Ectopic Pregnancy (Extrauterine Pregnancy)

Rock the Baby Bump is proud to talk about all kinds of things about trying to conceive, pregnancy and being an LGBTQ+ parent…and sometimes that includes posts like this, on subjects that are difficult to talk about.

If you’ve found your way to this page, first let me say – I’m sending you all kinds of positivity and warmth, because I can imagine the kind of stress you’re going through. I hope this information helps you arm yourself with the knowledge you need to find peace, no matter your outcome.

Now, onto the information you were looking for…let’s talk about ectopic pregnancy and HcG levels.

What is an Ectopic Pregnancy?

For a pregnancy to be successful, many things need to happen. One of the first is the fertilized egg needs to implant in the right place – the inner lining of the uterus.

If a fertilized egg implants elsewhere, it’s an ectopic pregnancy.

Ectopic pregnancies commonly form in the fallopian tubes and can also attach to the abdominal cavity or cervix.

A fertilized egg can’t grow properly unless it implants in the inner lining of the uterus. And by this logic, this means that an ectopic pregnancy is not viable, and will not result in a live birth.

HcG levels in Ectopic Pregnancies

Human Chorionic Gonadotropin (hCG) is known as the pregnancy hormone.

This hormone is produced by the placenta as soon as a fertilized egg implants. An important thing to note is that HcG is produced no matter where a fertilized egg implants.

Home pregnancy tests (HPTs) estimate the amount of hCG in your urine, and use a cut-off amount to determine if you’re pregnant or not pregnant.

Home pregnancy tests will show “pregnant” no matter where the fertilized egg implants, if you have enough hcg (pregnancy hormone) in your system.

HPTs are becoming more and more sensitive to allow testing earlier and earlier.
However, this also means HPTs are more likely to detect hCG from ectopic pregnancies.

Below is a quick little animation of what an ectopic pregnancy is…

 

Signs of an Ectopic Pregnancy 

Ectopic pregnancies occur at a rate of 1–2% of pregnancies for white women in the United States.
The rates are higher for non-white women (in the US), averaging 3%.

Usually (over 85% of the time), ectopic pregnancies don’t occur in a first pregnancy – although anything can happen.

Some things increase your risk of ectopic pregnancy:

• Mom is advanced maternal age – 35 years old or older
• Previous pelvic or abdominal surgery
• Previous inflammation or scarring of the fallopian tubes
• History of endometriosis
• Previous multiple abortions
• Previous history of PID (pelvic inflammatory disease)
• Conception that occurred despite IUD (intrauterine device) or tubal ligation
• Genetic abnormalities or birth defects of the reproductive system
• Conception aided by reproductive technology, such as fertility drugs or procedures
• Smoking
• Previous history of ectopic pregnancy
• History of STD (sexually transmitted disease), such as gonorrhea or chlamydia

Monica from Pregnancy Chat talks in the video below about signs and symptoms of an ectopic pregnancy – as well as her experience with a ruptured ectopic pregnancy that could have cost her her life.

 

How Do I Know If My Pregnancy is Ectopic?

Symptoms of ectopic pregnancy can appear early, but vary from woman to woman.

Although it’s not always easy to tell, there may be some red flags that can prepare you for getting the news of an ectopic pregnancy.

What Does an Ectopic Pregnancy Feel Like?

Well, some women have no symptoms at all until an ectopic pregnancy ruptures and they experience an emergency situation.

Here is a list of possible red flags for an ectopic pregnancy…

 

• As we explained earlier, if you take a home pregnancy test, it may be positive.
  And just like a typical pregnancy, you may miss your period or have tender breasts, fatigue or nausea.

 

• You  might experience severe abdominal or shoulder pain.
  Many women with ectopic pregnancy experience sharp waves of pain in the abdomen, shoulder, pelvis or neck.
  You may find it worsens with activity or while going to the bathroom.
  You might also have tenderness or pain in side.

 

• There may be some spotting or bleeding after a positive home pregnancy test.
  You might experience light spotting or a heavier flow that is not menstrual flow.
  The blood may look dark brown or red.

 

• If your fallopian tube ruptured with the ectopic pregnancy, you may experience signs of shock which can include:
  Fast, racing pulse, dizziness, fainting and/or clammy skin.

If you experience any of these symptoms, call your doctor or 911, or go to an emergency room!
It’s important to take any painful symptoms seriously (as ectopic pregnancies can rupture and cause an emergency situation for the mother.)

Diagnosis of Ectopic Pregnancy

If you or your doctor suspects an ectopic pregnancy he or she may order additional tests, and this can include a transvaginal ultrasound.

Transvaginal ultrasound is a special ultrasound used very early in pregnancy to locate a gestational sac in the uterus.
Transvaginal ultrasounds use wands inserted directly into the vagina.

Don’t worry, it’s less uncomfortable than a speculum, and most techs are very gentle.

