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Ectopic Pregnancy: Symptoms, Risk Factors and When to Get Help

An ectopic pregnancy happens outside the womb and needs urgent medical care. Learn the warning signs, who is at higher risk and what treatment involves.

Before you use this guide: This is general educational information, not an individual medical assessment. We do not identify a clinician reviewer on this page, so please confirm personal health decisions with your doctor, midwife or paediatrician.

An ectopic pregnancy is one in which a fertilised egg implants outside the womb, most often in one of the fallopian tubes. It affects around 1 in 100 pregnancies. An ectopic pregnancy cannot develop into a baby, and it can be dangerous for the mother if the tube ruptures. It is not caused by anything you did. With early care, most people recover well.

Symptoms to watch for

Symptoms usually start between about 4 and 12 weeks. Early on, you may have the usual signs of pregnancy, such as a missed period and a positive test. Then you might notice:

• Pain low in your tummy, often on one side
• Vaginal bleeding, or a brown, watery discharge, which may be different from a period
• Pain at the tip of your shoulder
• Pain when you pass urine or have a bowel movement
• Feeling sick, dizzy or faint

Emergency signs

Call your local emergency number or go to the nearest emergency department straight away if you have sudden or severe tummy pain, feel faint, dizzy or collapse, look pale and clammy, or have a rapid heartbeat. These can be signs of internal bleeding.

Who is at higher risk

Anyone can have an ectopic pregnancy, and many people who do have no known risk factors. The risk is higher if you have:

• Had an ectopic pregnancy before
• Damage to a fallopian tube, for example from pelvic infection, a sexually transmitted infection, endometriosis or previous surgery
• Become pregnant while using an intrauterine device (coil) or after sterilisation
• Had fertility treatment, including IVF
• Smoked
• Reached your mid-thirties or older

How an ectopic pregnancy is diagnosed

If you have a positive pregnancy test and any of the symptoms above, you should be seen the same day. The usual tests are an ultrasound scan, often done internally to get a clearer view, and blood tests to measure the pregnancy hormone hCG. Sometimes the pregnancy cannot be seen at first. In that case, you may be asked to come back for repeat blood tests a couple of days later. This is called a pregnancy of unknown location, and it needs close follow-up.

Treatment

The treatment depends on how early the pregnancy is found, your symptoms and your test results. Your care team will explain the options, which include:

• Waiting and monitoring, in a small number of cases where hCG levels are already falling
• A medicine called methotrexate, which stops the pregnancy tissue growing, for early, stable cases
• Keyhole surgery to remove the pregnancy, sometimes along with the affected tube
• Emergency surgery if a tube has ruptured

Afterwards

An ectopic pregnancy is a pregnancy loss, and it is normal to feel shock, grief or anxiety, even when the physical treatment goes well. Ask your doctor or early pregnancy unit about counselling and support. Your team will also tell you how long to wait before trying again, which depends on the treatment you had. Most people go on to have a healthy pregnancy, and it is sensible to book an early scan next time to check where the pregnancy is.

When to contact a doctor

If you have a positive test, or think you may be pregnant, and you have bleeding or pain on one side of your tummy, contact your doctor, midwife, early pregnancy unit or emergency department the same day. Do not wait for your booking appointment.

This content is for general information only and is not medical advice. Every pregnancy and every baby is different. Always talk to your doctor, midwife or paediatrician about your own situation, and seek urgent care if you are worried.