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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Does an ectopic pregnancy hurt?

Ectopic pregnancy is an abnormal pregnancy state where the fertilized egg implants outside the uterine cavity. As the pregnancy sac grows, there is a possibility of rupture and bleeding at the implantation site, which can lead to abdominal pain. In the early stages of an ectopic pregnancy, women generally do not exhibit any specific symptoms and are unaware of the condition. Symptoms are only felt when rupture occurs, causing pain in the lower abdomen. If rupture occurs, the pain often feels like tearing in the lower abdomen and is frequently accompanied by nausea and vomiting. It is recommended to promptly visit a hospital for an ultrasound and actively pursue surgical treatment.

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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 Lu
Obstetrics
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ectopic pregnancy symptoms

Ectopic pregnancy is not a normal state of pregnancy. Normally, the gestational sac should be located in the middle of the uterine cavity. An ectopic pregnancy refers to the implantation of the gestational sac outside the uterine cavity. Common types of ectopic pregnancy include tubal pregnancy, ovarian pregnancy, and abdominal pregnancy, with over 99% of ectopic pregnancies being tubal pregnancies. The symptoms of an ectopic pregnancy include the following aspects: 1. In the early stages of an ectopic pregnancy, there are no clinical symptoms because the early gestational sac is relatively small and does not stimulate the fallopian tube or the local area, thus causing no symptoms. 2. When the gestational sac grows to a certain size, it compresses the tube cavity, causing mild abdominal pain. This pain intensifies as the gestational sac grows and can lead to tearing pain, indicating a ruptured tubal pregnancy. 3. During an ectopic pregnancy, because the gestational sac cannot develop normally, the levels of estrogen and progesterone in the body are relatively low, leading to endometrial withdrawal bleeding, which manifests as a small amount of bright red vaginal bleeding.

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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 Tang Mei Xiang
Obstetrics and Gynecology
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Can you have intercourse with an ectopic pregnancy?

Ectopic pregnancy and sexual intercourse often occur when the patient is unaware, specifically during the early stages when there is no bleeding, no abdominal pain, and only amenorrhea is present; intercourse might occur under these circumstances. However, if there is irregular vaginal bleeding or abdominal pain, suspecting an ectopic pregnancy, it is advised not to have intercourse. This is because intercourse can cause excitement, which might lead some ectopic pregnancy masses to rupture, potentially causing severe bleeding.