Can an Ectopic Pregnancy Be Saved?

Signs of ectopic pregnancy

Verywell / JR Bee 

An ectopic pregnancy (also known as a tubal pregnancy) is one in which the fertilized egg implants somewhere other than in the uterus, most often in the fallopian tubes.

As the pregnancy advances, the developing fetus will cause the tube to stretch and sometimes rupture, leading to potentially life-threatening internal bleeding. While there have been rare, well-publicized cases where an ectopic pregnancy has been brought to term, pregnancies of this sort are almost universally considered nonviable.

Understanding Ectopic Pregnancy

Ectopic pregnancies affect about 1% to 2% of all pregnancies. These are most commonly seen in women who have pelvic inflammatory disease (PID) due to chlamydial infection. Smoking, tubal surgery, a history of infertility, and assisted reproduction are also known to contribute to the risk.

Up to 30% of ectopic pregnancies have no medical signs or symptoms in the early stages. When present, most will typically appear before the tenth week and may include:

  • Cramping on one side of the pelvis
  • Shoulder pain
  • Sudden onset of abdominal or pelvic pain
  • Tender cervix
  • Vaginal bleeding

In cases of heavy bleeding, the pregnancy may initially be diagnosed as a miscarriage. It is typically at this stage that an ultrasound will reveal the problem to be an ectopic pregnancy. Elevated hCG levels in the blood can further support the diagnosis (since miscarriage usually results in a drop in hCG). Almost as a rule, once an ectopic pregnancy is diagnosed, termination is recommended.

Why Ectopic Pregnancies Are Terminated

The vast majority of ectopic pregnancies implant in the fallopian tubes. If left unchecked, fetal growth will involve larger amounts of tissue and vascular structures. It is at this point that the pregnancy can become dangerous with any rupture likely to cause a massive bleed.

Since fetal death is all but certain and the risk to the mother is high, a termination will be recommended, either through surgery or abortive medications.

When the implantation is in the abdominal cavity, it still presents grave risks of hemorrhage and fetal malformation. Even in the extremely rare cases of live birth by surgery, the mother is at risk as the placenta does not naturally detach and be discharged as afterbirth as in a uterine pregnancy.

Sadly, no medical technology currently exists to move an ectopic pregnancy from the fallopian tubes to the uterus.

Successful Ectopic Pregnancies

While there have been cases where an ectopic pregnancy has been brought to term, the conditions by which these occurred were extremely unusual.

Most successful deliveries have involved the implantation of the egg somewhere in the abdomen rather than the fallopian tubes. Referred to as an abdominal pregnancy, these anomalies are usually situated near the liver or other organs where there the blood supply is rich.

Even then, the chances of survival are slim. Delivery can also be tricky depending on where major blood vessels or organs are located.

Most cases have occurred in parts of the world where prenatal care is lacking. It is this absence of care that accounts for the high rate of deaths in women with abdominal pregnancies. Some studies, in fact, suggest that the death rate may be as much as seven times greater than that of tubal pregnancies.

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