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901 Whitehorse Road Box Hill VIC 3128
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For pregnancy to occur a mature egg must be fertilised by sperm and implant in the lining of the uterus (womb).
During each menstrual cycle, a mature egg is released from one of the ovaries (this is called ovulation). The released egg is funnelled into the fallopian tube where it may meet and combine with sperm (this is called fertilisation). Fertilisation usually occurs in the fallopian tube. Once fertilised, the combined egg and sperm (embryo) move down the fallopian tube and into the uterus (womb) to implant in the uterine lining (endometrium) and pregnancy occurs.
An ectopic pregnancy occurs when the fertilised egg and sperm implant in a place outside the uterus (womb). This is usually in one of the fallopian tubes and in rare cases, in the cervix (entrance to the womb), abdominal cavity or ovary.
Unlike the uterus, the fallopian tube is unable to stretch and grow with pregnancy and does not have the blood supply to support the growing embryo. An ectopic pregnancy cannot continue. Around 1 – 2 in 100 pregnancies are ectopic.
If not diagnosed early an ectopic pregnancy can cause the fallopian tube to burst.
While ectopic pregnancy is thought to occur due to damage, scarring or a blockage of the fallopian tube, the cause is often unknown. Around 50% of those who have an ectopic pregnancy have no known risk factors.
Factors that can increase the risk of ectopic pregnancy include:
The use of IUDs decreases the overall risk of ectopic pregnancy. However, if a person does become pregnant when using a hormonal IUD (Mirena or Kyleena) there is around a 50% chance the pregnancy will be ectopic. The risk is around 15% if the person is using a copper IUD.
If a pregnancy occurs when using an IUD, an ultrasound should be performed to check the location and stage (length) of the pregnancy.
There is also a small increase in the risk of a pregnancy being ectopic if the person is using the progestogen only pill. There may also be a small increase in the extremely rare case that a person becomes pregnant while using the contraceptive implant.
All methods of contraception can be used by people who have had a past ectopic pregnancy.
Other early symptoms of ectopic pregnancy can include:
If you have any symptoms of ectopic pregnancy, you should seek medical care as soon as possible. Your doctor, nurse or midwife usually takes a medical and sexual health history. You will have the opportunity to ask questions and be given any information you may need. What you discuss will be kept confidential.
The doctor or nurse will then explain what tests are recommended. In most cases ectopic pregnancy can be diagnosed by:
Sometimes a laparoscopy may be required. This is when a small incision (opening) is made in the pelvic area (lower belly) and a small laparoscope (camera on a flexible tube) is inserted to view the fallopian tube. Laparoscopy is done under sedation.
Some cases of ectopic pregnancy are diagnosed in a hospital emergency clinic after the fallopian tube has ruptured.
An ectopic pregnancy cannot continue as the embryo will not develop and it is unsafe for the pregnant person. Treatment for ectopic pregnancy depends on the location of the pregnancy in the body and the stage (length) of pregnancy.
Sometimes an ectopic pregnancy will shrink on its own and miscarry.
In other cases, if the fallopian tube has not ruptured and the pregnancy is early, an injection of a medication (methotrexate) can be used to stop the pregnancy from growing. After the injection, the pregnancy cells will be absorbed by the body.
Sometimes laparoscopic surgery is needed to view and remove the ectopic pregnancy and repair any damage to the fallopian tube. In some cases, the fallopian tube will need to be removed.
A ruptured fallopian tube is a medical emergency. In this case immediate laparoscopic surgery is required. Occasionally larger surgery and a blood transfusion are required.
Most people who have had an ectopic pregnancy can become pregnant again, but will need careful monitoring, as their risk of ectopic pregnancy is higher.
Many cases of ectopic pregnancy are caused by damage, scarring or blockage to the fallopian tubes. Ways to reduce this risk include:
For more information on STI and BBV testing at Sexual Health Victoria see our clinics or you can book an appointment online.
Although predicting and preventing ectopic pregnancy is not possible, prenatal (pregnancy) health care in early pregnancy considerably reduces the number of complications from ectopic pregnancy. If you think you may be pregnant, it is recommended you see a doctor or nurse as soon as possible.
People at high risk of ectopic pregnancy should be offered closer monitoring during early pregnancy. This may include additional clinic visits, blood tests and/or ultrasound tests.
It is important to tell your doctor, nurse or midwife if your medical history includes any of the known risk factors for ectopic pregnancy. You should also see your doctor nurse or midwife immediately if you have unusual pregnancy symptoms such as cramping, pain or vaginal bleeding.
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