Ectopic pregnancy is a complicated and diverse term that can refer to almost any abnormal pregnancy. The strict definition of ectopic pregnancy is any pregnancy that exists outside of the uterine cavity where normal pregnancy occurs. This can refer to tubal pregnancies (the most common), cervical pregnancies, and abdominal pregnancies. Although a very small number of these abnormal pregnancies will end with the delivery of a viable (meaning live) infant, most are pregnancies incompatible with life and thus, must be terminated. Unfortunately, while the uterus is designed by God to stretch and accommodate a 6-9 pound infant, the tubes (the most likely site for an ectopic pregnancy) are not designed to stretch. Thus, if most ectopics are not recognized early enough in the pregnancy, the tubal pregnancy will burst and result in extreme pain and internal bleeding, occasionally resulting in maternal death.
How do ectopic pregnancies occur?
Ectopic pregnancies are caused by incomplete transfer of the fertilized egg/ embryo from the ovary to the tube to the uterine cavity. Thus, the embryo ends up implanting in the tube or out in the abdomen where it begins to grow. Most ectopics are caused by previous surgery or infection in or around the tubes that results in scarring and incomplete blockage of the tubes. Another common cause of ectopics is failed tubal ligations where a woman has her tubes tied and then gets pregnant. Thus, if you have a past history of pelvic infection and/ or are a previous tubal ligation, and you find out that you are pregnant, you need to see a physician immediately to verify an intrauterine pregnancy.
How are they treated?
Most ectopic pregnancies are either treated with medicine or outpatient surgery. Once the abnormal pregnancy is verified by labs and ultrasound, most physicians will give the patient a choice between a medicine called Methotrexate or a surgery called Laparoscopy to remove the abnormal pregnancy. The advantage of the medicine is the avoidance of surgery and possible permanent damage to the tubes. While the advantage of surgery is a quicker, more predictable cure without the worry of medicine failure.