There are several types of miscarriage — threatened, inevitable, complete, incomplete or missed. The vast majority of miscarriages will happen in the first 12 weeks of pregnancy, with some even happening before you knew you would have known you were pregnant. Read more on Pink Elephants Support Network website. Read more on Red Nose website. Unfortunately half of these pregnancies may also end in miscarriage, which cannot be prevented.
Miscarriage Despite being common and widespread, miscarriage can be a heartbreaking experience — with up to one in five pregnancies ending before week Read more on Gidget Foundation Australia website. Female sterilisation is a permanent form of contraception.
It's a surgical procedure to block the fallopian tubes that carry the egg to the uterus. Pregnancy, Birth and Baby is not responsible for the content and advertising on the external website you are now entering. Video call. This information is for your general information and use only and is not intended to be used as medical advice and should not be used to diagnose, treat, cure or prevent any medical condition, nor should it be used for therapeutic purposes.
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A message has been sent to your recipient's email address with a link to the content webpage. Your name: is required Error: This is required. Your email: is required Error: This is required Error: Not a valid value. Send to: is required Error: This is required Error: Not a valid value. Symptoms of ectopic pregnancy If you have an ectopic pregnancy, you might experience: One-sided abdominal pain — typically on one side of your abdomen tummy , which can be persistent and severe.
Bowel pain — you may experience pain when passing urine or stools. How is ectopic pregnancy diagnosed? Some of the tests used to diagnose an ectopic pregnancy include: vaginal ultrasound blood tests keyhole surgery How is an ectopic pregnancy treated?
Signs of a ruptured fallopian tube are: sudden, severe, sharp pain feeling faint and dizzy feeling nauseous or vomiting diarrhoea shoulder tip pain A ruptured fallopian tube is a medical emergency. Some women are at an increased risk of an ectopic pregnancy such as those:. If an ultrasound scan shows an empty uterus but the pregnancy test is positive the possibilities are:. The ectopic pregnancy may appear as a small pregnancy sac outside the uterus or as a mass.
However, you may not see evidence of the pregnancy location on a scan. In such cases repeated blood tests are done to measure the pregnancy hormone levels. In ectopic pregnancy the levels are usually lower and rise more slowly.
Although this has been tried, it has never been done successfully. Because the egg has implanted in the wrong place, often the baby isn't able to progress normally.
Sometimes, an ectopic pregnancy is absorbed and there are minimal or no symptoms like pain or bleeding. Nothing needs to be done in these circumstances except to ensure that the pregnancy hormone levels quickly return to normal. Sometimes medicine is used to dissolve the early ectopic pregnancy. Sometimes, an operation is required. You will find some more detailed information regarding these management options below.
Expectant management is increasingly common. It means that you are observed closely and the ectopic pregnancy given the opportunity to resolve without treatment. If monitored correctly, this is not dangerous as not all ectopic pregnancies will cause bleeding in the abdomen. Some ectopic pregnancies do not rupture and they clear without treatment.
The pregnancy often dies in a way similar to a miscarriage, but it is absorbed, and there is minimal pain or bleeding. In these circumstances, nothing further needs to be done. A "wait and see" approach is a safe and appropriate way to manage your ectopic pregnancy if:. You will, however, need close follow-up as there is still a very remote chance that the ectopic pregnancy may cause the fallopian tube to rupture and bleed.
Being managed with no treatment can feel quite scary but we are giving your body the best chance to resolve this naturally. If we have suggested this method of treatment, then there is an almost 90 per cent chance that the ectopic pregnancy will resolve all by itself. You will be given some request forms for blood tests to measure your pregnancy hormone levels over the next week. We will phone you after each blood test to let you know the results. You may also require a further scan.
We will let you know the specific follow-up plan for you. Please ask us if any of this information does not make sense to you. You should expect a small amount of bleeding. It is a chemotherapy drug which stops the pregnancy from growing. Only a small dose is used so it is extremely unlikely that you will lose your hair or experience any of the other side effects often associated with chemotherapy. Until recently, the only treatment that was widely available for ectopic pregnancy was an operation.
Although this is a relatively new treatment it has been used for about 10 years , it is one which has been found to be safe. It has the obvious advantage of not needing an open operation or even key-hole surgery, which commonly requires a hospital stay of a day or two and recovery time afterwards. Studies that look at how successful a subsequent pregnancy is following this treatment, have found that it is at least as good as following surgery and sometimes better. Surgery can cause scarring around the tube, and it may be that avoiding this is the reason why future pregnancies may be more likely to be successful after medical treatment.
