Ectopic Pregnancy

If the fertilized egg (zygote) does not succeed in passing through the fallopian tube, it nests outside the uterus and in most cases in the mucous membrane of the fallopian tube (tubal pregnancy). If the embryo grows in the fallopian tube, which is not very flexible, the pregnant woman’s life is often in danger because the fallopian tube can tear (rupture) and there can be severe internal bleeding in the abdomen. This can result in circulatory failure and shock.

An ectopic pregnancy occurs in about one to two percent of all pregnancies. Until an embryo is found in the uterus, there is always the theoretical possibility of an ectopic pregnancy. This is painless for the woman in the first few weeks and is not initially detectable even with ultrasound.

A pregnancy test (e.g. Clearblue®) can be used to detect the pregnancy. There is often irregular bleeding and in the course of the pregnancy pain (usually on one side), with the abdomen becoming very sensitive to touch. If there is sudden, very strong pain in the abdomen, this can indicate a possible tubal rupture.

An immediate laparoscopy or emergency surgery with abdominal incision is necessary to remove the embryonic tissue completely from the fallopian tube and in some cases the (damaged) fallopian tube itself. However, a natural regression of the pregnancy (tubal abortion) often occurs. In this case, the embryo in the fallopian tube dies and the tissue is either absorbed or expelled with the next menstrual period.

The natural termination of the pregnancy becomes noticeable by the return of menstruation and a (previously positive and now) negative pregnancy test. If an ectopic pregnancy is detected at an early stage, a surgical procedure can be planned, whereby an attempt is made to keep the fallopian tube as such functional. After an ectopic pregnancy, a new ectopic pregnancy cannot be ruled out, in most cases the risk is even increased, as scarring in the fallopian tube can occur. The risk of an ectopic pregnancy is generally increased if

Has already been through an inflammation of the fallopian tubes,
After previous operations, in case of endometriosis (proliferation of uterine lining outside the uterus),
For artificial insemination
Or contraception with a coil (intrauterine device).