Nausea and breast soreness are common symptoms in both ectopic and uterine pregnancies. The following symptoms are more common in an ectopic pregnancy and can indicate a medical emergency:
- sharp waves of pain in the abdomen, pelvis, shoulder, or neck
- severe pain that occurs on one side of the abdomen
- light to heavy vaginal spotting or bleeding
- dizziness or fainting
- rectal pressure
You should contact your doctor or seek immediate treatment if you know that you’re pregnant and have any of these symptoms.
Diagnosing an Ectopic Pregnancy
If you suspect you may have an ectopic pregnancy, see your doctor immediately. Ectopic pregnancies can’t be diagnosed from a physical exam. However, your doctor may still perform one to rule out other factors.
Another step to diagnosis is a transvaginal ultrasound. This involves inserting a special wand-like instrument into your vagina so that your doctor can see if a gestational sac is in the uterus.
Your doctor may also use a blood test to determine your levels of hCG and progesterone. These are hormones that are present during pregnancy. If these hormone levels start to decrease or stay the same over the course of a few days and a gestational sac isn’t present in an ultrasound, the pregnancy is likely ectopic.
If you’re having severe symptoms, such as significant pain or bleeding, there may not be enough time to complete all these steps. The fallopian tube could rupture in extreme cases, causing severe internal bleeding. Your doctor will then perform an emergency surgery to provide immediate treatment.
Treating Ectopic Pregnancy
Ectopic pregnancies aren’t safe for the mother. Also, the embryo won’t be able to develop to term. It’s necessary to remove the embryo as soon as possible for the mother’s immediate health and long-term fertility. Treatment options vary depending on the location of the ectopic pregnancy and its development.
Your doctor may decide that immediate complications are unlikely. In this case, your doctor can prescribe several medications that could keep the ectopic mass from bursting. According to the AAFP, one common medication for this is methotrexate (Rheumatrex).
Methotrexate is a drug that stops the growth of rapidly dividing cells, such as the cells of the ectopic mass. If you take this medication, your doctor will give it to you as an injection. You should also get regular blood tests to ensure that the drug is effective. When effective, the medication will cause symptoms that are similar to that of a miscarriage. These include:
- the passing of tissue
Further surgery is rarely required after this occurs. Methotrexate doesn’t carry the same risks of fallopian tube damage that come with surgery. You won’t be able to get pregnant for several months after taking this medication, however.
Many surgeons suggest removing the embryo and repairing any internal damage. This procedure is called a laparotomy. Your doctor will insert a small camera through a small incision to make sure they can see their work. The surgeon then removes the embryo and repairs any damage to the fallopian tube.
If the surgery is unsuccessful, the surgeon may repeat a laparotomy, this time through a larger incision. Your doctor may also need to remove the fallopian tube during surgery if it’s damaged.
Your doctor will give you specific instructions regarding the care of your incisions after surgery. The chief goals are to keep your incisions clean and dry while they heal. Check them daily for infection signs, which could include:
- bleeding that won’t stop
- excessive bleeding
- foul-smelling drainage from the site
- hot to the touch
You can expect some light vaginal bleeding and small blood clots after surgery. This can occur up to six weeks after your procedure. Other self-care measures you can take include:
- don’t lift anything heavier than 10 pounds
- drink plenty of fluids to prevent constipation
- pelvic rest, which means refraining from sexual intercourse, tampon use, and douching
- rest as much as possible the first week post surgery, and then increase activity in the next weeks as tolerated
Always notify your doctor if your pain increases or you feel something is out of the ordinary.