• a sharp, sudden and intense pain in your tummy
• feeling very dizzy or fainting
• feeling sick
• looking very pale.

A rupture can be life threatening, but fortunately they are uncommon and treatable, if dealt with quickly. Deaths from ruptures are extremely rare in the UK.

How is ectopic pregnancy treated?

Unfortunately, the only way to treat an ectopic pregnancy is to end the pregnancy. This can be very distressing, and you may need support afterwards to come to terms with what has happened.

Your healthcare team will talk to you about your options and what this means for you. Not all these options will be suitable and will depend on:

• how many weeks pregnant you are
• your symptoms (for example, how much pain you are in)
• if there is a lot of bleeding in your stomach
• your hCG levels (the pregnancy hormone)
• what is available at your local hospital.

It’s important that you understand all your options and what this may mean for you and your ability to get pregnant again (if you want to). Don’t be afraid to ask as many questions as you need to and raise any concerns you have about what is happening.

There are 3 treatment options for an ectopic pregnancy.

Expectant management

Expectant management means waiting for the pregnancy to end by itself naturally (miscarriage), without treatment. It is usually only possible when the pregnancy is still in the early stages and when you have a few or no symptoms.

Your doctor will need to check your hCG levels (pregnancy hormones) every few days until they go back to normal. This is to make sure that the pregnancy has completely ended. You may need more ultrasound scans.

Find out more about expectant management.

Medication 

You will be given medication as an injection. This stops the pregnancy from developing and it will gradually disappear. If you are given medication, your fallopian tube is not removed.

You may need to stay in hospital overnight. Many women are in some pain for the first few days, but this should settle if you take paracetamol.

You will need to go back to hospital in the first week and then once a week to check your hCG levels. It may take a few weeks make sure the pregnancy has completely ended and you may need further ultrasound scans. During this time, you should not have sex. You should also avoid getting pregnant by using reliable contraception for at least 3 months.

Some women who take medication may still need surgery.

Surgery

The aim of surgery is to remove the ectopic pregnancy. The surgery will be either be a laparoscopy (a type of keyhole surgery) or a laparotomy (open surgery). It may take longer to recover if you have open surgery.

You may have your fallopian tube removed (known as a salpingectomy). This will reduce the risk of having another ectopic pregnancy next time. 

If you only have 1 tube or your other tube does not look healthy, you may be advised to have a salpingotomy. This operation aims to remove the pregnancy without removing the tube. This means that you have a higher risk of another ectopic pregnancy, but you will still be able to get pregnant naturally.

You may be offered a follow-up appointment with your gynaecologist, particularly if you have had an emergency operation. If you have not had your fallopian tube removed, you will need to have your hCG levels checked until they are back to normal.

In an emergency

If the fallopian tube has ruptured, you will need emergency surgery to remove the ruptured tube and pregnancy. Your doctors will need to act quickly, so they may have to decide to operate for you.  

Will I still be able to have a baby in the future?

For most women, an ectopic pregnancy is a ‘one off’ event and does not happen again. Even if you have only one fallopian tube, your chance of getting pregnant again is only slightly reduced.

If you do get pregnant again, you may be offered an ultrasound scan at 6 to 8 weeks to confirm that the pregnancy is developing in the womb.

Talk to your GP if you do not want to become pregnant again. Some forms of contraception may be more suitable after an ectopic pregnancy.

How you may feel about an ectopic pregnancy

Having an ectopic pregnancy can have a huge impact on your mental health. Everyone is different but you’ll likely have lots of feelings and emotions and may need time to come to terms with the loss of a baby. Some women might also need time to accept that they could also have lost their life.

You may eventually want to try for another baby. Try to remember that the possibility of a normal pregnancy next time is much greater than the possibility of having another ectopic pregnancy.

You may find it helpful to:

• talk to your partner, family or friends about how you feel
• ask your care team what support is available – they may refer you to a counsellor who specialises in support for people affected by ectopic pregnancies
• talk to a Tommy’s midwife free of charge from 9am–5pm, Monday–Friday on our helpline 0800 0147 800 or email [email protected]
• visit The Ectopic Pregnancy Trust for more support and information.

