Dr Kerryn Phelps, Health Editor, with Tracey Grimshaw, Channel Nine, 'Today'

GRIMSHAW: Exactly what is an ectopic pregnancy? And what causes it, more importantly?

PHELPS: An ectopic pregnancy is a pregnancy that implants where it shouldn't be implanting, it should be implanting in the wall of the uterus, but in an ectopic pregnancy, most likely, it will implant in the tube leading down from the ovary to the uterus, or in fact it can implant on the ovary itself, or even in the abdominal cavity somewhere, and it is a medical emergency when it happens.

GRIMSHAW: Why does that happen?

PHELPS: Well, a lot of the time you don't know why it happens, but usually there is something wrong with the tube. The tube normally propels the eggs, and when it's fertilised the embryo, down into the uterus. If there is something wrong with that tube, it might be that you have a ruptured appendix in the past, it might be that you've had endometriosis, which has affected the tubes. Maybe there is a kink in the tube, or an abnormality. Sometimes it's because there has been a sexually transmitted disease, or a pelvic infection of some sort. So, anything that can cause an abnormality in the tube can cause the tube not to be able to get the egg down past that problem in the tube, and it sticks there.

GRIMSHAW: You've got a model with you, show us on the model.

PHELPS: Normally, you would have the egg released from the ovary, it would be fertilised somewhere in the tube, and then implant down in the uterus. But when you have an ectopic, you have the fertilisation occurring up in the tube as usual, but then you get implantation, so the pregnancy sticks in the tube. And then as the foetus grows, you get an enlargement of that tube, and it gets to a point where there is a lot of blood vessels there, and it can rupture, and when it ruptures you can get a lot of blood loss, and that can lead to collapse.

GRIMSHAW: Kerryn, how big is the fallopian tube, how big does the embryo or foetus become? In other words how advanced is it, before it creates a problem like that?

PHELPS: It usually starts creating problems around the six week mark of pregnancy, and you know that if a women, there are symptoms of ectopic pregnancy, the women will usually have missed a period, or had a very light period, she might have had some spotting. There will be some abdominal pain usually, there will be, sometimes if there has been a significant amount of bleeding, there will be pain referred up to the shoulder…

GRIMSHAW: Why the shoulder? That's interesting, how come?

PHELPS: Well, anytime you have irritation in the abdominal cavity, you can get pain refereed up to the shoulder, and it's one of the signs that there is some bleeding that is irritating the upper part of the abdominal cavity.

GRIMSHAW: So, something like this left unattended is life threatening?

PHELPS: Oh yes. Left unattended, if this ruptures, is fatal, so it is a matter of a medical emergency, and it will require surgery. Now, in the very early stages, if it hasn't ruptured, there is some chance that a surgeon might be able to just remove the foetus, and close the tube back up, but mostly you'll lose the tube.

GRIMSHAW: Potential for conceiving again, then is minimised?

PHELPS: Well, your infertility drops by about fifty percent, so there will be a problem with infertility in about half of women who have had a problem. Many of them, of course, have a problem in the other tube. There is an increased risk, when you've had one ectopic, of having another one, and of course, if you lose both tubes then you'd be looking at some sort of fertility treatment later on, to become pregnant.

GRIMSHAW: Okay. Just on another matter, and very quickly. Unfortunately, this new breast cancer drug - a lot of optimism about that, I believe?

PHELPS: Well, there is, it was only presented yesterday, to the scientific community, it's a drug called Anastrazole Now, women who have had breast cancer in one breast, have been treated for the last fifteen years if they have a hormone receptive cancer, with a drug called Tamoxifen, and that leads to an increased protection against them getting breast cancer in the other breast, or having a reoccurance of the breast cancer. This new drug called Anastrazole has somewhat better results, than Tamoxifen, which is obviously very good news for women who have not had successful treatment with Tamoxifen, and it appears that a few side effects, like getting hot flushes, and blood clots.

GRIMSHAW: Great news. Thanks

Ends