An ectopic pregnancy is one of few gynecological conditions that has the potential to be emergently life threatening. Ectopic pregnancies occur when an embryo is implanted outside of the uterine cavity. Most ectopic pregnancies cause nausea, vomiting and abdominal or pelvic pain. However, some ectopic pregnancies may actually rupture causing severe illness, shock and even death.
*IUD use and ectopic pregnancies:
Intrauterine devices are a popular form of birth control. IUD’s such as Mirena utilize local hormonal effects to prevent contraception for up to 5 years, while the copper IUD called Paraguard is hormone-free and may last up to 10 years.
Many articles on ectopic pregnancies will list IUD’s as a risk factor for ectopic pregnancy. However, this is a misleading statement. Women with IUD’s are not at an overall increased risk for getting an ectopic pregnancy. Actually, because of the IUD they have a decreased risk of becoming pregnant, whether it is an ectopic or normal pregnancy.
The idea that women who use IUD’s are prone to ectopic pregnancy comes from the fact that when a woman with an IUD does by chance become pregnant, the likelihood that the pregnancy will be ectopic is higher than if the woman had become pregnant while using other forms of birth control.
In other words, an IUD is not a risk factor for ectopic pregnancies because women are less likely to get pregnant at all. However, IUD use does increase the relative risk of an ectopic pregnancy among women who do become pregnant with an IUD in place.
*Other risk factors for ectopic pregnancy:
Anything that causes abnormal motility in the fallopian tubes can make a woman prone to ectopic pregnancies. The most important risk factor for ectopic pregnancy is a history of pelvic inflammatory disease (PID). Other risk factors include:
-prior ectopic pregnancy
-previous tubal, pelvic or abdominal surgery
-diethylstillbestrol (DES) exposure in utero
*Sites of ectopic pregnancies:
The most common site for an ectopic pregnancy is the fallopian tubes, especially in the ampulla region of the fallopian tubes near the ovaries. The fallopian tubes account for 98% of ectopic pregnancy implantation sites. However, ectopic pregnancies may also implant on the ovaries or even in the abdominal cavity.
*Signs and symptoms of an ectopic pregnancy:
An ectopic pregnancy commonly causes
-nausea
-vomiting
-abdominal and/or pelvic pain
-abnormal vaginal bleeding (including lack of menstrual period)
-pelvic mass on examination
A ruptured ectopic pregnancy may cause
-hypotension (low blood pressure)
-tachycardia (fast heart rate)
-local and then generalized abdominal tenderness
-shoulder pain
-shock
Ectopic pregnancies are medical emergencies. An IUD will lower the overall risk of developing an ectopic pregnancy by decreasing the likelihood of becoming pregnant. IUDs are considered to be excellent forms of birth control. Individuals should speak with their physician to determine whether an IUD may be right for them.