90,000 Treatment, operation, removal of an ectopic pregnancy in the early stages, removal of fallopian tubes, hCG and ultrasound for an ectopic pregnancy in Nizhny Novgorod at the Tonus clinic, laparoscopy of an ectopic pregnancy

In any case, if your period is delayed by more than 7-10 days, you must definitely visit a gynecologist!

One of the most important diagnostic methods for clarifying pregnancy is the determination of chorionic gonadotropin (hCG). An increase in hCG during an ectopic pregnancy causes a positive test.Although, the concentration of hCG in an ectopic pregnancy is somewhat reduced than in a normal pregnancy of the same period.

Early detection of ectopic pregnancy is the most effective prevention of complications.

Transvaginal Ultrasound in case of ectopic pregnancy – the most important stage of the whole complex of measures used in the diagnosis. The fertilized egg in the uterus is not detected.

Diagnostic laparoscopy is possible.An ectopic pregnancy is diagnosed by a characteristic thickening of the fallopian tube. Additionally, the ovaries, uterus, and the second tube are assessed.

Treatment of ectopic pregnancy. Removal of the fallopian tube

Treatment is surgical in any case. Medical treatment of such a pathology in Russia is not carried out, is not justified and can lead to serious consequences, therefore, it is not worth looking for a compromise. Patient monitoring takes place only on the basis of a round-the-clock hospital.

One of the methods for the treatment of ectopic pregnancy is laparoscopy for therapeutic and diagnostic purposes. Thanks to this operation, it is possible to diagnose ectopic pregnancies and remove fallopian tubes (radical surgery).

This method is very popular in gynecology, as it shortens the hospital stay, no ugly scars remain on the abdominal wall.

A contraindication to laparoscopy in case of ectopic pregnancy may be a serious condition of the patient.In this case, for a start, hemodynamics and other indicators are stabilized. and then they operate. The extent of the operation is determined individually, taking into account all indications. If a tubal abortion occurs during an ectopic pregnancy, the removal of the fallopian tube is mandatory.

90,000 7 weeks pregnant: signs, sensations, size and development of the fetus

A little more than half of the first trimester has passed.Your baby is about 10,000 times larger than it was at conception. This week, his brain begins to actively develop – about 100 new cells are formed in it every minute!

Constantly comparing your toddler’s size to food items may seem odd, but it removes the confusion and ensures we’re all talking about the same thing. Now, in the 7th week of pregnancy, your baby is about the size of a grape and your uterus is about the size of a medium orange. This makes everything much clearer!

Your baby has grown 10,000 times, but you still don’t feel this little grape jumping inside your uterus.The baby’s movements will become noticeable only in the middle of the second trimester.

Physical changes this week

• This week you may have a new unwanted friend – constipation. The large intestine can get a little lazy during pregnancy due to the effects of progesterone. Drinking plenty of fluids and eating foods high in fiber can help reduce the problem.

• You still feel the early pregnancy symptoms, they may have even worsened.Nausea, food intolerances, vomiting and heartburn can continue for most of the day.

• Increased salivation forces you to constantly swallow, and it seems like it’s time to get a bib. Be careful when brushing your itchy mouth and mouth, so that the toothbrush is not too deep. Now your gag reflex can easily react to brushing the back of your tongue.

• You may remember your teenage years due to an unexpected invasion of acne.This is all due to the hormones that are overflowing with your body.

• You may be sensitive to heat and want to throw off your clothes at the earliest opportunity. This is a consequence of the additional blood volume circulating in your body and hormonal surges that are observed in the first weeks.

• You may find a “thickening” in the middle of the abdomen, even though the uterus will only begin to rise up after the 12th week of pregnancy.Some women gain a few pounds in the first trimester, others lose weight – all individually.

• You may feel tired all the time, no matter how much you sleep. This is a common symptom of early pregnancy, but by the end of the first trimester, your energy levels will return to normal.

