Ectopic Pregnancy

Diagnosis

To diagnose an ectopic pregnancy, your healthcare professional will perform a combination of physical exams, blood tests, and imaging studies.

A pelvic exam can help identify tenderness, pain, or a mass near the ovaries or fallopian tubes, but it alone cannot confirm an ectopic pregnancy. Additional tests are needed to make a definitive diagnosis.

• Pregnancy test (HCG blood test): This test measures the level of human chorionic gonadotropin (HCG), a hormone produced during pregnancy. The test may be repeated every few days to monitor changes in HCG levels. Slower-than-expected increases may suggest an ectopic pregnancy.

• Ultrasound:

  • Transvaginal ultrasound provides a detailed image of the uterus, ovaries, and fallopian tubes using a wandlike device inserted into the vagina. It helps locate the pregnancy and detect if the fertilized egg is outside the uterus.

  • Abdominal ultrasound may also be used to evaluate internal bleeding or confirm pregnancy.

• Other blood tests: A complete blood count (CBC) helps identify anemia or internal bleeding. Blood typing may also be done in case a transfusion becomes necessary.

Treatment

Because an ectopic pregnancy cannot develop normally outside the uterus, treatment is required to prevent serious complications. The approach depends on the pregnancy’s stage, your symptoms, and overall health.

• Medication:
  For early, uncomplicated cases, the medicine methotrexate is often used. It stops the growth of rapidly dividing cells and helps the body absorb the pregnancy tissue naturally. Methotrexate is given as an injection, and blood HCG levels are monitored afterward to confirm the treatment’s success.

• Laparoscopic procedures:
  These minimally invasive surgeries treat ectopic pregnancies located in the fallopian tube.

  • Salpingostomy: The ectopic tissue is removed while preserving the fallopian tube.

  • Salpingectomy: Both the ectopic tissue and the affected fallopian tube are removed.
    The choice depends on bleeding severity, tube damage, and whether the other fallopian tube is healthy.

• Emergency surgery:
  If the ectopic pregnancy causes heavy bleeding or rupture, immediate surgery is required. This may be done laparoscopically or through a larger abdominal incision (laparotomy). In most cases, the damaged fallopian tube must be removed to prevent further complications.

Recovery and follow-up

After treatment, follow-up care includes regular monitoring of HCG levels until they return to zero, ensuring all pregnancy tissue has been removed. Physical recovery usually takes a few weeks, but emotional recovery may take longer.

Your healthcare professional may recommend waiting for several months before trying to conceive again, depending on the treatment method and your body’s healing process.

Future pregnancies should be monitored closely, as a history of ectopic pregnancy increases the risk of recurrence.