What is Ectopic Pregnancy?

Ectopic pregnancy occurs when a pregnancy implants outside of the womb. The commonest location of an ectopic pregnancy is the fallopian tube.

How common is ectopic pregnancy?

In the general population, the risk of ectopic pregnancy is 1 to 2%.

What are my options for treatment?

There are three options of treatment for ectopic pregnancy.

These include : 1) Conservative  2) Medical and 3) Surgical.

The medical option involves the use of Methotrexate, a chemotherapeutic agent. Women who are treated with methotrexate or who are managed conservatively will require close monitoring and follow up with regular blood tests and/or pelvic ultrasound.

What are the chances of it happening again?

Once you have had an ectopic pregnancy, your risk of having another ectopic pregnancy is increased. The risk of having another ectopic pregnancy is increased to 10%.

What are my chances of having a normal pregnancy after an ectopic pregnancy?

Overall, the chance of having a normal pregnancy is up to 80%. Once a viable pregnancy is confirmed within the womb, your chance of carrying the pregnancy to term is as good as anyone else’s. Your risk of ectopic pregnancy does not make your pregnancy, labour or delivery any more complicated.

When will I stop bleeding?

Bleeding following an ectopic pregnancy is normal. It is caused by the shedding of the lining of the womb. This should last no more than the duration of a period. It is however possible that your bleeding may go on a little longer than usual. If you are concerned for any reason then please see your doctor.

When can I try again for another pregnancy?

There is no good evidence to suggest that getting pregnant too early puts you at a greater risk for another ectopic pregnancy. If your ectopic was treated with Methotrexate, it is advisable to wait at least three months because this chemotherapeutic agent is known to harm the growing baby during its early stages of development. It is therefore advisable to use a secure form of contraception while you wait.

I had a salpingostomy, what does it mean?

A salpingostomy is where a small cut is made on the fallopian tube and the ectopic pregnancy is removed through this cut. None of the fallopian tube is removed, and the defect is left open to heal. This procedure is recommended if the other tube is abnormal.

When I had my operation the whole of the left tube was removed. What does it mean?

In most places, surgery for ectopic pregnancy involves removing the whole of the affected tube through keyhole surgery.

Because my ectopic pregnancy had burst, I had an abdominal operation rather than keyhole surgery. Would this affect my chance of becoming pregnant again?

Laparoscopic ‘key hole’ surgery has the benefit of a smaller incision on the abdomen, and a shorter hospital stay, plus, quicker recovery time and return to work. There is no evidence that either operation is superior in terms of subsequent pregnancy rates.

When will my periods return?

If you had normal periods before you got pregnant then you can expect to have your periods returned in 4 to 6 weeks. If you had irregular periods before you were pregnant then this may vary. If you are planning another pregnancy and your periods have not returned in this time then you should see your doctor.

What if I am Rhesus negative?

If you have a Rhesus negative blood group, then you should have anti-D given. This should be within 3 days of treatment, as an intramuscular injection. If you are not sure of your blood group, you should ask the doctors treating you. Your blood group is checked routinely when managing an ectopic pregnancy.

Is there anything I can do to prevent another ectopic pregnancy?

There is nothing you can do to prevent another ectopic pregnancy. No known medication is of proven benefit, neither is removing your tubes. The best thing you can do is to avoid falling pregnant by using contraceptives. You can also reduce your risk of pelvic infections by using a condom. If you do get pregnant it is important to remember that you are at an increased risk of having another ectopic pregnancy, therefore an early assessment is important to locate the pregnancy.

What should I do if the pregnancy test is positive?

It is very important that you seek medical advice at about 5 weeks. You can do this by visiting your doctor. He may refer you to an early pregnancy assessment unit for a special ultrasound scan.

Is there an accessible early pregnancy assessment service in Canberra?

JUNIC Specialist Imaging and Women’s Centre provides a community based early pregnancy assessment service (EPAS). This service was developed to assist women in Canberra manage the complications that could be associated with early (first trimester) pregnancy.