Ectopic Pregnancies and Their Treatment

Obie Editorial Team

While sitting on a bench at the playground, I started up a conversation with the lady sitting beside me. I had seen at least three children come up to her for sips of juice or snacks over the course of the afternoon and I was curious about how many she had. When I asked, she looked at me for a long, awkward moment. She told me she had three on earth and two in heaven. She told me she had experienced two ectopic pregnancies before her youngest child was born, and that her doctor had recommended she not attempt to have any more children because of it. I didn’t know what ectopic pregnancies were, but didn’t want to pry. What were these pregnancies, and why were they different from the miscarriages I had generally heard linked with her phrasing?

Ectopic pregnancies occur when the fertilized egg does not travel to the uterus, but instead begins to develop in another area of the body. Though these pregnancies most often occur within a fallopian tube, there have been cases in which ectopic pregnancies have developed in the abdominal cavity or even the cervix. There are many reasons such pregnancies occur, including endometriosis, scar tissue, birth defects in the mother or malformation of the reproductive organs. When these pregnancies occur, the mother is at tremendous risk of serious medical consequences and even death. Ectopic pregnancies must be treated very quickly to prevent a rupture that could lead to catastrophic bleeding. This treatment is generally done by inserting a very small needle into the fallopian tube and aspirating the embryo then rinsing the area to remove any cells that may remain. Surgical removal could also necessitate removal of part of the fallopian tube or parts of internal organs. Though many women who experience one ectopic pregnancy are able to conceive again, many will either not be able to conceive, or will go on to conceive another ectopic pregnancy.

While it was once believed that no ectopic pregnancy could result in a viable baby, recent medical advancements have proved this wrong. While babies developing in the fallopian tubes have virtually no chance of survival because as they grow they will rupture the tube, babies developing in the abdominal cavity may have some chance. In 2000 a set of triplets were born in Nottingham. What made this birth unique was the fact that one of the three babies had developed outside of the womb, and survived. Eight years later another Great Britain woman carried an ectopic baby nearly to term before having him delivered via C-section, and just this year a woman in the U.S. gave birth to a little boy at 32 weeks gestation who had developed in her abdominal cavity.

Source: Pouly, JL, et al. Conservative Laparoscopic Treatment of 321 Ectopic Pregnancies, Fertility and Sterility, 1986, 46(6): 1093-1097.