Ectopic pregnancies are a type of pregnancy complication where the fertilized egg implants in tissue other than the wall of the uterus. While most pregnancies of this type happen inside the Fallopian tubes (tubal pregnancies), this can also happen in the ovaries, abdomen, and cervix. Because the fetus produces enzymes which allow it implant in many different tissue types, it can cause a lot of damage by attaching in a location other than the uterine wall. It will attempt to reach a supply of blood adequate to support it. In an ordinary pregnancy, this is easy to find, since the lining of the uterus gives it plenty of room to grow. Ectopic pregnancies can be painful, and even fatal.
Not all incidences of an ectopic pregnancy are dangerous. About half of them resolve themselves untreated. Much of the time, bleeding from the burrowing embryo causes the implantation to be expelled, causing a tubal abortion. These are often mistaken for miscarriage, but the pregnancy could never have been viable in this case. However, heavy bleeding from ectopic implantation can sometimes threaten the woman' health or life. If the pregnancy won't resolve itself, surgery or treatment with drugs may be required.
It's unknown why tubal and other ectopic pregnancies happen. Some speculate that older mothers, women with tubal damage, and smokers are at greater risk. It is well known that if the inside of the Fallopian tubes have been scared at any point, or are blocked, this type of implantation is more likely. If both tubes are scarred and occluded, as sometimes occurs in pelvic inflammatory disease, pregnancies of any kind would not occur. It's only when a single tube is blocked that this is a risk. This condition can also happen in patients with damaged tubes who use in vitro fertilization, women who have had unsuccessful tubal ligations, and some women who have had a hysterectomy (the fetus implants in the abdomen). Ectopic pregnancies also sometimes happen in women with no history of problems.
Symptoms of an ectopic pregnancy can be absent, or very subtle. This means that it's hard to tell that implantation has gone wrong. Early signs include mild pain, vaginal bleeding, and internal bleeding, as well as cramping. Pain is often present in the lower abdomen, back, or pelvis. Some women, who are experiencing abdominal bleeding, can have shoulder pain caused by blood traveling inside the abdominal cavity. Symptoms of ectopic pregnancy can resemble those of PID, appendicitis, and other problems, making them hard to diagnose.
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