Ectopic pregnancy: signs and symptoms of an ectopic pregnancy

Find out what to do if you've been diagnosed with an ectopic pregnancy.
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  • An ectopic pregnancy is an alarming and sometimes life-threatening condition. Here’s how to spot the symptoms and what to expect if you have one.

    What is an ectopic pregnancy?

    An ectopic pregnancy occurs when a fertilised egg implants outside of the womb. This happens most often in one of the two fallopian tubes, which are too small to sustain a pregnancy. An ectopic pregnancy can also occur in the cervix, an ovary, in the abdomen, or even within a Caesarean scar.

    How common is an ectopic pregnancy?

    According to NHS statistics, 1 in every 90 pregnancies in the UK is ectopic – around 11,000 a year. A number of celebrities have suffered ectopic pregnancies, including Nicole Kidman, singer-songwriter Vanessa Carlton, and actress and model Jaime King.

    Who is more likely to have an ectopic pregnancy?

    Ectopic pregnancies can happen to any fertile woman. However, there’s an increased risk if you’ve had one before, if you’ve had tubal surgery previously, or if you have abnormal fallopian tubes or endometriosis.

    The following can also increase chances of an ectopic pregnancy:

    • A history of pelvic inflammatory disease (PID)
    • Recurring sexually transmitted infections that can scar the tubes such as chlamydia or gonorrhoea
    • Using an intrauterine device (IUD)
    • Abdominal surgery
    • Emergency contraception
    • Being pregnant over the age of 40
    • Smoking

    You are not more likely to have an ectopic pregnancy if you’ve had miscarriages, abortions or played sport. The condition also isn’t hereditary.

    Ectopic pregnancy, illustration

    How do I know if I have an ectopic pregnancy?

    There are not always clear symptoms of an ectopic pregnancy, which makes it hard to diagnose. Symptoms mimic signs of early pregnancy, so it’s often picked up during an ultrasound scan.

    Early symptoms (before the 12th week of pregnancy) include:

    • A positive pregnancy test (but you may also get a negative reading)
    • Brown, watery discharge or vaginal bleeding
    • One-sided stomach pain
    • Discomfort when going to the toilet
    • Diarrhoea
    • Pain in the tip of the shoulder

    Sometimes an ectopic pregnancy ends in rupture, which is when the pregnancy tears the fallopian tube and causes internal bleeding. This is serious and requires emergency surgery. Call an ambulance if you’re pregnant, or think you’re pregnant, and get the following symptoms:

    • An intense pain in the stomach
    • Severe pain in the neck or tip of the shoulder
    • Nausea or vomiting
    • Dizziness, fainting or collapse
    • Going pale
    Shoulder tip pain ectopic pregnancy

    Credit: Getty

    What does ectopic pain feel like?

    It is usually an intense pain in the abdomen or pelvis, and it can be on one side or all over. Pain is also felt in the shoulder or neck where blood from a ruptured fallopian tube may build up and irritate nerves. Not all women feel pain, however, and it can vary from a low ache to sharp, stabbing pain. Dr Jackie Ross, Consultant Gynaecologist at Kings College Hospital, describes it as “a sharp, stitch-like pain, but the pain can also be more non-specific than that.”

    What colour is ectopic bleeding?

    Any bleeding from an ectopic pregnancy can look like a normal period. It could be bright red or a darker brown colour, which is why some women mistake it for a period. If you have any other abnormal symptoms and there is a chance you could be pregnant, you should consult your doctor.

    How soon would I know if I have an ectopic pregnancy?

    Ectopic pregnancy symptoms typically emerge between weeks four and 12 of pregnancy. This could be before you even realise you’re pregnant. Otherwise, you may discover the embryo in an early scan (12 weeks or earlier). If you’re not due a scan but you have symptoms or concerns, you must visit your GP or the Early Pregnancy Unit.

    How long can it go unnoticed?

    If it’s not picked up in a scan, an ectopic pregnancy can go unnoticed for the first 16 weeks of pregnancy, until the fertilised egg is large enough to cause significant pain. However, it usually creates symptoms earlier than this.

    What happens if I have an ectopic pregnancy?

    The NHS offers three treatments if it is discovered early enough:

    1. Close monitoring – the fertilised egg will sometimes dissolve and no treatment is needed
    2. Medication to stop the unviable pregnancy
    3. Surgery (usually keyhole surgery) to remove the fertilised egg and, sometimes, the affected fallopian tube

    However, if the fallopian tubes burst or rupture, you will undergo emergency surgery to remove the egg and fallopian tube.

    Woman hospital ectopic pregnancy

    Credit: Getty

    Can an ectopic pregnancy survive?

    Sadly no. An ectopic pregnancy is not a viable pregnancy as the fertilised egg won’t have room to grow outside the womb and the pregnancy can’t be moved.

    Will an ectopic pregnancy reduce my chances of getting pregnant?

    According to the NHS, most women get pregnant again, even with one fallopian tube. “If you take 100 women who’ve had an ectopic pregnancy 60-70 percent of those women will be able to get pregnant again naturally,” says Dr Jackie Ross. Fertility treatment is also an option for anyone who has suffered from an ectopic pregnancy.

    Professor Dharani Hapangama, is consultant gynaecological surgeon at the University of Liverpool and researcher at women’s health research charity Wellbeing of Women. She recommends mothers getting early scans for subsequent pregnancies: “When they know they are pregnant, their location of pregnancy needs to be checked. This is usually around six weeks of pregnancy at a dedicated early pregnancy unit in the local hospital.

    “If one fallopian tube is removed and if the remaining tube is normal, the impact on fertility is not much. But the risk may be higher the next time; so the location of pregnancy needs to be checked early in the pregnancy.”

    Can I give birth after an ectopic pregnancy?

    “Giving birth after previously experiencing an ectopic pregnancy should not be affected,” reassures Lesley Gilchrist, Registered Midwife and Founder of My Expert Midwife. “There are two fallopian tubes, so if the ovary and fallopian tube on the unaffected side are healthy then future pregnancy is possible.” Nevertheless, you should always inform your doctor or midwife of your past medical history so they can keep an eye on how your future healthy pregnancy develops.

    Where can I go for support?

    “The earlier a women comes and seeks help, the more options she has and the better the assessment can be made,” advises Dr Jackie Ross.

    The Ectopic Pregnancy Trust charity is a helpful resource that offers counselling, email support and discussion forums for women who have a shared experience. Loss and grief are natural feelings, and it’s essential that all women get the help and support they need.

    If you’d like more information, watch this educational video on where and how ectopic pregnancies happen: