Observation for ectopic pregnancy

If the doctors suspect an ectopic pregnancy, further examinations and bloodtests are required.

You have been referred due to complications in your early pregnancy. We have not been able to identify any pregnancy inside the uterus by ultrasound and therefore we cannot exclude a pregnancy outside the uterus. It is also possible that you are pregnant inside the uterus at a very early stage or that you are having a miscarriage.

What is an ectopic pregnancy?

A pregnancy outside the uterus occurs when a fertilized egg is situated outside the uterine cavity. This is called an ectopic pregnancy (EP). The pregnancy can either be situated in the ovaries, in the cervix, in the abdomen or most commonly (95 %) in the oviduct. A pregnancy outside the uterus is normally not viable and in most of the pregnancies a fetus does not evolve.

A pregnancy outside the uterus can be followed by the most common pregnancy symptoms such as nausea and tense breasts. Some may not experience any symptoms.

An ectopic pregnancy can be dangerous. This is due to the pregnancy growing and as a result it might cause bleeding in the abdominal cavity or it will cause the oviduct to burst, which will lead to intra-abdominal bleeding.

The cause

During a normal intrauterine pregnancy the fertilized egg is transported through the oviduct to the uterine lining where it grows.

Former pelvic inflammation disease (PID), abdominal or pelvic operations, former ectopic pregnancy or endometriosis can result in partial, full blockage or destruction of the oviduct. The fertilized egg can as a result be retained in the oviduct and may grow here.

How is it diagnosed?

There will always be a positive pregnancy test, but it is possible that it is only slightly positive. We will run a blood test and measure your pregnancy hormone hCG which doubles within 48 hours during a normal pregnancy. If hCG doesn’t increase normally or if it is very high without having seen anything intrauterine, an ectopic pregnancy can be the case.

Sometimes you can see the pregnancy outside the uterus by ultrasound scan and ultrasound examination.

The treatment

If you are unaffected or only feel light pain and do not bleed in the abdominal cavity, we will wait and see for a couple of days and follow you with blood tests. On the basis of the result of the blood tests and your condition, we will make a plan on how to proceed. Half of all the ectopic pregnancies will perish. If that happens, you will not need any further treatment. You will be followed with blood tests until there is no longer hCG in your blood and the observation is completed. In other cases it can be necessary to operate or treat you with medicine. The treatment is decided in cooperation with you and will be based on your symptoms and blood test result.

Pain and Bleeding Warning

If you are having an ectopic pregnancy, you may experience light pain and/or bleeding. The bleeding can occur as weak spot bleeding or brownish discharge. The bleeding might also be like your normal period. In worst case an ectopic pregnancy can be life threatening.

Therefore it is very important that you pay attention to and react on the following symptoms:

  • Increasing or sudden severe pain in the abdomen, lower abdomen and/or shoulder
  • Fainting or severe dizziness.
  • Heavy bleeding from the vagina.

There is a risk that you can become uncomfortable very quickly and therefore we strongly recommend you stay together with another adult who can call for help if needed. We also advice you to avoid flying and sailing as you might require emergency help. Should you experience any of the mentioned symptoms please call ward 5032 day or night. In a few cases it can be necessary to call an ambulance.

Good advice

You are more than welcome to call us if you have questions about your treatment or condition. If it is not an emergency please call ward 5032 during daytime.

When your treatment is completed you are welcome to call us within the first coming week in case of problems and questions that are unanswered.

Later on we advise you to call your local doctor or the doctor on call.