20.4.1  Ectopic pregnancy

Important! If you suspect an ectopic pregnancy you must send the woman for evaluation and treatment to the nearest health facility.

Ectopic pregnancy is when pregnancy occurs outside the endometrial cavity of the uterus. The most common site for an ectopic pregnancy is in a fallopian tube (the pair of tubes connecting the uterus with the interior of the abdomen, each one ending close to the ovary on that side. Look back at Figures 3.3 and 5.3 in Antenatal Care, Part 1, to remind yourself of the anatomy of the uterus and the adjacent structures. Other possible sites are the ovarian ligaments, the ovaries and the abdominal cavity surrounding the uterus.

If the embryo implants in the fallopian tube, it cannot support the growing fetus for longer than the first few weeks. There is a high risk that the tube will rupture and the woman will start bleeding into the abdominal cavity. This is a life-threatening situation leading to shock, which must be quickly treated to stop the bleeding. The typical symptoms of ectopic pregnancy are lower abdominal pain, late menstrual periods and vaginal or internal bleeding.

20.4  Other causes of early pregnancy bleeding

20.4.2  Molar pregnancy