What it is
A fertilized egg is meant to travel down the tube and implant in the uterus. In an ectopic pregnancy it implants somewhere else, most often in the tube itself.
A tube has little room to stretch. As the pregnancy grows the tube can rupture and bleed internally. That is why it is treated urgently.
Finding it takes two things together: how the hCG level moves over 48 hours, and what the ultrasound shows. One number on its own rarely settles it.
What you might notice
- A positive pregnancy test with pain on one side
- Bleeding or brown spotting in early pregnancy
- Cramping sharper on one side than the other
- Pain at the tip of the shoulder
- Feeling faint, dizzy or clammy
- An hCG level that rises too slowly
- An ultrasound showing no pregnancy inside the uterus
- A history of tubal surgery, pelvic infection or a prior ectopic
How Dr. Mueller finds the cause
- 1
Confirm pregnancy
A urine or blood test confirms you are pregnant.
- 2
hCG level
Blood is drawn and repeated 48 hours later to see the trend.
- 3
Pelvic ultrasound
A vaginal probe looks for a pregnancy inside the uterus.
- 4
Put it together
The trend and the scan together tell Dr. Mueller whether the pregnancy is in the uterus.
- 5
Medication or surgery
Methotrexate by injection, or surgery through the laparoscope.
- 6
Follow hCG down
Levels are drawn weekly until they reach zero.
Questions people ask
- Can an ectopic pregnancy be moved into the uterus?
- No. There is no way to relocate it. Treatment ends the pregnancy, with medication or with surgery.
- Will I lose my tube?
- Not always. Methotrexate avoids surgery when it is caught early. Surgery either opens the tube or removes it.
- Can I get pregnant again after an ectopic?
- Most women can, including after losing one tube. Tell your next pregnancy provider so an early scan is arranged.
- How early can an ultrasound see it?
- Once hCG climbs into the low thousands, a vaginal scan usually shows a pregnancy in the uterus. Below that the scan is repeated in two days.
- Is one-sided cramping always an ectopic?
- No. Early pregnancy cramps on one side for ordinary reasons. It is checked because missing one is serious.
- Can I breastfeed after methotrexate?
- Not right away. Dr. Mueller will tell you how long to wait based on the dose.