Ectopic pregnancy: All you need to know

1 to 2% of pregnancies are ectopic pregnancies, and yet there is not enough information and awareness about this issue. Therefore, I will answer the most frequently asked questions on Ectopic pregnancy in this article.

Cherifa Sharaf
Published on:Jun 7th 2022 |Updated on:Apr 10th 2024
الحمل خارج الرحم

What is an ectopic pregnancy?

Pregnancy happens when the sperm fertilized the egg inside the fallopian tube, after which the embryo travels up to the uterus, in a 5 to 6 days journey. In 98% of ectopic pregnancies, the embryo stays inside the fallopian tube, which is not fit to host a fetus.

When is an ectopic pregnancy discovered?

Delays in discovering this type of pregnancy were one of the main reasons behind pregnancy-related deaths in the past. But today it is different, as the pregnancy can be found out early on before even a missed period, with the help of blood tests.

A vaginal ultrasound in the fifth week of pregnancy can find out whether the pregnancy is ectopic. It is worth mentioning that vaginal ultrasounds are perfectly safe in the first weeks of pregnancy. A red flag is raised If the pregnancy sack is not visible during this ultrasound. Therefore, I advise all pregnant women to see their OBGYN immediately after finding out that they are pregnant. Start prenatal care early, to avoid any complications from potential risks.

If the sack is not visible, we test hCG Levels, if the results are between 1000 and 2000, then there must be a pregnancy sack, it is just not visible. In this case, we repeat the test, while letting the expecting mother know the severity of the situation. And indicate that she should hear to the emergency room in case she has cramps or any other serious symptoms. If the hCG Levels continue to increase, there is a possibility that the pregnancy calculation is wrong. The test is repeated every 48 hours, along with the ultrasound. If the results double in number, then the pregnancy is healthy, but if there is only a slight increase in hCG Levels, this could indicate an ectopic pregnancy.

Risk factors

- Infections in the fallopian tubes are caused by certain STDs like Chlamydia.

- A previous surgery in the tubes.

- Smoking, affects the movement of the tubes, increasing the chances of ectopic pregnancies.

- A previous ectopic pregnancy.

Ectopic pregnancy symptoms

It is noteworthy that early prenatal care visits are essential and more important than waiting for the symptoms to appear.

- Severe abdominal pain.

- Light spotting.

- Fainting.

Treatment of ectopic pregnancies

After the ectopic pregnancy is confirmed, it can be terminated through medication under these conditions.

- No fetal heartbeat.

- hCG Levels higher than 5000.

- That the pregnancy sack is smaller than 3 or 4 centimeters.

- That the mother is healthy enough to receive the medication.

These injections are similar to chemotherapy, and they stop fetal growth. After it is administered, we continue to monitor the hCG Levels to make sure they decline. The other option is surgery either laparoscopic or regular in case there is bleeding or any other complications. In this surgery, the sack is extracted, and the tube is left to heal on its own. In case the sack explodes, or there is a severe bleed the tube is extracted. It is worth mentioning that the extraction of the tube will not affect any future chances of pregnancy.

Finally, normal pregnancy is possible following an ectopic pregnancy, especially if there are no complications, and the course of treatment was sound.

Also read Everything you need to know about miscarriage


Cherifa SharafObstetrics & Gynecology Consultant

Consultant of obstetrics, gynecology & Infertility, with years of experience in women’s healthcare. Dr.Cherifa is practicing at Qasr El Eyni Hospital/ Cairo University in addition to several other hospitals and centers in Cairo Egypt. She holds a Ph.D. in medicine from Cairo University in addition to the European Diploma of Operative Gynecology from Clermont-Ferrand, France, and Diploma of Management of Infertility from Antoine Béclère Faculty of Medicine Paris, France. Dr. Cherifa is very passionate about providing the appropriate health care to women and believes the overall health of a woman is key to her reproductive and maternal health. She is a strong believer in the importance of raising women’s awareness and educating them about everything related to health in general and reproductive health in particular.

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