Introduction

An ectopic pregnancy is when a fertilised egg implants itself outside of the womb, usually in one of the fallopian tubes.

The fallopian tubes are the tubes connecting the ovaries to the womb. If an egg gets stuck in them, it won't develop into ababy and your health may be at risk if the pregnancy continues.

Unfortunately, it's not possible to save the pregnancy. It usually has to be removed using medicine or an operation.

In the UK, around 1 in every 80-90 pregnancies is ectopic. This is around 12,000 pregnancies a year.

This page covers:

Ectopic pregnancy Symptoms of an ectopic pregnancy

When to get medical advice

When to get emergency help

How an ectopic pregnancy is treated

Help and support after an ectopic pregnancy

Trying for another baby

What can cause an ectopic pregnancy?

Symptoms  of an ectopic pregnancy

An ectopic pregnancy doesn't always cause symptoms and may only be detected during a routine pregnancy scan.

If you do have symptoms, they tend to develop between the 4th and 12th week of pregnancy.

Symptoms can include a combination of:

• a missed period and other signs of pregnancy
• tummy pain  low down on one side
• vaginal bleeding or a brown watery discharge
• pain in the tip of your shoulder
• discomfort when peeing or pooing

However, these symptoms aren't necessarily a sign of a serious problem. They can sometimes be caused by other problems, such as a stomach bug .

This is very serious and surgery to repair the fallopian tube needs to be carried out as soon as possible.

A rupture can be life-threatening, but fortunately they're uncommon and treatable, if dealt with quickly. Deaths from ruptures are extremely rare in the UK.

How an ectopic pregnancy is treated

There are three main treatments for an ectopic pregnancy:

• expectant management you're carefully monitored and one of the treatments below is used if the fertilised egg doesn't dissolve by itself
• medication an injection of a powerful medicine called methotrexate is used to stop the pregnancygrowing
• surgery keyhole surgery (laparoscopy) performed under general anaesthetic is used to remove the fertilised egg,usually along with the affected fallopian tube

You'll be toldabout the benefits and risks of each option. In many cases,a particular treatment will be recommended based on your symptoms and the results of the tests you have.

Some treatments may reduce your chances of being able to conceive naturally in the future, although most women will still be able to get pregnant (see below). Talk to your doctor about this.

It's not uncommon for these feelings to last several months, although they usually improve with time. Make sure you give yourself and your partner time to grieve.

If you or your partner are struggling to come to terms with your loss, you may benefit from professional support or counselling . Speak to your GP about this.

Support groups for people who have been affected by loss of a pregnancy can also help. These include:

• The Ectopic Pregnancy Trust
• The  Ectopic Pregnancy Foundation
• The Miscarriage Association
• Cruse Bereavement Care

If you were treated with methotrexate, it's usually recommended that you wait at least three months, because the medicine could harm your baby if you become pregnant during this time.

Most women who have had an ectopic pregnancy will be able to get pregnant again, even if they've had a fallopian tube removed. Overall, 65% of women achieve a successful pregnancy within 18 months of an ectopic pregnancy. Occasionally, it may be necessary to use fertility treatment such as IVF .

The chances of having another ectopic pregnancy are higher if you've had one before, but the risk is still small (around 10%).

If you do become pregnant again, it's a good idea to let your GP know as soon as possible, so early scans can be carried out to check everything's OK.

What  can cause an ectopic pregnancy?

In many cases, it's not clear why a woman has an ectopic pregnancy. Sometimes it happens when there's a problem with the fallopian tubes, such as them being narrow or blocked.

The following are all associated with an increased risk of ectopic pregnancy:

• pelvic inflammatory disease(PID) inflammation of the female reproductive system, usually caused by a sexually transmitted infection (STI)
• previous ectopic pregnancy the risk of having another ectopic pregnancy is around 10%
• previous surgery on your fallopian tubes such as an unsuccessful  female sterilisation procedure
• fertility treatment, such as IVF taking medication to stimulate ovulation (the release of an egg) can increase the risk of ectopic pregnancy
• becomingpregnant while using an intrauterine device (IUD) or intrauterine system (IUS) for contraception it's rare to get pregnant while using these, but if you do you're more likely to have an ectopic pregnancy
• smoking
• increasing age the risk is highest for pregnant women who are aged 35-40

You can't always prevent an ectopic pregnancy, but you can reduce your risk by using a condom when not trying for a baby, to protect yourself from STIs, and by stopping smoking .

Cervix

The cervix is at the lower end of the womb. It connects the womb with the vagina.

Fallopian tubes

Fallopian tubes (also called oviducts or uterine tubes) are the two tubes that connect the uterus to the ovaries in the female reproductive system.

Ovaries

Ovaries are the pair of reproductive organs that produce eggs and sex hormones in females.