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  • Michael Frey, MD

Ectopic Pregnancy

A pregnancy outside the uterus - usually in the fallopian tube.

Risk factors

  • Birth defect in the fallopian tubes

  • Scarring after a ruptured appendix

  • Endometriosis

  • Having had an ectopic pregnancy in the past

  • Scarring from past infections or surgery of the female organs

  • Age over 35

  • Getting pregnant while having an intrauterine device (IUD)

  • Having your tubes tied

  • Having had surgery to untie tubes to become pregnant

  • Having had many sexual partners

  • Sexually transmitted infections (STI)

  • Some infertility treatments


  • Abnormal vaginal bleeding

  • Mild cramping on one side of the pelvis

  • No periods

  • Pain in the lower belly or pelvic area

If the area around the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include:

  • Fainting or feeling faint

  • Intense pressure in the rectum

  • Low blood pressure

  • Pain in the shoulder area

  • Severe, sharp, and sudden pain in the lower abdomen

Exams and Tests A pregnancy test and vaginal ultrasound will be done. Human chorionic gonadotropin (hCG) is a hormone that is produced during pregnancy. Checking the blood level of this hormone can detect pregnancy.

  • When hCG levels are above a certain value, a pregnancy sac in the uterus should be seen with ultrasound.

  • If the sac is not seen, this may indicate that an ectopic pregnancy is present.

Treatment Ectopic pregnancy is life-threatening. The pregnancy cannot continue to birth (term). The developing cells must be removed to save the mother's life. If the ectopic pregnancy has not ruptured, treatment may include:

  • Surgery

  • Medicine that ends the pregnancy

You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to bleeding and shock. If there is a rupture, surgery is done to stop blood loss and remove the pregnancy. In some cases, the doctor may have to remove the fallopian tube.

Outlook (Prognosis) One out of three women who have had one ectopic pregnancy can have a baby in the future. Another ectopic pregnancy is more likely to occur. Some women do not become pregnant again.

The likelihood of a successful pregnancy after an ectopic pregnancy depends on:

  • The woman's age

  • Whether she has already had children

  • Why the first ectopic pregnancy occurred


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