This information is provided for informational purposes only. Please consult a physician if you think you are experiencing a medical emergency.
This article will help you understand the differences between an ectopic pregnancy and a miscarriage.
Ectopic pregnancy and miscarriage are two of the most common pregnancy complications. They are both a type of pregnancy loss, but they are completely different diagnoses.
They can be confusing because they often have similar symptoms, they can both present early in pregnancy, and the symptoms can often be confused for normal pregnancy symptoms.
The Bottom Line
In a normal pregnancy, the pregnancy implants and grows within the uterus.
A miscarriage occurs when the pregnancy dies of natural causes. A miscarriage may occur very early (before a pregnancy can be seen on ultrasound), or after the pregnancy has been seen within the uterus on ultrasound.
An ectopic pregnancy implants and grows outside of the uterus. An ectopic pregnancy cannot survive and can be life-threatening to the mother.
Keep reading for more info on these two conditions.
Ectopic Pregnancy: Definition
In a normal pregnancy, the fertilized egg implants and grows within the uterus.
According to the American College of Obstetricians and Gynecologists, “an ectopic pregnancy occurs when a fertilized egg grows outside of the uterus.”
Ectopic Pregnancy: Location
95% of ectopic pregnancies occur within the fallopian tube. These are also called tubal pregnancies.
Ectopic pregnancies can also occur in the abdominal cavity, cervix, ovaries, or in an existing c-section scar. However, these are less common.
Ruptured Ectopic Pregnancy
The greatest risk of an ectopic pregnancy is internal bleeding and death of the mother.
As an ectopic pregnancy grows, it can rupture and lead to internal bleeding and death of the mother.
The symptoms of a ruptured ectopic pregnancy include:
- Severe abdominal pain
- Vaginal bleeding: light spotting or heavy vaginal bleeding
- Shoulder pain
Ectopic Pregnancy: Treatment
Doctors cannot predict when an ectopic pregnancy will rupture. Because of the risk of rupture, once an ectopic pregnancy is diagnosed, it should be treated.
There are two main treatment options for ectopic pregnancies:
- Medical treatment with a medication called methotrexate
Your doctor will determine whether medical treatment or surgery is the best option for you.
A medication called methotrexate can be used to treat an ectopic pregnancy. The advantage of methotrexate is it can save your fallopian tube (which is often removed during surgery for ectopic pregnancy).
However, methotrexate does not work 100% of the time. Even after treatment with methotrexate, ectopic pregnancies can still rupture.
You will need follow-up appointments to be sure the medication has worked.
Multiple doses of methotrexate may be required.
WARNING: Methotrexate can cause birth defects and should not be used during a normal pregnancy.
WARNING: Methotrexate is excreted in breast milk. You should not breastfeed if you have been treated with methotrexate.
Ectopic Pregnancy: Surgical Treatment
In some cases, surgery is the safer option for treatment.
For example, if the ectopic pregnancy has ruptured or if there is a heartbeat present, then your doctor will recommend surgery.
Laparoscopic surgery is most commonly performed. This is performed by making several small incisions in the abdomen.
Cervical and c-section scar ectopics require a different surgical procedure, known as a D&C.
Your doctor will discuss what type of surgery they plan to perform and what to expect during the recovery process.
Who is at risk for an ectopic pregnancy?
These factors increase the risk of ectopic pregnancy:
- Sexually transmitted infections
- History of pelvic inflammatory disease
- Previous ectopic pregnancy
- Prior abdominal surgery
- Prior pelvic surgery
In a normal pregnancy, the embryo implants in the uterus and grows.
A miscarriage occurs when the pregnancy dies or stops growing naturally. The medical term for a miscarriage is spontaneous abortion.
First trimester miscarriage is often due to a genetic abnormality. However, for most miscarriages, a cause is never found.
Symptoms of miscarriage include:
- Abdominal pain
- Pelvic pain
- Vaginal bleeding
- Low back pain
Sometimes, there are no symptoms at all.
- Expectant Management
- Medical Management
Miscarriage: Expectant Management
For early miscarriages, most women will pass the pregnancy naturally. There is often bleeding and cramping during this process.
Expectant management means waiting for the process to happen naturally.
Miscarriage: Medical Management
Your doctor may prescribe medication to help you pass the miscarriage.
Your doctor may offer you a surgical procedure known as a D&C.
The tools used to diagnose ectopic pregnancy and miscarriage are:
- Medical history – Your doctor will ask you questions such as
- When was your last period?
- How many times have you been pregnant?
- Are you having any bleeding?
- Are you having any pain?
- Physical Exam
- Beta human chorionic gonadotropin (beta hCG) is a pregnancy hormone, which is often simply called hCG
- Ultrasound examination
Your doctor will talk to you and perform a physical exam.
They will obtain blood tests to check your hCG levels.
An ultrasound will be performed. This will help determine if there is a normal pregnancy in the uterus or an ectopic pregnancy.
In early pregnancy, transvaginal ultrasound is often needed to detect the small developing pregnancy.
Making the diagnosis of an ectopic pregnancy or miscarriage is not always straightforward. It can often take multiple appointments for your doctor to figure out what is going on. If your doctor schedules you for repeat testing, remember to keep your follow-up appointment.
Medical Emergency: When to seek medical care
You should seek immediate medical attention if you experience symptoms of an ectopic pregnancy.
Early Pregnancy Loss
It is normal to grieve the loss of a pregnancy. Seek emotional support from friends, family members, or other resources.
When can I try to get pregnant again?
Many women who experience a miscarriage or ectopic pregnancy can go on to have a normal healthy pregnancy.
Talk to your doctor about the best time to start trying to conceive again.