Diagnosis

An ectopic pregnancy is a pregnancy that has implanted in the fallopian tube rather than in the uterus. An ectopic pregnancy is a dangerous condition as the tube can eventually rupture and bleed severely into the abdominal cavity. An ectopic pregnancy is a rare event (1:500 pregnancies) but is much more common if you have tubal damage due to infection or if your pregnancy is the result of IVF treatment. Ectopic pregnancy usually presents with abnormal vaginal bleeding and pain. If diagnosis is left too late and the ectopic pregnancy ruptures, collapse and low blood pressure may result.

Ectopic pregnancy is usually diagnosed by a pregnancy test and clinical examination. A transvaginal ultrasound scan may also be very useful in the diagnosis. When the pregnancy is very early, differentiating between an ectopic and a normal pregnancy can be difficult, and these tests often have to be repeated

Treatment

Very small and early ectopic pregnancies can be treated with a chemotherapy drug call Methotrexate. This causes the pregnancy tissue to die. Follow-up over several weeks with blood tests of a hormone called Beta-HCG is necessary to ensure that this process occurs. Surgery may still be necessary of the Beta-HCG level does not fall rapidly.

If an ectopic pregnancy is larger, or has ruptured, surgical removal may be required. In most cases this can be done through keyhole surgery. If the pregnancy is very small it may be possible to remove the pregnancy from the tube. It is usually necessary to remove the tube if the pregnancy is larger, or has ruptured. There is no difference in subsequent pregnancy rates whether the tube is preserved or removed. Keyhole or laparoscopic surgery is the surgery of choice and usually means you are only in hospital for 24 hours and off work for a few days. If you have had one ectopic pregnancy, you are unfortunately at more risk of having another ectopic pregnancy.