What causes an ectopic pregnancy?

Written by Liu Qin
Obstetrics and Gynecology
Updated on December 10, 2024
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Ectopic pregnancy refers to the implantation of a fertilized egg outside the uterine cavity, with tubal pregnancy being the most common type, accounting for up to 95% of cases. There are many causes of ectopic pregnancy, with the main reasons including the following: First, inflammation of the fallopian tubes is a major cause of ectopic pregnancy because the inflammation can cause the mucous membranes of the tubes to adhere, narrowing of the lumen, or impairment of the cilia function, leading to obstruction of the fertilized egg's movement within the tube, preventing it from reaching the uterine cavity, thus, it implants in the tube. Second, the patient has a history of fallopian tube surgery or a previous ectopic pregnancy. Third, poor development or abnormal function of the fallopian tubes. Fourth, the implementation of assisted reproductive technology. Fifth, the intake of emergency contraceptive pills by individuals who experienced contraceptive failure. (The use of medications should be done under the guidance of Doctor Yan.)

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Written by Du Rui Xia
Obstetrics
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How many days can an ectopic pregnancy be detected?

Generally around six weeks after a missed period, an ectopic pregnancy can be detected through an ultrasound examination. For women with regular menstrual cycles, if menstruation is delayed by a week and a pregnancy test shows a positive result, it indicates pregnancy. At this time, it is necessary to visit the hospital for an ultrasound to ascertain the implantation site of the gestational sac. In the case of an ectopic pregnancy, it is normal that no gestational sac is visible within the uterine cavity during an ultrasound. The ultrasound might reveal irregular echo areas in the adnexal area, which includes the fallopian tubes or ovaries, possibly indicating thickened fallopian tubes or enlarged ovaries. At this point, one should be vigilant about the possibility of an ectopic pregnancy and seek timely treatment.

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Written by Yue Hua
Obstetrics and Gynecology
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ectopic pregnancy early symptoms

First, there will be a cessation of menstruation, followed by a brief period of amenorrhea, and then irregular vaginal bleeding will occur. This vaginal bleeding is usually light and droplet-like, and the color is dark red. Additionally, most women will experience pain on one side of the lower abdomen, which manifests as a distension pain. At this time, because the ectopic pregnancy in the fallopian tube has not ruptured, the enlarging embryo causes the fallopian tube to expand, leading to spasms of the tube, and thus these symptoms occur. If the condition continues to progress, the fallopian tube may rupture, resulting in acute and severe pain on one side of the lower abdomen.

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Written by Liu Wen Li
Obstetrics
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How to check for an ectopic pregnancy?

The examination for an ectopic pregnancy is divided into two steps, the first step is to confirm whether one is pregnant. Then, pregnancy can be detected either by a pregnancy test strip or the most accurate method, which is through a blood test. Once pregnancy is confirmed, the second step involves an ultrasound examination. A blood test only indicates whether or not one is pregnant, but an ultrasound can specifically determine whether it is an intrauterine pregnancy or an ectopic pregnancy. If it is an intrauterine pregnancy, the pregnancy can simply continue. If it is an ectopic pregnancy, surgical or medical treatment is necessary. On an ultrasound, an ectopic pregnancy is indicated by the absence of a gestational sac within the uterine cavity, but a gestational sac or mass is found outside the uterus, which confirms the diagnosis of an ectopic pregnancy.

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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 Li Li Jie
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.