Symptoms of an ectopic pregnancy usually develop between the 4th and 12th weeks of pregnancy. Some women don't have any symptoms at first. They may not find out they have an ectopic pregnancy until an early scan shows the problem or they develop more serious symptoms later on. You may have an ectopic
pregnancy if you miss a period, have a positive pregnancy test, and have other signs of pregnancy. Contact your GP or call NHS 111 if
you have a combination of any of these symptoms and you think you might be pregnant – even if you haven't had a positive pregnancy test. Vaginal bleeding tends to be a bit different to your regular period. It often starts and stops, and may be watery and dark brown in colour. Some women mistake this bleeding for a regular period and don't realise they're pregnant. Vaginal bleeding during pregnancy is relatively common and isn't necessarily a sign of a serious problem, but you should seek medical advice if you experience it. You may experience tummy pain, typically low down on one side. It can develop suddenly or gradually, and may be persistent or come and go. Tummy pain can have lots of causes, including stomach bugs and trapped wind, so it doesn't necessarily mean you have an ectopic pregnancy. But you should get medical advice if you have it and think you might be pregnant. Shoulder tip pain is an unusual pain felt where your shoulder ends and your arm begins. It's not known exactly why it occurs, but it can be a sign of an ectopic pregnancy causing some internal bleeding, so you should get medical advice right away if you experience it. You may experience pain when going for a pee or poo. You may also have diarrhoea.Main symptoms
Vaginal bleeding
Tummy pain
Shoulder tip pain
Discomfort when going to the toilet
Some changes to your normal bladder and bowel patterns are normal during pregnancy, and these symptoms can be caused by urinary tract infections and stomach bugs.
But it's still a good idea to seek medical advice if you experience these symptoms and think you might be pregnant.
Symptoms of a rupture
In a few cases, an ectopic pregnancy can grow large enough to split open the fallopian tube. This is known as a rupture.
Ruptures are very serious, and surgery to repair the fallopian tube needs to be carried out as soon as possible.
Signs of a rupture include a combination of:
- a sharp, sudden and intense pain in your tummy
- feeling very dizzy or fainting
- feeling sick
Call 999 for an ambulance or go to your nearest accident and emergency (A&E) department immediately if you experience these symptoms.
Page last reviewed: 23 August 2022
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review due: 23 August 2025
Ectopic Pregnancy
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What is an ectopic pregnancy?
A pregnancy that develops outside the uterus is called an ectopic pregnancy. It almost always happens in a fallopian tube. Because of this, it’s often called a tubal pregnancy. In rare cases, an ectopic pregnancy will happen in an ovary, in the cervix, or the belly (abdomen).
What causes an ectopic pregnancy?
A fertilized egg normally moves down a fallopian tube and into the uterus. But the egg can get stuck in the tube if the tube is blocked. This might be from an infection or scar tissue. If the fertilized egg can't reach the uterus, it begins to develop in the tube.
Who is at risk for an ectopic pregnancy?
Ectopic pregnancy is more common in women who:
- Have had trouble getting pregnant (infertility)
- Have endometriosis. This is when uterine tissue grows in other areas of the pelvis.
- Have a sexually transmitted disease. This can cause infection and scarring in the pelvis.
- Had tubal surgery
- Use an IUD
- Had an ectopic pregnancy in the past
- Have multiple sex partners
- Smoke
- Are older
What are the symptoms of an ectopic pregnancy?
Women with an ectopic pregnancy may have irregular bleeding and pelvic or belly (abdominal) pain. The pain is often just on 1 side. Symptoms often happen 6 to 8 weeks after the last normal menstrual period. If the ectopic pregnancy is not in the fallopian tube, symptoms may happen later. The classic symptoms of an ectopic pregnancy are:
- Belly (abdominal) pain
- No recent period
- Vaginal bleeding not related to a period
How is an ectopic pregnancy diagnosed?
Your healthcare provider will measure the level of the hormone hCG (human chorionic gonadotropin) in your blood. They will use ultrasound to check the uterus for a fetus or other pregnancy tissue. In some cases, your healthcare provider will use laparoscopy to diagnose and treat an ectopic pregnancy. This is surgery that uses a lighted tube inserted into your abdomen to check inside the pelvis. It often gives the most accurate diagnosis.
How is an ectopic pregnancy treated?
Ectopic pregnancy may be treated in several ways. This depends on whether the fallopian tube has broken open (ruptured), how far along the pregnancy is, and your hormone levels. Treatments may include:
- Letting the ectopic pregnancy heal and the body absorb it on its own. This is only for certain cases.
- Using the medicine methotrexate to stop the pregnancy from growing further
- Using surgery (usually laparoscopy) to make a small opening in the fallopian tube. The surgeon removes the pregnancy and sometimes the tube.
In rare cases, healthcare providers must make a larger incision in the abdomen to remove the ectopic pregnancy or damaged fallopian tube.
What are possible complications of an ectopic pregnancy?
When the embryo implants in the fallopian tube, it does not have enough room to grow or enough blood flow to keep it healthy, so it dies.
The tube may start to let out some of the tissues or bleed. Some embryos do keep growing and may become large enough to burst the fallopian tube. This can cause severe bleeding and shock.
Ectopic pregnancy is the leading cause of pregnancy-related deaths during the first 3 months of pregnancy in the U.S.
When should I call the healthcare provider?
Don’t ignore symptoms of ectopic pregnancy. Call your healthcare provider if you have any bleeding or pain in pregnancy.
Key points about ectopic pregnancy
- Pregnancy that develops outside the uterus is called ectopic pregnancy.
- Women with an ectopic pregnancy may have irregular bleeding and pelvic or abdominal pain, often on one side.
- Symptoms most often appear 6 to 8 weeks after the last normal menstrual period.
- Ectopic pregnancy may be treated in several ways, depending on whether the fallopian tube has burst.
- Don’t ignore symptoms of ectopic pregnancy. Call your healthcare provider if you have any bleeding or pain in pregnancy.
Next steps
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
Medical Reviewer: Irina Burd MD PhD
Medical Reviewer: Donna Freeborn PhD CNM FNP
Medical Reviewer: Heather M Trevino BSN RNC
© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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