Ectopic Pregnancy

Ectopic or tubal pregnancy  is a noteworthy pregnancy complication. Fortunately it is not common but should be identified and treated as soon as possible.

After fertilization, egg implants to the inside of the uterus. Ectopic pregnancy occurs when egg attaches itself outside of the uterus, most commonly in the fallopian tube(that’s where the term tubal pregnancy comes from). Embryo can not continue proper development outside of the uterus and if left untreated, can be life threatening or cause serious damage to the mother.



As ectopic pregnancy occurs in the beginning of the pregnancy it may happen that a female does not yet know about her condition. Therefore, it is also possible that there are no present symptoms. When the pregnancy test is positive and there are other early pregnancy signs too (sore breasts, nausea..), it is important to watch out for following symptoms:

  • Vaginal spotting or bleeding – bleeding might vary from light to heavy. After getting a positive pregnancy test, beginning of red/brown bleeding or spotting should not be left inattentively. Ectopic pregnancy may also cause the fallopian tube rupture which may lead to severe bleeding. In this case doctor should be contacted immediately.
  • Pelvic pain
  • Abdominal pain  – pelvic or abdominal pain might be of different intensity(mild, sharp,severe) and appear irregularly. Pain may be on the one side of the body.
  • Shoulder or neck pain – ectopic pregnancy might cause internal bleeding. Blood will then gather under the diaphragm and irritate the nerves that go in the area.
  • Weakness, dizziness
  • Fainting


Causes and risk factors

In reality, it might be complicated to find out the cause of ectopic pregnancy. However, commonly, the problem is caused by the damaged fallopian tube that prevents egg from getting into the uterus, leaving it no other way but to implant outside of it. Common causes of blocked tube include:


  • Pelvic infection and inflammation
  • Scar tissue from previous surgery
  • Abnormal growth that changes tube’s shape


Ectopic pregnancy might happen to anyone, however,there are several risk factors that might increase the chances. They include :

  • Maternal age above 35
  • Having experienced ectopic pregnancy before
  • Pelvic inflammatory disease
  • Previous pelvic surgeries
  • Endometriosis
  • Smoking
  • Fertility drugs


Diagnosis and treatment

Ectopic pregnancy can be diagnosed through several methods :


  • Pregnancy test to confirm the pregnancy
  • Ultrasound – is used to check the location of the embryo, whether it is in the uterus or fallopian tube. Because an embryo can not continue proper development anywhere other than uterus, mother might have already miscarried before the exam. It is also possible than a female is on such an early stage of pregnancy that an embryo cannot yet be seen. Swollen fallopian tube or tissues left from the embryo will help to clarify the situation.
  • HCG levels – HCG is is a hormone that is produced during pregnancy. Provided that the pregnancy is confirmed, HCG levels should not be lower than expected.
  • Pelvic exam – will help to locate pain and check for tenderness in the abdomen.


If ectopic pregnancy is diagnosed, the treatment will vary according to the condition. Unfortunately, there is no way to transplant embryo in the uterus, so removing pregnancy tissues is the only way to support mother’s recovery. Remember that if the fallopian tube ruptures, it will cause severe bleeding and can lead to fatal consequences.


Treatment with Methotrexate

If ectopic pregnancy is identified on the early stage of pregnancy and there has been no damage to fallopian tube, the injection of methotrexate can be performed. It will stop cells from developing and allow the body to absorb remaining tissues instead.


Surgical Treatment

On later stages, medication might not be helpful and a small surgery will need to be performed. Laparoscope, a relatively thin instrument will be inserted through a very small incision in the abdomen. Remaining pregnancy tissues will be removed with the instrument. Surgery itself is called laparoscopy. According to the situation, fallopian tube might need to be removed during the laparoscopy.

When fallopian tube is already ruptured and a woman is experiencing heavy bleeding, emergency surgery will need to be done. It is called laparotomy and is performed through a larger incision.


Future Perspectives

Thinking about future pregnancy can be hard after a painful experience. Doctors may suggest to wait for 6 months approximately until the next try, however the duration may vary according to the treatment and the actual reason that caused the problem. If the fallopian tube was not removed, HCG levels should be checked regularly to see if the ectopic tissue was removed completely. If the results are 0, the recovery is progressing well and there is a good chance to have a successful pregnancy.

When the tubes are very damaged and a woman can not conceive naturally, remember that IVF treatment is a way to successful pregnancy and parenthood.


Surrogacy and Preeclampsia

Preeclampsia is a medical condition that appears only during pregnancy. It’s characteristics may be quite distinct. However, if the condition is mild, it is important to be familiar with all common symptoms and contact the doctor in a timely manner. There is also a connection between surrogacy and preeclampsia. Further we will additionally discuss what can intended parents do to make their parenthood journey less complicated.