Emotional changes this week

• There have been no significant changes on the emotional front this week.You may still not fully believe that you are pregnant because the symptoms are screaming about it and your appearance is not.

• You may feel a little guilty towards your friends who are trying to get pregnant, but they have not succeeded yet. Be attentive to their feelings, but drive away the remorse.

• You may start to worry about what kind of mother you will become and how you will raise and educate your child. Try not to look that far and not lose confidence in your abilities.Talk to your own mom or other women who have children and who likely have the same feelings.

What happens to the baby this week

• Your baby’s bones begin to form and his facial features become more recognizable. The back of the head grows faster than the front.

• At 7 weeks, the baby’s mouth and tongue begin to form, as well as the baby’s arms and legs. While they still look like fins, over time they will become more like human limbs.

• This week the child’s brain develops most actively, about 100 new cells are formed in it every minute. It’s no wonder you’re constantly hungry – it takes a lot of energy to grow quickly.

• The baby’s genitals are beginning to form, but so far the ultrasound does not yet show what gender your baby has.

• The kidneys are already where they should be, but they are not filtering the blood yet. Soon, they will begin to produce urine, which will be excreted into the amniotic fluid.

Tips of the Week

• Make an appointment with the dentist. Poor oral hygiene and gum disease are associated with the risk of premature birth and other complications. Talk to your dentist about how to maintain oral health throughout your pregnancy. Be sure to tell him you are pregnant because X-rays are not recommended at all stages of pregnancy.

• Include more ginger in your diet.Many women say it can help manage nausea during pregnancy. Eat small meals often and avoid long breaks between meals. Don’t worry if tea and coffee become unpleasant for you – this often happens during pregnancy. Try replacing them with herbal teas and herbal teas.

• Many women at this time want salty food, pickled foods. Often, pregnant women at this time tolerate snacks better than full meals.Stock up on crackers and pates, but make sure they contain B vitamins and other nutrients.

And what awaits you in the eighth week?

90,000 Fetal development by days, weeks, months

The ability to bear and give birth to a fetus is a real miracle that a woman performs. Indeed, at this time – it is a magic vessel in which a microscopic cell is transformed into a full-fledged human body.

The average duration of pregnancy is 280 days, that is, 10 obstetric (28 days) or 9 calendar months, the countdown is made from the first day to the last menstrual cycle. During this period, a tiny egg in the uterus will have time to develop to the stage of a mature fetus – a little man, prepared for an out-of-uterine existence. Are you interested in tracking your baby’s development from month to month? Then use our pregnancy calendar .

Stages of pregnancy by months

1 month (1-4 weeks of gestation)
After the fertilization of the egg, the fallopian tube starts the process of cell division.All processes are carried out with such a rapid speed that it is just right to say that “the child is growing by leaps and bounds.”

• Already after three days after conception, the hCG hormone begins to be produced in the fetus, due to which the female body undergoes some changes.
• During the first three weeks, the fertilized cell becomes an embryo.
• The baby is laying down all the organs.
• By the end of the 4th week, blood circulation starts in the embryo, the umbilical cord is formed as a connection with the placenta.
• The embryo is implanted into the uterus.
• The first month of pregnancy ends with the formation of the eye sockets, the rudiments of the legs and arms.
• By the end of 4 weeks, the appearance of the embryo is comparable to that of the auricle and has a grain size of about 1 mm.

2 month (5-8 week)
The fetus stops receiving nutrition from the ovum and immediately after its attachment to the inner walls of the uterus receives nutrition from the woman. From that moment on, its development accelerates significantly.

