During pregnancy, typically the fertilized egg travels through the fallopian tube to reach the mother's womb. However, in some cases the egg fails to reach the womb but gets lodged in the fallopian tube, where it continues to grow. This is known as 'ectopic' or 'tubal' pregnancy. More rarely, the fertilized egg lodges in the cervix, abdomen, or c-section scar, and is known as heterotopic pregnancy.

If an ectopic pregnancy is left untreated, the embryo will continue to grow till it ruptures the fallopian tube. This could result in complications, and may even be fatal for the expecting mother. Since there is no way to move the egg into the womb, ectopic pregnancies are terminated.

Risks

Your spouse is at greater risk of ectopic pregnancy in the following situations:

* Her pregnancy occurs even though she had a tubal ligation (surgical sterilization)

* She had an intrauterine device (IUD) when she became pregnant

* She has undergone surgery of the fallopian tubes

* She previously had an ecoptic pregnancy

* She has an infection in the upper reproductive tract (pelvic inflammatory disease or PID)

* She has been treated for infertility because of damaged tubes


Symptoms

Ectopic pregnancy is usually diagnosed around six weeks of pregnancy. Your spouse should consult her obstetrician if she has any of the following symptoms:

* Pain or tenderness in the abdomen or pelvis, especially while coughing or moving bowels, and which may become more severe or chronic with time

* Vaginal bleeding

* Shoulder pain, especially while lying down

* Symptoms of shock, such as a weak, racing pulse, pale and clammy skin, or dizziness, which may indicate a ruptured tube that requires urgent attention


Diagnosis

Ectopic pregnancies are often difficult to diagnose. However, based on the symptoms, the obstetrician may prescribe any of the following tests:

* Blood test

* Vaginal examination

* Ultrasound


If the tests are still inconclusive, the obstetrician may suggest examination of the fallopian tubes using laparoscopic surgery.

Treatment

If the embryo is still small, the ectopic pregnancy may be terminated by injecting the drug methotrexate. However, in more advanced cases, or where the medication is not advisable, a surgery may be required.