What is preeclampsia?

Preeclampsia is a complication that may appear only during pregnancy. It will usually start after 20 weeks of gestation. It is important to diagnose preeclampsia and treat it on time. Otherwise, the condition can lead to fatal consequences for baby and a mother.

The most common symptoms of preeclampsia are high blood pressure (more than 140/90 mmHg) and protein in the urine (proteinuria).

High blood pressure solely does not necessarily indicate preeclampsia. For example, gestational hypertension is a condition of having high blood pressure during pregnancy, but without extra protein in urine  or problems with  any other organs. However, there are cases when gestational hypertension ultimately develops to preeclampsia.

When the condition is more severe, symptoms can be accompanied with:


  • severe headaches
  • abdominal pains
  • blurred vision or sensitivity to light
  • shortness of breath
  • seldom urination


Swollen hands and legs can sometimes characterize preeclampsia.

Fatigue, dizziness and nausea may also be signs of preeclampsia and in order not to confuse them with the symptoms of pregnancy, it is essential that pregnant females attend prenatal checkups regularly.

On the appointment, doctor will check blood pressure, make urine and blood tests. Usually doctors will check kidneys, because preeclampsia can affect them too.  Ultrasound may be needed to make sure that baby is growing as supposed.

We already know that during pregnancy, baby gets oxygen and food through placenta. Preeclampsia can prevent placenta from getting enough blood. Insufficient blood flow to placenta means that baby will get less nutrients and oxygen finally resulting in premature birth. Preeclampsia can also be the reason of placental abruption(placenta separating from the uterus) finally resulting in a stillbirth. Preterm labour is also a common occurrence when having preeclampsia.


Risk factors

There are no known causes of preeclampsia. However, several factors have been identified to be potentially risky:

  • Having experienced preeclampsia during previous pregnancies
  • Chronic hypertension (high blood pressure)
  • Being pregnant with multiple babies (ex: twins, triplets…)
  • Being pregnant for the first time
  • Babies from different partner on second or further pregnancies
  • Having body mass index (BMI) 30 or higher, referred to as obesity
  • History of chronic high blood pressure, kidney diseases , blood clotting before pregnancy.
  • Age (younger than 20 or older than 40)
  • Genetic factors (sister or mother had preeclampsia)



Preeclampsia is not only a threat to a baby. In future moms, it can cause complications including :

  • stroke
  • seizure
  • fluid in the lungs
  • heart failure of cardiovascular disease
  • problems in kidneys, liver or even eyes. If severe, preeclampsia can seriously affect other organs.


Complications may also include:

Hemolysis (HELLP) which is a more complicated and severe form of preeclampsia and can cause fatal consequences for mother and a baby. HELLP causes the disruption of red blood cells, erythrocytes. Hemolysis is a threat for other organ systems.

If preeclampsia is accompanied by seizure, then the condition develops to eclampsia. Because of its severnes, independant from the stage of pregnancy, the delivery becomes unavoidable.


Treatment and consequences

If the symptoms are mild and the baby is not yet developed sufficiently, doctor may advise  a bed rest, consumption of plenty of water as well as  food rich in proteins. Medicines to lower  blood pressure may be prescribed. Regular prenatal checkups are required to control the course of pregnancy. With the help of ultrasounds, doctor will have to check the heartbeat of a baby. Steroid injections are sometimes used to accelerate the development of baby’s lungs.

Actually, the only cure to preeclampsia is the delivery. Doctor may have to induce the labour, even if mother is not close to term. When preeclampsia is severe and fetus is on the early stage of development, parents and doctor might have to discuss fatal consequences that could be caused by keeping the fetus.

Of course, it is better to be as close to due date as possible. For example after 37 weeks of gestation, when the baby is usually developed enough, delivery is the only option to keep preeclampsia from getting worse. In this case, usually both, mother and baby do just fine.


Surrogacy and Preeclampsia

Professional surrogacy agencies control the health of a surrogate mother regularly. Basically one of the main things intended parents should ensure is that their agency is going to screen the surrogate frequently. It is important that parents are always updated with the information about health of a surrogate and their baby.

Experienced agencies and clinics are already familiar and have experienced patients with most of the pregnancy complications. While some of the conditions are easier to control and manipulate than preeclampsia, the agency will not hesitate to explain their approach to this health condition and share best practices from their experience.

Remember, that the desired results are not always achieved on the first try. In fact, a lot of good things come after times of struggle and failure. There is certainly quite a high possibility to make everything work out just fine, however, it’s important to have a solid, stable and well thought backup plan(s). Same applies for surrogacy agencies and at some point, this is what intended parents should care about in the beginning too.