Methotrexate is given by a single injection in the arm. In certain situations, an infusion via a drip into the vein may be required. This is done over one to two days and a short stay in hospital is required. The doctor will discuss with you which treatment option is best in your individual situation. We will then need to check the pregnancy hormone levels, as before, to ensure that they fall appropriately.
This will mean several blood tests over the following month. Most women require only one injection or infusion, but very occasionally two may be necessary. You may notice some mild abdominal pain after the treatment, though if you do, this should not be severe. Other occasional side effects affecting up to 15 percent of women include nausea, vomiting, indigestion, mouth ulcers, sensitivity to light, or feelings of fatigue.
Very rarely it can affect the liver or blood counts, but this really is unusual if it does occur and should only last a short time. Generally your chances of having a successful pregnancy in the future are at least as good following medical management as compared to surgical management.
Pregnancies following completion of methotrexate therapy are not associated with increased abnormalities, miscarriages or other pregnancy complications.
However, you will need to avoid pregnancy for four months after treatment because of the possible effects on the developing baby. The pregnancy hormone levels frequently rise in the first few days and will then start to drop, it will take between three to five weeks to fall to normal levels. An operation is one way of treating an ectopic pregnancy. In some circumstances this may be the only choice available to you. The operation is performed under a general anaesthetic.
In this procedure the surgeon usually makes three small incisions in your abdomen—one inside your belly button and one or two lower incisions lower down on your abdomen. A small telescope is inserted through the hole in your belly button to allow the surgeon to see what they are doing.
If an ectopic pregnancy is confirmed usually the tube is removed. Sometimes it may be possible to make a cut in the tube and remove the pregnancy leaving the tube intact.
The downside of this is that sometimes not all of the pregnancy tissue is removed. Further, this tube is now damaged and there is an increased chance of another ectopic in that tube in the future. We will have already discussed some of these issues with you. While most operations for ectopic pregnancy are done using keyhole surgery, sometimes an open operation needs to be performed. This is more likely if you have had a lot of bleeding and are unwell, or if the keyhole surgery is not technically possible.
Like all operations, small anaesthetic and surgical risks are involved. There is a very small risk approximately one chance in every procedures of injury to the bowel or blood vessels when entering the abdomen using keyhole surgery. In such cases, we would usually change to performing open surgery.
There is a very small risk of infection, although this is slightly higher if an open procedure is performed. Sometimes you may have had a lot of bleeding or there may be bleeding during the procedure.
If you are very unwell from this blood loss we may, rarely, need to give you blood as a transfusion. In the hour period after the anaesthetic you will probably feel tired. You may well feel fatigued for some days to weeks following the procedure especially if you had lost a significant amount of blood.
After the operation you will have some pain. Following keyhole surgery, it is very common to experience shoulder-tip pain as well as pain in your abdomen. This is because of some undissolved air from the operation irritating nerve endings in your abdomen and chest. The best way to manage this pain is to mobilise early and your nurses will help you with this.
You will be given pain relief. You should expect to be sore for some days but it should always be improving.
Following open surgery, you will have pain for some weeks and it will be sore to walk. You will take some weeks to recover following open surgery. You will have a dressing on your wound s. The staff looking after you will advise you on how to care for your wound. The sad truth is that when a pregnancy is ectopic, the fetus will not survive. How is it treated? There is no medical technique for transferring an ectopic pregnancy to the uterus where it could develop into a healthy pregnancy and baby.
Methotrexate is commonly used for treating cancer because it destroys rapidly dividing cells. What happens to the mother? Sometimes, ectopic pregnancies result in miscarriages, but more often, the fallopian tube where the fetus is implanted stretches and becomes inflamed and extremely painful.
Most cases of ectopic pregnancy require emergency medical treatment because the growing fetus can cause the fallopian tube to rupture and as a result, massive internal bleeding can occur. In developed, high-income countries where emergency health care is easily accessible, severe injury or death is rare. Prior to the age of modern medicine and even today in countries where safe diagnostic and surgical techniques are unavailable, ectopic pregnancy can result in maternal death in more than 50 percent of cases.
When women can access the right healthcare, risk for death drops to less than five in 10, pregnancies. Accurate statistics for maternal outcomes in developing countries are difficult to come by.
Can mom get pregnant again? Many women can get pregnant again and go on to deliver healthy babies, but it depends on what caused her ectopic pregnancy in the first place, how much abdominal damage occurred, whether she still has a remaining fallopian tube and her willingness to risk having another complication.
When a woman has had one ectopic pregnancy, she has a 15 percent chance of having another.
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