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Ectopic Pregnancies

To confirm a diagnosis, your doctor will perform a blood test to check your level of the pregnancy hormone, human chorionic gonadotropin (hCG). If it is high enough to suggest a pregnancy, but not as high as it should be at your stage, the pregnancy may be ectopic. Your doctor may also perform a vaginal exam to look for a mass or enlarged fallopian tube or to confirm vaginal tenderness, all of which indicate an ectopic pregnancy.

An ultrasound can also confirm an ectopic pregnancy. However, in most cases, the embryo dies early in the process and is too small for the sonographer to find. In this case, he or she will usually look for a swollen fallopian tube and may see blood clots as well as any remaining tissue from the embryo.

Your doctor will treat an ectopic pregnancy depending on the size of the embryo, its location, and whether you want to be able to conceive again. If it is discovered early, your doctor may give you an injection of methotrexate, which dissolves the fertilized egg and allows your body to reabsorb it, thereby minimizing scarring of your pelvic organs. However, if the pregnancy is further along, you will probably need surgery to remove the embryo. If you're in stable condition and the embryo is small enough, it can be removed using laparoscopic surgery, which involves a small incision and general anesthesia. If you have extensive scar tissue, heavy bleeding, or if the embryo is too large, it must be removed with major abdominal surgery. Regardless of treatment, your doctor will want to see you regularly afterward to make sure your hCG levels return to zero, which may take up to 12 weeks. If your hCG levels remain elevated, it could indicate that some ectopic tissue was not removed.

Your ability to conceive after an ectopic pregnancy depends on how early the ectopic was discovered and removed, and the damage to your fallopian tube. Approximately 30 percent of women who have had ectopic pregnancies will have fertility issues in the future.

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