Early recognition of ectopic pregnancy -- the medical term for an embryo that implants outside the uterus -- can help prevent potentially life-threatening complications. Approximately 1.9 percent of pregnancies are ectopic, according to a November 2005 "American Family Physician" article.(ref 4) If you're in the first two months of pregnancy, when most ectopic pregnancies become symptomatic and develop any of the signs of an ectopic pregnancy, seek immediate medical evaluation.
Normal Pregnancy Symptoms
An ectopic pregnancy can produce some of the same symptoms as a pregnancy that develops in the uterus, because an ectopic pregnancy produces the same hormones, such as human chorionic gonadotropin, or hCG, progesterone and estrogen as a normal pregnancy. The levels, however, may be lower than in a normal pregnancy. Between 20 and 30 percent of women with ectopic pregnancies experience breast tenderness, dizziness or faintness or gastrointestinal symptoms common in pregnancy, according to the textbook "Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management in Early Pregnancy of Ectopic Pregnancy and Miscarriage."(ref 3) Around 73 percent experience amenorrhea, or absence of a menstrual period. Urinary frequency may also occur.
Symptoms not normally seen in early pregnancy that indicate a possible ectopic include abdominal or pelvic pain, present in 93 percent, according to "Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management in Early Pregnancy of Ectopic Pregnancy and Miscarriage." Vaginal bleeding occurs in 64 percent of cases.(ref 4) Shoulder pain develops in 10 to 20 percent of women, according to studies reviewed by the textbook's authors.(ref 3) Shoulder pain, which is caused by blood irritating certain nerves, might worsen when you breathe in.(ref 5) If the tube ruptures and bleeding increases, you might experience a rapid heartbeat, extreme weakness, faintness, pallor or shock from very low blood pressure. (ref 3)
Your doctor might detect signs of ectopic pregnancy by doing serial blood tests to check the pregnancy hormone hCG. In ectopic pregnancy, the levels of hCG might not rise as quickly as they do in a normal pregnancy, although in 17 percent of cases, hCG levels rise appropriately in ectopic pregnancy, the textbook "Obstetrics and Gynecology" reports.(ref 5) By the time your hCG levels reach 1,500, a transvaginal ultrasound should detect a gestational sac in the uterus.(ref 4) Progesterone levels are lower than normal in around 15 percent of cases, the 2005 "American Family Physician" article reports.(ref 4)
The earlier an ectopic pregnancy is detected, the less likely you are to experience serious complications. Early prenatal care can help prevent the complications of ectopic pregnancy. Awareness of potential risk factors, such as history of pelvic inflammatory disease, previous tubal surgery or in vitro fertilization treatment, can also lead to a higher suspicion of an ectopic is symptoms develop.(ref 1) The use of the medication methotrexate, classified as a folic acid antagonist, to dissolve the pregnancy can prevent loss of the fallopian tube and eliminate the need for surgery. If the risk of tubal rupture is imminent or if the tube has already ruptured, you will need surgery to remove the fetus and the tube.