​Ectopic Pregnancy

​The fundamental disorder in an ectopic pregnancy is that the pregnancy occurs at an irregular (ectopic) location in the body.

Normally, an egg released from the ovary moves towards the uterus through a narrow passage known as the ‘fallopian tube’. If a sperm penetrates the egg while it is making its way along the fallopian tube, it becomes ‘fertilized’ and implants itself in the inner lining of the uterus wall, where it begins to develop into a baby. At times, the fertilized egg (labelled as the ‘embryo’) attaches itself to an abnormal spot such as the fallopian tube (leading to a tubal pregnancy), cervix (lower opening of uterus) or ovary. It can be dangerous for a pregnancy to progress at such sites because they are not adapted to nourish and physically support the growth of a baby. In such instances surrounding structures are likely to be damaged and the mother’s health is endangered.​

Anything which interferes with the regular pathway taken by an embryo, may lead to an ectopic pregnancy. Most commonly an obstruction is encountered in the fallopian tube – it may be narrowed by inflammation (chemical reaction to injury or infection). A previous episode of pelvic inflammatory disease​ or any pelvic surgery may cause tubal scarring and thus block the fertilized egg. Certain other risk factors that have been identified include:

  • Smoking

  • Age above 35 years

  • Insertion of IUD for birth control

  • A failed tubal ligation (procedure performed to close the fallopian tubes for birth control)

  • Reversal of tubal ligation (scarring from blocking them)

  • A history of ectopic pregnancy

  • Fertility drugs usage

  • Fertility treatments such as in vitro fertilization

  • An inborn structural defect in the fallopian tube(s)

If left untreated it may lead to serious complications such as life-threatening blood loss, in case the fallopian tube bursts.

Early treatment of an ectopic pregnancy can help preserve the chances for future healthy pregnancies.​​

It is quite possible that you may not have any clue in the initial stages of the ectopic pregnancy. Similar to signs of any pregnancy, you may miss a period, feel nauseous, get a positive pregnancy test or notice breast tenderness. However an abnormal pregnancy may show up as it progresses through:

  • Irregular vaginal bleeding
  • Lower abdominal, back or pelvic pain – especially cramping on one side

  • Urge to have a bowel movement

  • Dizziness or weakness

  • Sharp pain in shoulder​​

Any pregnancy, suspected or confirmed, calls for medical check-up and regular follow up. Doctors working with the Women’s Health Care Service Line​ at The Aga Khan University Hospital can provide consultation, during and after this precious period of nine months.

However an ectopic pregnancy can lead to life threatening scenarios, such as severe bleeding inside the abdomen if a fallopian tube bursts. Do not hesitate to access the 24/7 Emergency and Acute Care Service Line at The Aga Khan University Hospital if you encounter any of these symptoms during pregnancy:

  • Severe abdominal or pelvic pain, with or without vaginal bleeding
  • Extreme light-headedness or fainting

  • Shoulder pain​​​​

Your time with your doctor maybe limited, so makes sure to prepare for your visit beforehand. ​Here are some tips to help get you started.​ ​​
A few questions regarding your health and a physical pelvic examination are usually the first step in evaluating the possibility of an ectopic pregnancy. It is possible that your doctor may order a blood test (to confirm pregnancy) and/or a special imaging technique known as trans-vaginal ultrasound (a small stick-like instrument will be placed inside your vagina to get a clear image of reproductive system).

Your doctor will assess all possibilities before making a decision and acting in the best interests of you and baby. When intervention is inevitable, there are two treatment options available. Your health care provider will choose the one that best suits your case:

1. Medical: will include an injection of methotrexate, to stop the growth of the embryo and dissolve the existing cells.

2. Surgical:

  • Laparoscopic surgery: to remove the ectopic embryo and repair any damage to surrounding structures. A thin tube with a camera and light will be inserted into the abdomen through a small cut to visualize the internal area
  • Laparotomy (open surgery): usually performed in case of an emergency. The belly is cut open to directly localize the focus of bleeding and remove the ectopic embryo

Any of these management plans will be followed by regular blood tests over the next few weeks to keep a check on certain hormone levels. Also it is possible that if a fallopian tube is damaged beyond repair, it may need to be removed completely.​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.
Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.​