Causes of ectopic pregnancy

Written by Liu Qin
Obstetrics and Gynecology
Updated on February 03, 2025
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Ectopic pregnancy refers to the implantation of a fertilized egg outside the uterine cavity, among which tubal pregnancy is the most common type, accounting for about 95% of ectopic pregnancies. There are many causes of ectopic pregnancy, with the main cause being inflammation of the fallopian tubes. The inflammation can cause the mucous membrane of the fallopian tube to become sticky, narrowing the lumen of the tube, or impairing the function of the cilia inside the tube, leading to obstruction of the fertilized egg's movement within the tube and resulting in implantation at that location. Other causes include surgery on the fallopian tubes, poor development or abnormal function of the fallopian tubes, further development of assisted reproductive technologies, and the use of emergency contraceptive pills, also known as contraceptive failure, among others. (The use of medications should be under the guidance of a doctor.)

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Written by Du Rui Xia
Obstetrics
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ectopic pregnancy rate

The probability of an ectopic pregnancy occurring is generally quite low, with an incidence rate of about 2%-3%. An ectopic pregnancy refers to a fertilized egg that does not implant within the uterine cavity, and occurs outside the uterine cavity; the most common site for an ectopic pregnancy is the fallopian tube, followed by the ovaries and the abdominal cavity. These are the common sites for ectopic pregnancies. The main causes of ectopic pregnancies are chronic inflammation or congenital diseases, which lead to adhesions and blockages in the fallopian tubes, affecting the migration of the fertilized egg.

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Written by Du Rui Xia
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Can an ectopic pregnancy result in a live birth?

In the case of an ectopic pregnancy, it is necessary to terminate the pregnancy promptly. The pregnancy cannot continue, nor can it reach full term. Ectopic pregnancy refers to the implantation of a fertilized egg in a location outside the uterine cavity, known as an ectopic pregnancy. Normally, after the sperm and egg combine, implantation should occur in the uterine cavity for a normal pregnancy, since the uterus is the site where the fetus is nurtured. The uterus can expand gradually as the pregnancy sac grows, until the baby is delivered month by month. However, in an ectopic pregnancy, where the embryo does not implant in the uterus, it does not expand with the growth of the pregnancy sac. Therefore, as it progresses, it can lead to rupture of the implantation site, causing bleeding, fainting, shock, and potentially leading to severe consequences.

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Written by Zhang Lu
Obstetrics
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How long does it take for an ectopic pregnancy to bleed?

Ectopic pregnancy test strips indicate that the gestational sac is implanted outside the uterine cavity, with the most common type being a tubal pregnancy. The bleeding caused by a tubal pregnancy includes two types: vaginal bleeding and intra-abdominal bleeding. Firstly, the vaginal bleeding caused by an ectopic pregnancy mainly occurs because the gestational sac lacks a normal developmental environment, with relatively low levels of estrogen and progesterone. This leads to insufficient endometrial proliferation, resulting in regressive bleeding. Typically, vaginal bleeding appears around the fifth week of an ectopic pregnancy, but the amount of bleeding is generally small. Secondly, if the gestational sac in an ectopic pregnancy is relatively large, it can cause the local rupture of the fallopian tube, leading to intra-abdominal bleeding. This usually occurs around the seventh to eighth week of pregnancy. If the gestational sac is too small, even if there is mild abdominal pain, it will not cause intra-abdominal bleeding.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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Ectopic pregnancy medical conservative treatment

Under normal circumstances, the treatment of ectopic pregnancy is generally divided into conservative treatment and surgical treatment. Conservative treatment is usually applied when the ectopic pregnancy has not ruptured, using medication for about a week. After one week, a follow-up examination is done to check blood HCG levels and an ultrasound scan. If blood HCG levels have dropped significantly, the ultrasound shows that the mass has not grown, and the symptoms of abdominal pain have decreased, it indicates that the conservative treatment was successful. The threat is only considered resolved when blood HCG returns to normal levels. Otherwise, the conservative treatment for ectopic pregnancy may fail, and surgery will be necessary to treat the ectopic pregnancy symptomatically. If there is a particularly large amount of bleeding or a rupture has occurred, surgical treatment is the only option.

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Obstetrics and Gynecology
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How to Self-Diagnose an Ectopic Pregnancy

Generally, ectopic pregnancy can be ruled out through one's own symptoms and signs. Firstly, through one's own clinical symptoms, if pregnancy has been confirmed by a urinary pregnancy test and the patient does not experience abdominal pain, abnormal vaginal bleeding, or other such conditions, but does experience significant early pregnancy reactions like nausea and vomiting, the likelihood of an ectopic pregnancy is small. It can generally be judged to be an intrauterine pregnancy. However, self-diagnosis is not very accurate, and ultimately, it depends on an ultrasound to see the intrauterine gestational sac to confirm whether it is an intrauterine pregnancy. Therefore, the most scientific method is to go to the hospital for an ultrasound and have a blood test for HCG. This method is more scientifically accurate. If an ectopic pregnancy is confirmed, surgical treatment must be pursued immediately as it can be life-threatening.