If the doctor finds a sac in the uterus, ectopic pregnancy can be ruled out for that gestational sac.

You may also need a quantitative blood test, which determines the level of hCG and progesterone in your blood. Both hormones are present during pregnancy, and the amount of hCG increases directly with pregnancy in the beginning.

For healthy pregnancies, the amount of hCG should consistently increase over the first few weeks. In the beginning it should double every two to three days.

If your hCG is not increasing enough, or is decreasing, it might be a sign of ectopic pregnancy.

Remember, you might not have time for any of these tests if you have an emergency situation. Ectopic pregnancies cause approximately 40 maternal deaths each year in the US. It’s a very serious condition, so listen to your doctors and pursue treatment.

Treatment for Ectopic Pregnancies

Once your doctor has confirmed an ectopic pregnancy, what happens next depends on how dangerous the situation is for mom, and the location of the ectopic pregnancy.

What needs to happen?
The fertilized egg has to be removed to ensure the mother’s safety.

This can be done in a few different ways, and we’ll go through a few scenarios below.

Methotrexate for Ectopic Pregnancy

What Will Happen:
Your doctor may decide to prescribe a medication that can keep the ectopic mass from bursting.
A standard treatment medication may include methotrexate.

Methotrexate stops the growth of the ectopic mass.

It is given as an injection.
Regular quantitative hCG blood tests will be required to ensure the medication worked.

How It Works:
When it works, it causes symptoms similar to a miscarriage: cramping, bleeding and passing of tissue.

You will not be able to become pregnancy again for a few months after taking the medication.

This medication has less risks than surgery, which is another treatment option.

If you’re interested in learning more about methotrexate for ectopic pregnancy, Kelsey shares her experience in the video below.

 

Surgery for Ectopic Pregnancy

What Will Happen:

Surgery carries more risk than medication, in the form of risk of damage to the fallopian tubes and damage to long-term fertility.

If required your doctor may perform a laparotomy (tiny incision) to remove the embryo and repair any damage to the fallopian tube.

If there is severe damage to the fallopian tube, it may need to be removed.

While these treatment options can sound really frightening, an important thing to remind yourself is that the earlier an ectopic pregnancy ends, the less damage to the mother’s body.

Listen to your healthcare provider, and pursue treatment to ensure your long-term health and fertility.

For some information from someone who has had an ectopic pregnancy and went through surgery to rectify it, watch the video below.

 

After Diagnosis and Treatment of Ectopic Pregnancy…What Now?

Any loss of pregnancy is devastating.
How do you heal, how do you move forward?

Sometimes it seems impossible, because this involves grieving the loss of the pregnancy and potential baby, and dealing with any outcomes from the ectopic pregnancy.

You may be frightened, scared and concerned.
You may be recovering from major surgery.

You’re probably physical and mentally exhausted and emotionally wrecked.
You may be suffering a hormonal roller-coaster, which makes you feel depressed or alone.

Please understand this: you are not alone.

You will get better and your body will heal.

Your heart will heal, although you will always remember your lost little one.

Some of the most important ways to cope with an ectopic pregnancy loss…

• Take the time you need to recuperate.
  Be kind with yourself and know your limits. You’ve just gone through something you and only you can understand – and because of that, you need to allow yourself time, space and energy to heal and cope in the ways you think best. Whether it’s taking some time from work, pausing your current conception trials for a few months or taking a family vacation – give yourself permission to recuperate in whatever ways work.

 

• Talk to your significant other and explain how you feel.
  Although you are the mother and physically/emotionally/hormonally you’ve been through this ordeal – please don’t forget your partner. Emotionally invested into this life you had created together, your partner may be grieving that loss too. Support each other, talk to each other – share your fears and your doubts and your tears, and heal together as a couple.

 

• Share your pain with those you love.
  While it’s really easy to close yourself off and isolate yourself, this can actually make it harder as you could get buried in your pain. Reach out but more importantly, accept help from loved ones when they offer it. Whether it’s a friend coming over to cook you dinner or your husband offering to take you away for a weekend – accept the help and know there are people who are ready to pull you back up onto your feet when you’re ready.

 

• Share your pain with strangers in a support group.
  Sometimes you need an outside ear, a sympathetic hug from another woman who has been through what you have or just a community of people who understand that you will need time to heal – support groups exist for a reason! Both in person and online, there is strength in community and with the right community, you can find your way back to a good place.

If you’ve been talking with your significant other, friends or family and still feeling like you can’t move on (or start trying to conceive again), you may want to talk to a specialist. If you don’t know a good therapist or counselor, ask friends or your doctor for a referral.

Its normal to be emotionally invested in our pregnancies, and losing one – no matter how early – is terribly hard.

Take heart knowing you are not alone in the struggle. Take care of yourself and be kind to yourself as you heal.
And please, please – reach out in the comments below or send us an email if you’re struggling…our baby bump rocking community will have your back.