• In the first month, two layers are distinguished in the fetus – endoderm and mesoderm, at the 5th week a third appears – ectoderm, from which the nervous system, skin, hair, and tooth enamel are built. In addition, the formation of a groove is noted in the embryo, which gradually folds. It transforms into a neural tube – later – into a notochord, central and peripheral system. A primitive heart tube is formed in the chest.
• At 6 weeks, your baby undergoes active organogenesis – the process of the formation of the most key systems in the body: arms, legs, head.
• Week 7 is marked by rapid head growth, as the brain is actively developing. In the rounded head, you can already distinguish the eye sockets. The formation of the nose and mouth begins. Two bronchial branches are already present in the area of ​​the future respiratory system. The heart is divided into chambers and arteries. The appearance of veins is also accompanied by the conception of organs such as the liver, spleen and gallbladder.
• At 8 weeks, the ultrasound will show a picture of the baby’s first unconscious movements.It will be possible to observe the outlines of pens and fingers, upper lip, nose and ears. At 2 months of development, the child has a height of 13 mm.

3rd month of development (9-12 week)
In the third month your baby will have to move from the status of “embryo” to the so-called “status” of the fetus by obstetricians.

• 9th week is notable for changes in the baby’s skeleton. The transformation of the cartilage of the arms into bones begins, the bending of the arms and legs, the final formation of the neck.Eyelids will appear, albeit welded to each other at this stage of development.
• Week 10 – The fetus completes a stage called embryonic development. The fingers and toes are separated on the hands and feet. It is not yet possible to identify the external genitals, but the boy will already start producing testosterone.
• At 11, the tail disappears completely. A child can already be compared to a small person, but his body has not yet assumed the proportions that are characteristic of a newborn. At this stage, 10% of its weight is taken up by the liver.The kidneys are already working in the body – the amniotic fluid is replenished with the produced urine.
• 12 weeks – complete completion of organogenesis. The complete formation of all systems comes to an end and at the subsequent stages of the baby’s development they simply continue their development.

By the end of 3 months, the fetus reaches 61 mm in height and 14 g in weight.

4 month (13 – 16 weeks)

• 14 week – the entire system of cartilage, from which the skeleton of the fetus was built, becomes bones.The genitals can already be attributed to a specific gender, but ultrasound still cannot show them.
• 15 weeks – the appearance of hair on the head, the formation of eyebrows. At this stage, the formation of the gallbladder is triggered.
• Week 16 – The eyes and ears take their final shape. Solid lengthening of the legs – in relation to the body, they will become proportional. At this stage, the child will have fully formed nails.

The weight of a child at 4 months is 130 g, height – 12 cm.

5 month (17-20 weeks)

• The final formation of grooves on the palms and heels, from which the basis for prints is formed in the future.
• The size of the baby is the same as the size of the placenta.
• Week 18 – the beginning of the child’s perception of external sounds and responses to them.
• Week 19 – a slowdown in the rapid growth of the child, from this moment subcutaneous fat begins to form. Bronchioles form in the lungs.The baby’s reaction to light is noted.
• By week 20, the girl will have a fully formed uterus, but the vagina is still missing.

By the end of the 5th month, the child will reach 16 cm in height and 320 g in weight.

6 month (21-24 week)

• A striking example of a leap in the development of the nervous system is the baby’s ability to swallow amniotic fluid.
• Milk and permanent teeth in their infancy can be seen on ultrasound.
• The hair continues to grow on the head, but its color cannot yet be determined, since the time for the appearance of the pigment has not yet come.
• 23 weeks – on the ultrasound, you can follow the rapid eye movements during the baby’s sleep, which confirms the high activity of the brain.
• Week 24 – the child’s viability at a qualitatively different level begins exactly at this time. In the lungs, the formation of terminal sacs is noted at the ends of the capillaries, separated from the alveoli using a thin film.The lungs begin to produce surfactant, a surface substance that prevents capillary sacs from closing during breathing.

By the end of 6 months, the fetus grows to 21 cm in length, and up to 630 g in weight.

7 month (25 – 28 weeks)

• Subcutaneous fat is actively formed, but the child is still thin, has red and wrinkled skin.
• The appearance of taste buds on the tongue.
• Normal functioning of all organs is noted, but their development is still ongoing.
• In the last three months, the growth of the brain is especially enhanced.
• 28 weeks – the baby will open his eyes. At this time, the boy’s testicles will descend into the scrotum.

