Ectopic pregnancies are nonviable pregnancies that implant outside of the uterus. They’re often called tubal pregnancies because they primarily occur in the fallopian tubes. In rare cases, they implant in the abdomen. Studies show that between 6% to 16% of pregnant people who go to an emergency department in the first trimester for bleeding, pain, or both have an ectopic pregnancy. Learn more about ectopic pregnancy statistics.
How Common Is Ectopic Pregnancy?
According to the March of Dimes, about 1 in every 50 pregnancies in the U.S. is an ectopic pregnancy (tubal pregnancy.) However, the likelihood of you having an ectopic pregnancy may actually be lower or higher than the average as various health factors will raise or lower your personal risk. For example, smoking, previous ectopic pregnancy, and a history of tubal surgery all increase your risk of ectopic pregnancy.
Risks of Ectopic Pregnancy
Ectopic pregnancies can be dangerous to the mother. Bleeding from ectopic pregnancy causes 10% of all pregnancy-related deaths, and it’s the leading cause of first-trimester maternal death. Unfortunately, ectopic pregnancies are not viable and cannot result in a baby. Unfortunately, we do not yet have the technology to move a fetus implanted in the fallopian tubes to the uterus.
Treatment of Ectopic Pregnancy
There are three primary treatments for ectopic pregnancy. One is used only rarely, and involves a wait and watch approach, which is also called a natural miscarriage. It is only used if the fetus appears to be miscarrying and hCG levels are dropping. Other teatments include either surgically removing the pregnancy or using the medication methotrexate to stop the pregnancy. If the pregnancy is found soon enough and there is little risk of rupture, and injection of methotrexate is most often used. If, however, there is a threat of rupture or any signs that rupture has occurred, surgical treatment is needed.
Risk Factors for Ectopic Pregnancy
If specific risk factors don’t apply to you, your odds of having an ectopic pregnancy may be actually lower than 1 in 50. There are several known and a few possible risk factors for an ectopic pregnancy which may boost your risk higher than average. Some of these include:
A previous ectopic pregnancy: If you have one ectopic pregnancy, the chance that your next pregnancy will be an ectopic pregnancy is 15%Being older than 35EndometriosisExposure to a manufactured form of the hormone estrogen called DES (diethylstilbestrol) in the womb (doctors stopped using DES in pregnant women in the early 1970’s so most women today are not at risk)Getting pregnant after having your tubes tied (tubal ligation): Roughly a third of women who become pregnant after a tubal ligation will have an ectopic pregnancyGetting pregnant when using an IUD (intrauterine device): The risk of an ectopic pregnancy in women who have an IUD varies depending upon the type of IUDHaving multiple sexual partners (probably secondary to sexually transmitted diseases)Problems getting pregnant or fertility treatments (women with a history of infertility have a greater risk)Scars inside the pelvic area: These may occur from prior pelvic surgery or abdominal surgery such as an appendectomySexually transmitted infections like chlamydia and gonorrhea that can lead to pelvic inflammatory diseaseSmoking: The risk of ectopic pregnancy is 4 to 20 times higher in women who smokeSurgery on a fallopian tube or a birth defect in a fallopian tube or your uterus
What Happens Next Time?
Women who have an ectopic pregnancy are often curious about what a pregnancy will look like in the future. It’s normal to worry about this. You should know that you can have a normal pregnancy even after an ectopic pregnancy. A third of women with an ectopic pregnancy have a healthy pregnancy down the line. However, you do have a 15% chance of another ectopic pregnancy after the first one. How your ectopic pregnancy was treated may play a role in this. Studies show that women treated with medication (methotrexate) rather than surgery have a lower risk of recurrent ectopic pregnancy (8% versus up to 15%). This is one reason to get suspicious symptoms such as bleeding checked out as early as possible—ectopic pregnancies caught early are more likely to be treated with methotrexate instead of surgery.
