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.

When to seek expert advice

Any pregnancy, suspected or confirmed, calls for medical check-up and regular follow up. Doctors working with the Department of Obstetrics and Gynaecology 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 Department of Emergency Medicine 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​​​​