By the 6th month of pregnancy, the baby will grow to 35 cm in length and weigh approximately 1 kg.

8 months (29 – 32 weeks)

• White subcutaneous fat continues to form – an important source of energy for the child.
• The immune system starts working, however, the baby’s blood is also replenished with the mother’s antibodies.
• The teeth in the gums are covered with enamel.
• Already in the uterine cavity, the child prepares for independent existence: he breathes amniotic fluid (an analogue of respiratory charging, which allows the lungs to enlarge), sucking on a fist or a finger can be observed (development of the sucking reflex).
• The baby is plump, the subcutaneous vessels are no longer visible.

By the end of this gestation period, the fetus will reach 40-41 cm in height, and 1600 g in weight.

9 month (33 – 36 weeks)

• The child’s activity increases, his water room becomes more and more cramped for him.
• The ratio of white subcutaneous fat is 8% of its weight.
• The baby’s lungs secrete more and more sufractant.

By the 10th month, the fetus grows to 45 cm, and weighs approximately 2500 g.

10 month (37 – 40 weeks)

• Loss of lanugo – hair covering the surface of the baby’s head and body.
• Original grease is reduced in volume.
• The baby takes the position in which it is born (knees are firmly closed with the chin).
• His preparation for independent living is complete.

As a rule, full-term babies are 51 cm tall and weigh 3400 g.
The final stage of fetal development of the baby is behind, and you have to cope with a serious test – childbirth, after which you will finally get to know your long-awaited treasure.

See what the growth of the fetus looks like from start to finish.

Even if you are at an early stage, very soon you will need special underwear for expectant mothers, cosmetics for stretch marks and pigmentation on the skin will also come in handy.

Closer to the expected date of birth, mothers begin to prepare a dowry for the baby. In the online store of baby goods Lapsi, you can buy everything you need for babies: strollers for newborns, cribs for newborns, infant carriers and car seats, discharge kits, toys and other baby products.

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10 signs of an ectopic pregnancy that should not be missed

What is an ectopic pregnancy and how dangerous it is

A normal pregnancy proceeds like this.The sperm cell enters the egg, which is released during ovulation into the fallopian tube. The latter begins to contract, pushing the fertilized egg into the uterus. There, the egg is attached to the uterine wall and begins to transform into an actively growing embryo.

With an ectopic pregnancy ^{, as the name implies, the egg does not enter the uterus. Most often, it lingers in the fallopian tube – too twisted, narrow or weak to push the ovum where it is needed.But there are times when an egg is implanted into the cervix, ovary, or other place in the abdominal cavity.}

The ectopic pregnancy does not end well with anything. The growing embryo sooner or later breaks the walls of the organ to which it has attached. The result is massive internal bleeding, an infection in the abdominal cavity and peritonitis (however, you may not live to see it).

According to the American Pregnancy Association ^{, every fiftieth pregnancy is ectopic.}

What signs of an ectopic pregnancy should you see a doctor

At first, an ectopic pregnancy does not feel much different from a usual one. A delay in menstruation, discomfort in the lower abdomen, soreness in the chest, two strips on a home test – it seems as if everything is normal.

Disorders can manifest themselves at any time between the fifth and fourteenth weeks of pregnancy. But most often it happens about two weeks later ^{after the delay. It was during this period that warning signs appear:}

1. Stitching pains and cramps in the lower abdomen.
2. Nausea and vomiting accompanying the pain.
3. Constant dizziness, weakness.
4. Pain in the rectum or radiating to the shoulder and neck.
5. Discharge similar to menstrual flow.

For any of these symptoms, it is important to consult a gynecologist as soon as possible.

When to call an ambulance

Do not wait and seek emergency medical help if:

1. You have severe pain that lasts more than a few minutes.
2. You are bleeding.
3. Acute rectal pain accompanied by a feeling of unbearable urge to use the toilet.
4. Severely and for a long time (more than a few minutes) shoulder pain. Sometimes, blood that rushes into the abdominal cavity after a ruptured fallopian tube accumulates at the diaphragm and irritates the nerves associated with the shoulder.
5. You have extreme dizziness – to such an extent that you seem to be about to pass out.

