It is an amazing thing: the ovaries produce an egg each month, and that egg travels down the fallopian tubes to the uterus, where it waits for its prince in shining armor (sperm,) to arrive with its flapping tail and pierce its outer shell. The egg waits in its warm cushy, blood rich environment (the uterus,) because it is exactly the place it is supposed to implant itself once fertilization takes place. But what happens if the egg is too slow getting to the uterus, or looses its way and ends up somewhere other than the uterus?
A fertilized egg that implant outside of the uterus is called an ectopic pregnancy, (ectopic means “out of place”.) While only 1% of pregnancies end up outside of the uterus, 95% end up in the fallopian tubes, (which is why you may also hear the term “tubal pregnancy”.) The fertilized egg can also implant in other parts of the reproductive system, such as the cervix, the ovary, or the abdominal cavity.
Different factors can contribute to the egg’s implantation in other parts of the reproductive track: the egg may not have been able to make its journey due to a blockage in the tube, or there may be adhesions in the tubes that slow the egg’s travel, allowing it to be fertilized before it reaches the uterus. Women with Endometriosis and Pelvic Inflammatory Disease have a higher instance of ectopic pregnancies: their medical conditions can cause inflammation and swelling in the fallopian tubes. Hormonal imbalances, environmental toxins such as smoking, and previous surgeries that may have resulted in scar tissue, can also be factors.
The body will still send all the signals that it is pregnant (positive pregnancy test, due to rising levels of hCg in the bloodstream, tender breasts, etc.) Regular pregnancy symptoms can be accompanied by mild cramping on one side or the other, pain in lower abdominal area, low back pain, and vaginal bleeding.
Although the body may attempt to maintain the pregnancy, the fetus requires a nutrient rich environment, and the proper amount of space to grow. So, although the body will proceed as if the fetus were in the proper place, the pregnancy cannot be sustained outside of the uterus. The pregnancy generally continues until the fetus grows beyond the confines of the space in which it implanted, causing a rupture of the area.
Symptoms of a rupture are faintness or actual fainting, severe sharp pain in the abdominal cavity, pressure in the rectum, or pain in the shoulder or neck area (due to blood build up from internal bleeding.) This can be a life-threatening situation, so if you experience any of these symptoms, go to the emergency room right away.
In some cases, an ectopic pregnancy is detected early on. In these cases, an injection of Methotraxate can be given to stop the progress of the pregnancy and dissolve existing cell formation. If the pregnancy has progressed too far, laparoscopic surgery may be necessary. In some cases, fertility is lost in the tube that requires surgery, and if the tube has ruptured, it must be removed.