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Ectopic Pregnancy

What Is Ectopic Pregnancy?

Last modified: 
16/04/2013 - 11:51

Contributing Author: Guy Slowik FRCS

An ectopic pregnancy is a pregnancy that occurs outside a woman's uterus (womb). Ectopic means "out of place."

Normally, after fertilization (i.e. after the egg and sperm have become united), an embryo (the combined egg and sperm) implants itself inside a woman's uterus and begins to grow and develop. Occasionally, however, the embryo may accidentally attach elsewhere along its path to the uterus and begin to grow in this abnormal site, where it does not have the normal environment to develop. Such sites may include the:

  • Fallopian tubes (the tubes that lead from the ovaries to the uterus, down which a fertilized egg travels to implant itself in the womb). Most ectopic pregnancies occur in the fallopian tubes.
  • Cervix (the opening to the uterus)
  • Ovary (the organs that produce the eggs)
  • Abdominal cavity

What Happens During Fertilization?

The uniting of the sperm and egg, called fertilization, occurs in a one of a woman's fallopian tubes. Fallopian tubes connect the ovaries to the womb (uterus). The fertilized egg, now known as the embryo, floats down the fallopian tube and into the uterus. The uterus is the site where the embryo normally implants itself and begins to grow and develop into a baby.

The Risks Of Ectopic Pregnancy

Ectopic pregnancies cannot lead to the healthy growth and delivery of a baby. There is not enough room or the proper environment outside the womb for the fetus to develop normally. In many cases, as the ectopic embryo starts to grow, it bursts the organ (usually the fallopian tube) that contains it, and is said to have "ruptured." This can cause bleeding, severe pain, and even death for the mother. Fortunately, testing can identify an ectopic pregnancy early, before it becomes dangerous. However, the mother must still cope with the unhappy termination of her pregnancy.

Facts About Ectopic Pregnancy

  • The rate of ectopic pregnancy in the United States and worldwide has quadrupled since 1970 and now occurs in almost 2% of all pregnancies. Fortunately, despite the rising incidence of ectopic pregnancy, the death rate from this cause has gone down and is now only four per million pregnancies.
  • The fallopian tubes are the most common site of ectopic pregnancy-95 percent of all ectopic pregnancies occur in this area.
  • Approximately 2 out of 100 pregnancies will result in an ectopic pregnancy.
  • There is no chance of a normal pregnancy or delivery in an ectopic pregnancy.
  • Today, 80 percent of ectopic pregnancies are diagnosed within the first six weeks of pregnancy, before the fallopian tube has ruptured.
  • Women who have had a pelvic infection (such as an STD) or pelvic inflammatory disease are five times more likely to have an ectopic pregnancy.
  • A woman who had a previous ectopic pregnancy is at a 7-15 percent risk of one happening again.
  • More than 40 percent of women who had a fallopian tube removed during treatment for an ectopic pregnancy go on to have a normal pregnancy.
  • Of all women who get ectopic pregnancies, 50% have problems with their fallopian tubes. This leaves 50% of cases in which no tubal disease is present and where the cause is unknown.
  • The risk of ectopic pregnancy is highest in women over 35 years of age.
  • Black women have a twofold higher risk of ectopic pregnancies than white women.

 

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Ectopic Pregnancy

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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.