Ectopic pregnancy occurs when the embryo implants outside the endometrial tissue of the uterus. Many women with ectopic pregnancy have little to no symptoms. In virtually all ectopic pregnancies, the fetus rarely survives past the first trimester.
The risk factors for ectopic pregnancy include tobacco smoking (decreases tubal motility), pelvic inflammatory disease, history of infertility (≥ two years), prior tubal surgery, and use of assisted reproductive technology. Women with a previous history of ectopic pregnancy also have an increased likelihood (10-25%) of another ectopic pregnancy.
More than 90 percent of ectopic pregnancies occur in the fallopian tube. Other sites include the ovaries, cervix, and abdomen. It can be confirmed through blood tests and ultrasound. Prevention of ectopic pregnancy is to decrease modifiable risk factors. Management usually involves surgery and the use of specific medications. Ectopic pregnancy has been estimated to occur in about 1 to 2 percent of live births and can be as high as 4 percent in patients using assisted reproductive technology.
Symptom #1: Pain
Pain is caused by damaging stimuli and results in distress. It is unpleasant both emotionally and physically, and can be associated with potential tissue damage. Pain is the commonest reason for people to seek medical attention.
In ectopic pregnancy, patients may present with abdominal or pelvic tenderness. This refers to the pain or discomfort that a patient can experience when the affected area is touched. In most of these patients, it can be unilateral or bilateral, and it is usually much worse on the affected side. Some patients may also report shoulder tip pain if the pregnancy is causing internal bleeding in the peritoneal cavity. Furthermore, some patients don’t experience severe pain despite internal bleeding, but may only report mild discomfort or diarrhea. However, without timely diagnosis a ruptured ectopic can be a surgical emergency. It can present with severe abdominal or pelvic pain, abdominal rigidity, severe tenderness, as well as signs of hypovolemic shock (i.e. increased heart rate and respiratory rate). Hypovolemic shock is a life-threatening condition that results in multiple organ failure due to rapid fluid loss (i.e. internal hemorrhage) and subsequent inadequate perfusion of tissues.