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What Is An Ectopic Pregnancy?

What Is An Ectopic Pregnancy?

Dr Alex Eskander - The Gynae CentreAn ectopic pregnancy occurs when a fertilised egg becomes implanted on the outside of the uterus. Unfortunately, an ectopic pregnancy cannot be saved, and needs to be removed with medicine or through surgery.

We sit down with Dr Alex Eskander, one of the UK’s most esteemed obstetrician-gynaecologists and director of London’s leading women’s health clinic The Gynae Centre. He tells us about the symptoms and causes of ectopic pregnancy, how often it occurs and what the risks are.

What Are The Symptoms Of Ectopic Pregnancy?

Symptoms for ectopic pregnancy can occur from as early as four weeks into a pregnancy, to 12 weeks or later. The first symptom of ectopic pregnancy is usually mild external bleeding, combined with pain on one side of the lower abdomen. This is easily confused with causes other than ectopic pregnancy, such as a period or miscarriage.

Less commonly, sudden acute pain in the lower abdomen, dizziness and fainting can occur as symptoms. However, the most crucial symptom to be mindful of is the pain. Any unusual, severe pain with no or mild bleeding following a positive pregnancy test must be investigated without delay in order to exclude ectopic pregnancy. The severity is not to be confused with mild, colic-like pain or period-like pain, as these can be common in a normal pregnancy.

What Causes Ectopic Pregnancy?

A normal pregnancy sees fertilisation taking place in the ampulla (the outer third) of the fallopian tube. Following fertilisation, the egg slowly moves along the tube towards the uterus, a journey which takes between seven to ten days. During this time, the fertilised egg forms the trophoblast, which is capable of attaching itself to the well-prepared uterine wall, establishing connections with the mother’s circulation.

In an ectopic pregnancy, the fertilised egg is prevented from making its way down the fallopian tube. It is usually blocked by scar tissue around or inside the tube. As the trophoblast will attach itself anywhere as soon as it has developed, the blockage causes it to attach before it reaches the uterus, usually in the fallopian tubes but sometimes in the ovaries.

The fallopian tubes can only support the pregnancy for a few days, after which it will rupture or the blastocyst will separate from the tube, leading to abdominal bleeding, which can be catastrophic.

If you feel as though you may be experiencing symptoms of ectopic pregnancy and need to see a gynaecologist, we can help you find a Top Private Gynaecologist or Private Clinic or Hospital for Gynaecology Care.

How Many Women Have Ectopic Pregnancies?

In the UK, it is estimated that ectopic pregnancies make up just over 1% of pregnancies. That’s around 1 in every 90 pregnancies.

Unfortunately, any woman who becomes pregnant is at risk of experiencing an ectopic pregnancy. The cause cannot be determined, but ectopic pregnancy is more likely due to:

  • Pelvic inflammatory disease
  • Previous ectopic pregnancy
  • The mother being of an older age
  • Endometriosis
  • Surgery on the abdomen or fallopian tubes
  • Fertility treatment
  • Certain contraceptives such as the copper coil (IUCD), ‘mini pill’ (progesterone-only pill) or the ‘Morning After Pill’
  • Cigarette smoking

What Treatments Are Available For Ectopic Pregnancy?

An intact ectopic pregnancy can be treated with relatively small doses of a chemotherapy drug called Methotrexate with no or very little side effects, unlike the large doses used for treating cancer.

Acute ectopic pregnancy associated with internal bleeding must be treated as an emergency, with ambulance transfer and immediate surgery to remove the blastocyst, and sometimes the tube, and stop the bleeding.

The best way to help prevent an ectopic pregnancy is to avoid pelvic infection. You can do this by using adequate protection during sex and attending regular six-monthly screenings, unless you are in a long-term monogamous relationship.

We would like to thank The Gynae Centre for providing their specialist knowledge for this article.

The Gynae Centre

The Gynae Centre
Suite 23
Milford House
7 Queen Anne Street
London W1G 9HN

Tel: 020 7580 8090


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