Why, if you suspect a pregnancy, you need to go to the doctor

It is impossible to determine an ectopic pregnancy at home.At least until it makes itself felt with obvious dangerous symptoms.

Conclusion: when you see two strips on the test, do not delay a visit to the gynecologist. The physician will find out at the initial stage whether everything is in order. To do this, he will:

1. Carry out an examination of the pelvic organs. This is to find out if there is unusual tenderness or painful growths in the abdominal cavity.
2. Do an ultrasound scan to determine the place where the ovum is attached. In the early stages (up to 5-6 weeks), examinations are done with an intravaginal sensor – it gives a more accurate result.However, there are times when the place of implantation cannot be determined. Then the doctor will prescribe you an additional ultrasound scan for a period of 8-9 weeks.
3. Asks you to take blood or urine tests to determine the level of the hormone hCG (human chorionic gonadotropin). At the beginning of an ectopic pregnancy, the amount of this hormone is much less than during a normal pregnancy, and tests will show this.

The second strip on the test for an ectopic pregnancy often looks very pale.This is due to low hCG levels.

How to treat an ectopic pregnancy

There are no options – the pregnancy will have to be terminated. But in what way depends on the timing.

Drug treatment

Used when abnormal egg attachment can be detected at an early stage. The specialist will inject methotrexate (Trexall), which stops the growth of the placenta and forces the body to get rid of the pregnancy on its own.

Note: This may require several treatments, so it is important to keep in touch with your doctor and follow their recommendations.

Laparoscopy

This is a small operation during which the surgeon will remove the ovum. Most likely, the fallopian tube will not be injured.

Surgery

This is an emergency option. If the fallopian tube has been ruptured, the surgeon will remove part or all of it to save the woman’s life.

Is it possible to get pregnant after an ectopic pregnancy

It depends on what caused the disorder. Common causes of ectopic pregnancy are:

• Infections in the fallopian tube.Because of the inflammation, the tube cannot move the ovum into the uterus.
• Endometriosis.
• Scars and adhesions. As a rule, these are the consequences of previous operations (the same abortions) or infections. They also interfere with the movement of the fertilized egg.
• Personal characteristics. In some women, the fallopian tube is too narrow or twisted.

What is the reason in your case and what to do with it, it is best to discuss with the gynecologist. The specialist will read your medical record, conduct additional research and draw up a rehabilitation plan that will help you one day conceive and bear a healthy baby.

Read also 🧐

Science: Science and technology: Lenta.ru

For the first time, biologists managed to grow embryos in a test tube that have reached the stage of implantation into the wall of the uterus. Prior to this, researchers received germ cells that did not develop beyond this stage. Now specialists can create convenient platforms for studying the development of animals and humans, as well as solve the problems of developing an artificial womb.”Lenta.ru” tells about the scientific work of scientists from the University of Cambridge, published in the journal Science.

The development of vertebrates from one cell to a multicellular organism is a very complex process. There are several stages in it, as a result of which various groups of cells influencing each other are formed. Although everyone has the same DNA, their location in the embryo determines which genes will be active. This, in turn, determines the function of cells in the tissues of the developing organism.

Materials on the topic

00:03 – February 21, 2017

In mammals, the development of the embryo can occur both in the mother’s body and in the egg (in the echidna and the platypus). The embryo occurs when an oocyte (egg) is fertilized. After that, it is fragmented – a series of divisions with the formation of ever smaller cells (blastomeres). As a result, a morula is formed – a ball, the entire internal space of which is filled with 16 blastomeres.

The morula stage is followed by the blastocyst stage.Blastomeres continue to divide, becoming more and more dense and forming a hollow sphere. It starts the process of cell differentiation, and two types of cells are formed: the trophoblast, which forms the outer layer of the blastocyst, and the embryoblast (inner cell mass), which is inside it. The embryoblast creates a compact formation at one of the poles of the blastocyst.

