Though rarely discussed previously, the overturning of Roe v. Wade put ectopic pregnancies in the spotlight. Access to reproductive healthcare in the case of ectopic pregnancy is necessary for the pregnant person’s survival, and in some states, that may be at risk now. Here’s everything to know about an ectopic pregnancy, including what it is, how it’s treated and risk factors you may not have known about previously.
What Is an Ectopic Pregnancy?
According to Dr. James A. Gohar, OB-GYN and CEO and Co-Founder of Viva Eve, an ectopic pregnancy is when a fertilized egg implants itself outside of the uterus. He explains, “Most of these pregnancies occur in a fallopian tube, but can sometimes occur in the abdominal cavity or an ovary.”
Are There Any Predictable Risk Factors for Ectopic Pregnancies?
Dr. Mary Jacobson, MD, and Chief Medical Officer at Alpha Medical, tells us that some of the risk factors for an ectopic pregnancy may include:
Having a prior ectopic pregnancyDamage to the fallopian tubesFactors secondary to an ascending pelvic infectionPrior pelvic or fallopian tube surgeryHistory of infertility
Dr. Gohar noted that endometriosis and using in-vitro fertilization may also increase the odds of ectopic pregnancy. Less significant risk factors for ectopic pregnancy include smoking and being over 35 years old. However, Dr. Jacobson points out, “Bear in mind that 50% of all persons do not have any known risk factors.”
What Are the Symptoms Of an Ectopic Pregnancy?
“Symptoms of ectopic pregnancy may include pain in the lower abdomen and pelvic area and bleeding, which can then cause weakness, dizziness and low blood pressure,” Dr. Gohar tells Parade. “There is usually a sharp pain if a fallopian tube bursts, and it’s important to understand that ectopic pregnancies can be medical emergencies. It is imperative to be seen and managed by a medical doctor and/or go to the ER immediately.” Dr. Jacobson advises that persons with known significant risk factors should be evaluated for possible ectopic pregnancy, even in the absence of symptoms.
What Risks Does an Ectopic Pregnancy Pose?
The greatest risk to the patient is bleeding to death from a ruptured ectopic pregnancy, Dr. Jacobson says. Other risks include:
Bleeding that requires a blood transfusionSurgery to remove the ectopic tissue which may involve removal of the affected fallopian tubeFuture difficulty conceiving Risk of a recurrent ectopic pregnancy
“Ectopic pregnancies can be life-threatening for the mother and is fatal for the fetus. The uterus is the only suitable place for a growing fetus,” Dr. Gohar explained. “Other areas such as the fallopian tube or ovary, etc., lack the ability to grow in the same manner and therefore can rupture or become injured. Ectopic pregnancies can cause death or internal bleeding, which is why it is considered a medical emergency.”
How Are Ectopic Pregnancies Treated?
How ectopic pregnancies are treated can vary depending on how far along the pregnancy is. Dr. Gohar tells us, “Ectopic pregnancies can be treated by stopping the growth of the pregnancy using a medication called methotrexate if it is diagnosed and managed early enough. In other cases, such as if the fallopian tube has ruptured or is at risk to rupture, surgery is required. The main priority is to save the life of the mother during ectopic pregnancies. Ectopic pregnancies, by definition, are non-viable pregnancies. This means that the fetus cannot develop into a normal, healthy pregnancy outside of the uterus.” According to Dr. Jacobson, surgery is required if patients show signs of the following:
Hemodynamic instability, which can present itself as low blood pressure and elevated heart rate, fainting and loss of consciousness due to massive blood lossSymptoms of an ongoing ruptured ectopic mass (such as pelvic pain)Internal bleeding
How Does the Overturning of Roe v. Wade Impact Women With Ectopic Pregnancies?
The overturning of Roe v. Wade may impact pregnant persons’ access to medical care in the case of ectopic pregnancies depending on where they live. “If you are in a state that has banned abortions, you may be denied treatment for ectopic pregnancies, along with other non-viable pregnancy-related conditions,” Dr. Gohar says. “It’s important to understand the rapidly changing nature of each state’s laws as it pertains to abortion.” Next, find out the signs of infertility and what you can do about them.
Sources
Dr. James A. Gohar, OB-GYN and CEO and Co-Founder of Viva EveDr. Mary Jacobson, MD, and Chief Medical Officer at Alpha Medical
