Ectopic Pregnancy: Risks, Symptoms, Diagnosis

Pregnancy occurs when the fertilised egg, resulting from the union of an egg and sperm, successfully implants itself into the uterus. However, various complications could occur when it comes to pregnancy, one of them being an ectopic pregnancy.

What is an ectopic pregnancy?

The term “ectopic pregnancy” derives from the Greek word “ektopas,” which translates to “out of place.”

In a normal pregnancy, the fertilised egg migrates from the fallopian tube to the uterus, where it implants and continues growing. However, in some cases, this process is disrupted, and the fertilised egg implants and begins developing outside the uterus, resulting in an ectopic pregnancy.

Most ectopic pregnancies develop in the fallopian tubes, which is referred to as a tubal pregnancy. Ectopic pregnancy is typically caused by damaged fallopian tubes, which ultimately prevent the fertilised egg from traveling to the uterus.

What are the risk factors of an ectopic pregnancy?

About half of the women who have had an ectopic pregnancy did not have known risk factors.

Some of the common risk factors for ectopic pregnancy include:

• Previous ectopic pregnancy
• Previous fallopian tube or tubal surgery
• Previous pelvic or abdominal surgery
• Structural abnormalities such as scarring of the fallopian tubes from a previous medical condition, infection, or surgery
• Abnormalities present since birth in the fallopian tubes
• Certain sexually transmitted infections (STIs)
• Pelvic inflammatory disease (PID)

Other factors that may increase a woman’s risk of ectopic pregnancy include:

• Older than 35 years old
• History of infertility
• Undergoing fertility treatments such as assisted reproductive technology or in-vitro fertilisation (IVF)
• Smoking

What are the symptoms of an ectopic pregnancy?

Women who are sexually active should be aware of changes in their bodies, especially if they experience symptoms of an ectopic pregnancy.

Some women do not experience symptoms, some may experience a few symptoms, while others may experience many symptoms.

The symptoms of an ectopic pregnancy may include:

• Pain in your lower abdomen that develops suddenly for no apparent reason or may come on gradually over several days. It may be on one side only.
• Spotting or vaginal bleeding that is different from your normal period. The bleeding may be lighter or heavier or darker than normal.
• Pain at the tip of your shoulder caused by blood leaking into the abdomen is a sign that the condition is getting worse. This pain is there all the time and may be worse when you are lying down. It is not helped by movement and may not be relieved by painkillers. You should seek urgent medical advice if you experience this type of pain.
• Upset tummy such as having diarrhoea or pain during bowel movement.
• Severe abdominal pain may develop if the affected fallopian tube bursts or ruptures and causes internal bleeding. In rare instances, collapsing may be the very first sign of an ectopic pregnancy. This is a medical emergency, and you should seek urgent medical attention.

When do ectopic pregnancy symptoms start?

Most women experience physical symptoms in the sixth week of pregnancy (about 2 weeks after a missed period). You may or may not be aware that you are pregnant if your periods are irregular, or if the contraception you are using has failed.

Due to the wide variation of symptoms, diagnosing an ectopic pregnancy may not be straightforward.

How is an ectopic pregnancy diagnosed?

Diagnosis of an ectopic pregnancy will be made based on the following:

• Consultation and physical examination: Your doctor will ask about your medical history and symptoms and will examine your abdomen.
• Urine pregnancy test: This test will be done to find out whether you are pregnant.
• Transvaginal ultrasound: This scan will be done to check your uterus, ovaries, and fallopian tubes to evaluate your condition.
• Blood tests: A test for the level of the pregnancy hormone βhCG (beta human chorionic gonadotrophin) or a test every few days to look for changes in the level of this hormone may help to give a diagnosis. This is usually checked every 48 hours because, with a pregnancy in the uterus, the hormone level rises by 63% every 48 hours (known as the ‘doubling time’) whereas, with ectopic pregnancies, the levels are usually lower and rise more slowly or stay the same.

Book an appointment at Pantai Hospitals

Each pregnancy is unique. Regular prenatal appointments and open communication with your doctor are crucial for monitoring your health and addressing any concerns throughout pregnancy.

A dedicated and expert team of obstetricians and gynaecologists at Pantai Hospital is available for consultation to provide patients with the best care and assistance. Get in touch with us to book an appointment today if you have any concerns or questions about an ectopic pregnancy.

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.