At the blastocyst stage, processes occur in the cells of the embryo that establish the axes of symmetry, and also regulate gene expression, which in the following stages will lead to the formation of various tissues.The embryo, which previously resembled a sphere, becomes asymmetrical. Trophoblast gives rise to extraembryonic (extraembryonic) tissues, from which the placenta, yolk sac and amnion are then formed. Two more groups of cells develop from the embryoblast – the epiblast and the hypoblast.

Human blastocyst 5 days after fertilization

As a result, the body of the future organism is formed from the epiblast. However, this happens only under the condition that the cells of this group interact with extraembryonic tissues.The hypoblast promotes the formation of some extraembryonic structures, including the primitive endoderm, which then gives rise to the visceral endoderm, which surrounds the epiblast and performs regulatory functions.

After the blastocyst is introduced into the uterine lining during pregnancy, the structure of the embryo changes, gradually becoming more complex. The epiblast cells are ordered to form a rosette. A cavity appears inside. The trophoblast at this time turns into an extraembryonic ectoderm (ExEc), which also has a cavity.Eventually, both cavities are connected. In addition, mesoderm and primary germ cells arise, and the embryonic cylinder is formed.

Epiblast consists of embryonic stem cells (ESCs) capable of differentiating into three germ layers: ectoderm, mesoderm and endoderm. The cells of these three layers are pluripotent, that is, they can turn into all types of cells in an adult organism. That is why ESCs are used to create embryonic structures – embryoids. They help to understand the mechanisms of fetal development, but the problem is that they do not reproduce the processes that occur in vivo (in a living organism) after being introduced into the wall of the uterus.

In vitro development of the mouse embryo

Image: Magdalena Zernicka-Goetz, University of Cambridge

Scientists decided to make sure that extraembryonic tissues support the further development of the embryo by conducting appropriate in vitro experiments (in vitro). We took embryonic stem cells and small groups of stem cells from trophoblast (TSC) – precursors of cells of extraembryonic organs. From them, cell cultures were obtained that mimic the interaction of epiblast with trophoblast.Connections between cells were carried out through three-dimensional extracellular structures from the collagen matrix “Matrigel”.

Matrix replaced primitive endoderm in culture, providing polarization of epiblast cells and formation of a cavity. It turned out that under these conditions, ESCs and TSCs formed a shape resembling an embryonic cylinder and characteristic of mouse embryos after implantation. However, there was not only external similarity. A careful analysis of the morphology, size, number of cells and activity of genes characteristic of certain cell lines showed that in embryos, both in vivo and in vitro, there were separate structures derived from epiblast and trophoblast stem cells.

Researchers have identified several stages in the development of an embryo in a test tube. First, spontaneous self-organization is observed, which leads to cell polarization and the formation of cavities within the embryonic and extraembryonic parts of the embryo. The cavities are then combined into one large equivalent of the pro-amniotic cavity. Then the two groups of stem cells interact via the Nodal signaling pathway. The signals are proteins involved in embryonic induction; they direct the development of individual parts of the embryo – for example, they contribute to the formation of the nervous system.Everything ends with the release of bone morphogenetic protein, which induces the formation of cells that resemble primary germ cells.

The research results are important for solving the problem of creating an artificial womb. In this device, embryos could be carried without the participation of a living being. However, not all the factors influencing the differentiation of cells on the part of the mother’s body are still known. For example, the role of blastocyst implantation is still completely unclear. Cultivation of fetuses in vitro during the post-implantation period is impossible without studying what happens to the cells of the embryos during this period.New embryoids will allow appropriate research.

Post-term pregnancy

In modern obstetrics, with organized supervision in antenatal clinics, post-term pregnancy is a rarity. However, the potential risk of being late still remains. How not to “delay” the appearance of a child, and what is the danger of “delay”?

