Published: Sep 10, 2016, edited: Nov 10, 2018 by Dr. Zelmanovich (Gynecologist in NYC), Manhattan Women's Health & Wellness

Ectopic Pregnancy

Ectopic PregnancyAn ectopic pregnancy occurs when a fetus begins to form outside of the womb. It’s a pregnancy that happens anywhere except inside the uterus where it’s supposed to happen. An ectopic pregnancy is life-threatening for the mother and cannot support the full-term growth of the baby.

Commonly, a fertilized egg travels to the womb, or uterus, through the fallopian tube. Sometimes, the egg becomes blocked for some reason and cannot continue along the path. Left untreated, the tissue that begins to grow from the egg can cause damage to surrounding organs, leaving you infertile. Severe blood loss can lead to death. Early intervention is vital to prevent further damage. Any signs or symptoms should always be evaluated with a thorough consultation and examination by a physician  for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition.

Manhattan Gynecologist Dr. Zelmanovich of Manhattan Women’s Health & Wellness offer a comprehensive Obstetrics & Gynecology care in NYC for women of all ages. At our obgyn clinic of we provide a full range of gynecology services, from annual check-ups and routine pap smears to Ectopic Pregnancy Treatment and gyn procedures, surgeries performed in our office or in the hospital. Our state of the art gynecology NYC facility equipped with a latest obgyn equipment.

Ectopic Pregnancy Statistics

Ectopic pregnancies occur in about one in 50 pregnancies, representing about two percent of all pregnancies nationwide, according to the American Pregnancy Association. Of all pregnancies that lead to death, nearly nine percent are caused by ectopic pregnancies.

An ectopic pregnancy doesn’t have to mean that future endeavors to conceive won’t succeed. Close to 33 percent of women who’ve had an ectopic pregnancy at some point in their lives go on to have a normal pregnancy and healthy delivery at a later time.  But if you’ve had an ectopic pregnancy, your risk of having another one increases nine times over women who’ve never had one.

Risks play into the ectopic pregnancy statistics as well because having an appendectomy doubles the chances that you’ll have an ectopic pregnancy. You also are at a greater risk if you’re over the age of 35 or under the age of 20.

Placement Varies

Most of the time, an ectopic pregnancy occurs in the fallopian tubes, which is why an ectopic pregnancy often is referred to as a tubal pregnancy. Though less common, an ectopic pregnancy also can occur in the cervix, which is the neck of the uterus, or in the ovaries or abdominal cavity.

A heterotopic pregnancy happens when you have a normal pregnancy and an ectopic pregnancy at the same time. Very uncommon in natural forms of conception, heterotopic pregnancies usually occur after some level of assisted fertilization. Heterotopic pregnancy sometimes is also referred to as combined ectopic pregnancy, coincident pregnancy or multiple-sited pregnancy.

Causes Range Widely

Many ectopic pregnancies occur because the fallopian tubes are damaged or misshapen somehow, causing the egg to get stuck. Hormone imbalances, usually difficult to detect, also are a major cause of ectopic pregnancies. Other conditions that can contribute to such an ill-fated pregnancy include:

  • Having a previous tubal pregnancy
  • Endometriosis
  • Scarring after you’ve had an appendectomy
  • Birth defects that left your fallopian tubes damaged
  • Signs of pregnancy with IUD (and getting pregnant while it’s still in place)
  • Following a tubal ligation (that obviously didn’t hold)
  • Having multiple sexual partners
  • Trying certain fertility treatments
  • Smoking just prior to conceiving

Know the Symptoms

Ectopic pregnancy pain usually begins with common symptoms you get from a regular pregnancy such as nausea in the mornings and tenderness in your breasts. All signs and symptoms should always be evaluated with a thorough consultation and examination by a physician  for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition. You’ll stop having your period and may experience one or more of the following symptoms, indicating problems:

  • Ectopic pregnancy bleeding from your vagina
  • Varying pain locations from your pelvis and abdomen to your lower back

When fallopian tube pain increases, it may indicate that a rupture has taken place. Signs that you need immediate emergency medical attention include:

  • Falling blood pressure
  • Pain in your shoulders
  • Feeling faint or actually fainting
  • Intense rectal pressure
  • Sharp, severe and sudden pressure and pain in your lower belly area
  • Dizziness

The consequences of a rupture are life threatening because it’s caused by excessive blood loss.

