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In a normal pregnancy, the fertilized egg enters the uterus and settles into the uterine lining where it has plenty of room to divide and grow. An ectopic pregnancy occurs when the fertilized egg attaches itself in a place other than inside the uterus. About 1% of pregnancies is in an ectopic location with implantation not occurring inside of the womb, and of these 98% occurs in the Fallopian tubes, thus sometimes called tubal pregnancies. The fallopian tubes are not designed to hold a growing embryo; the fertilized egg in a tubal pregnancy cannot develop normally and must be treated. An ectopic pregnancy happens in 1 out of 60 pregnancies.

Ectopic pregnancies are caused by one or more of the following:

• An infection or inflammation of the fallopian tube can cause it to become partially or entirely blocked.

• Scar tissue left behind from a previous infection or an operation on the tube may also impede the egg’s movement.

• Previous surgery in the pelvic area or on the tubes can cause adhesions.

• An abnormality in the tube’s shape can be caused by abnormal growths or a birth defect.

The risk of ectopic pregnancy is highest for women who are between 35 and 44 years old and have had PID (Pelvic Inflammatory Disease), a previous ectopic pregnancy, surgery on a fallopian tube and infertility problems or medication to stimulate ovulation.

Ectopic pregnancy can be difficult to diagnose because symptoms often mirror those of a normal early pregnancy. These can include missed periods, breast tenderness, nausea, vomiting, or frequent urination. Other symptoms are:

• Sharp or stabbing pain that may come and go and vary in intensity. The pain may be in the pelvis, abdomen or even the shoulder and neck (due to blood from a ruptured ectopic pregnancy gathering up under the diaphragm).

• Vaginal bleeding, heavier or lighter than your normal period

• Gastrointestinal symptoms

• Weakness, dizziness, or fainting

If these symptoms happen to you, you should consult it with your doctor in order to get early treatment. Doctor will decide the best treatment for you. The following are the treatment which you may have:

• Methotrexate, which allows the body to absorb the pregnancy tissue and may save the fallopian tube, depending on how far the pregnancy has developed.

• If the tube has become stretched or it has ruptured and started bleeding, all or part of the fallopian tube may have to be removed. Bleeding needs to be stopped promptly and emergency surgery is needed.

• Laparoscopic surgery under general anesthesia may be performed. This procedure involves a surgeon using a laparoscope to remove the ectopic pregnancy and repair or remove the affected fallopian tube. If the ectopic pregnancy cannot be removed by a laparoscope procedure, then another surgical procedure called a laparotomy may be done.

The most common complication if you have an ectopic pregnancy is rupture with internal bleeding that leads to shock. Death from rupture is rare. Infertility occurs in 10 - 15% of women who have had an ectopic pregnancy.

The chances of having a successful pregnancy after an ectopic pregnancy may be lower than normal, but this will depend on why the pregnancy was ectopic and your medical history. Approximately 30% of women who have had ectopic pregnancies will have difficulty becoming pregnant again. Your prognosis depends mainly on the extent of the damage and the surgery that was done. If the fallopian tubes have been left in place, you have approximately a 60% chance of having a successful pregnancy in the future.

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