“Flowers” long-awaited, belated

Spouses Andrei and Nastya counted the days until the birth of a partner: the parents-to-be had conscientiously “unlearned” at school at the antenatal clinic and were sure that they had prepared well for the main exam – the birth of a child.The 41st week of pregnancy was ending, and the contractions did not come. The couple were confused: this did not fit into their scenario. +

An obstetrician-gynecologist recommended hospitalization to Nastya in order to understand the reasons and prevent prolonged pregnancy. Andrei took his wife to the clinic, and a few days later he became a dad. Childbirth, although belated, went well, the boy weighed 3700 g.

Yuri MALEVICH,

Professor of the Department of Obstetrics and Gynecology, Belarusian State Medical University

Postterm pregnancy exceeds 42 weeks in duration and is characterized by the birth of an “overripe” baby.Often, due to the aging of the placenta and a decrease in blood flow to the fetus, it grows in length, and the weight of the subcutaneous tissue decreases. If the newborn has no signs of postmaturity, the pregnancy is considered prolonged.

Why sometimes childbirth does not come on time? Their onset depends on a number of factors: body weight, density of the bones of the skull and the hormonal status of the fetus; overstretching of the uterus and the accumulation in it of a sufficient amount of nutrients, energy substances; the focus of excitation in the cerebral cortex of a woman, which gives an impulse for contractions, etc.

Main reasons for prolonged pregnancy:

• age of the woman in labor over 30 years old,
• menstrual dysfunction,
• inflammatory diseases or infantilism of the female genital organs,
• endocrine pathology,
• hormonal insufficiency of the placenta,
• gestosis,
• no generic dominant,
• low accumulation of glycogen, adenosine triphosphoric acid, catecholamines in the uterus;
• Malformations and disorders in the pituitary-adrenal system of the fetus.

The diagnosis of prolonged pregnancy is given at:

• the lack of readiness of the female body for childbirth;
• decrease in abdominal circumference due to a decrease in the volume of amniotic fluid;
• increase in the height of the fundus of the uterus due to the growth of the fetus;
• fetoplacental insufficiency;
• aging placenta;
• turbid waters with flakes on amnioscopy;
• signs of a post-term fetus (increased density of the bones of the skull, a decrease in the subcutaneous fat layer, sutures and fontanelles; lack of cheese-like lubricant and vellus hair, aspiration of meconium, reduced ability to configuration, etc.).

A woman re-nursing a pregnancy should be hospitalized. In the hospital, doctors assess the condition of the fetus; if necessary, induction of labor is prescribed (they are called artificially). The most common indications for its use are intrauterine fetal suffering, complications of pregnancy.

Stimulation of labor

Most often prostaglandins are used for induction of labor – natural biologically active compounds with a wide spectrum of pharmacological action.The ability of prostaglandins to cause uterine contractions has been established. They have a pronounced effect even in minimal doses, and then quickly transform into inactive metabolites. With endocervical administration, the concentration of the drug in the blood plasma reaches a maximum in 30–45 minutes, after which it rapidly decreases.

Prostaglandins are used on average in 84–98% of induced labor in primiparas and in 96–100% in multiparous, including those with a scar on the uterus. If prolongation is combined with another pathology, a cesarean section is performed on the woman.

Delayed childbirth is dangerous for the child with injuries. Birth is always accompanied by compression of the baby’s head; the “overripe” fetus has denser bones of the skull, it is more susceptible to the risk of traumatic brain injury. In addition, a large child traumatizes the mother.

Even with normal delivery at term, the fetus experiences oxygen starvation (like an adult at an altitude of 3-4 thousand meters). At 40 weeks, the baby tolerates hypoxia more steadily, labor stress even contributes to better adaptation to living conditions outside the womb; but the “overripe” fetus has a more complex nervous system, it is more difficult to adapt to a lack of oxygen.

Perinatal morbidity and mortality among “overripe” fetuses is 3-5 times higher than among those born at term, and the share of caesarean section in the 1st group is 40-50%, in the 2nd – 20-22%.