Diagnosis Discovered

The first step in diagnosing an ectopic pregnancy is through a pelvic exam where your gynecologist, Dr. Zelmanovich looks for inappropriate pain and tenderness. Sometimes, the tubal pregnancy can be felt in the fallopian tubes as it grows. Sometimes, an ultrasound can confirm the presence of a growing embryo outside the uterus.

During testing, your hormone levels are checked for abnormalities, since your human chorionic gonadtropin (or hCG) levels usually are lower if you have an ectopic pregnancy. Higher than normal progesterone levels also may indicate the presence of an abnormal pregnancy.

An ultrasound is performed to try to find the location of the pregnancy.

Early Treatment

Early treatment is best for your overall health and for recovering as much of your reproductive organs as possible and early diagnosis and treatment by your physician is crucial.  Methotrexate is the most common medication used to treat an ectopic pregnancy. In a methotrexate ectopic pregnancy abortion, your body simply absorbs the egg and pregnancy tissue. It’s vital that Midtown gynecologist, Dr. Zelmanovich be absolutely sure that you have an ectopic pregnancy before delivering a dose of methotrexate.

Another method to treat ectopic pregnancy that’s caught early is laparoscopic surgery. It begins with a tiny incision in your abdomen near your navel. Your gynecologist, Dr. Zelmanovich then relies on a thin tube equipped with a camera to view the entire tube and uterus. If found, the ectopic tissue can safely be removed through the incision. Your fallopian tube, if damaged, also can be removed at this time.

Emergency Procedures

If you experience heavy bleeding, you may have to undergo a laparotomy, which involves a larger incision through which the surgeon can remove the ectopic tissue and any damaged fallopian tubes. Heavy bleeding can lead to shock if not treated immediately with:

  • Raised legs
  • Fluids
  • Keeping you warm
  • Oxygen
  • Blood transfusions
  • Surgery

Recovery time following an emergency laparotomy can last as long as six weeks. If your tubes and uterus weren’t removed during the surgery, you may be able to conceive again successfully. To increase your chances of a successful pregnancy next time:

  • Practice safe, monogamous sex
  • Stop smoking
  • Get tested early for possible STDs that could damage your fallopian tubes
  • Reduce risk of pelvic inflammatory disease by using a condom
  • See your OBGYN early when you suspect that you are pregnant

Keep regular appointments to check your and your baby’s progress throughout your pregnancy


Important Reminder: This information is only intended to provide gynecology guidance, not a definitive medical advice. Please consult obgyn NYC doctor about your specific condition. Only a trained, experienced board certified gynecologist or certified gynecology specialist can determine an accurate diagnosis and proper treatment.

Do you have questions about Ectopic Pregnancy? Would like to schedule an appointment with the top rated OBGYN in NYC, Dr. Anat Zelmanovich, please contact our office.

Manhattan Women’s Health & Wellness
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Midtown OB/GYN)
51 East 25th Street, Ste 403, New York, NY 10010
(Between Madison Ave & Park Ave)
(212) 533-4575
Manhattan Women’s Health & Wellness
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Upper East Side OB/GYN)
983 Park Ave, Ste 1D, New York, NY 10028
(Between 83th & 84th Street)
(212) 427-8761
Manhattan Women’s Health & Wellness
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Union Square OB/GYN)
55 W 17th St Ste 104, New York, NY 10011
(Between 5th & 6th Avenue)
(212) 378-9985
The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self diagnoses should not be made based on information obtained online. It is important to consult a best in class gynecologist in Midtown regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or our Gynecology NYC office today and schedule a consultation with a top Midtown OBGYN gynecologist.