Ectopic pregnancy

Symptoms of an ectopic pregnancy

An ectopic pregnancy doesn't always cause symptoms. It may only be detected during a routine pregnancy scan.

If you do have symptoms, they tend to develop between the sixth and 14th week of pregnancy.

Symptoms can include a combination of:

• a missed period and other signs of pregnancy 
• tummy pain low down on one side
• vaginal bleeding or a brown watery discharge
• pain in the tip of your shoulder
• discomfort when peeing or pooing

These symptoms aren't necessarily a sign of a serious problem. They can sometimes be caused by other problems, such as a stomach bug.

When to get medical advice

Contact your GP or GP out of hours service if you have a combination of any of the symptoms above and you might be pregnant. This is even if you haven't had a positive pregnancy test.

An ectopic pregnancy can be serious, so it's important to get advice right away.

Your GP will ask about your symptoms. You’ll usually need to do a pregnancy test to find out if you could have an ectopic pregnancy.

You may be referred to a specialist early pregnancy clinic for further assessment.

When to get emergency help

Call 999 for an ambulance or go to your nearest emergency department immediately if you experience a combination of:

• a sharp, sudden and intense pain in your tummy
• feeling very dizzy or fainting
• heavy vaginal bleeding 
• feeling sick
• looking very pale

These symptoms could mean that your fallopian tube has split open (ruptured). This is potentially very serious. Surgery to repair the fallopian tube needs to be carried out as soon as possible.

A rupture can be life-threatening. But fortunately a rupture is uncommon and can be treated, if dealt with quickly.

How an ectopic pregnancy is treated

Unfortunately, it's not possible to save an ectopic pregnancy.

You will be referred to hospital for diagnosis and treatment. The hospital doctors will help you decide on the best treatment for you.

Help and support after an ectopic pregnancy

Losing a pregnancy can be devastating. Many women will experience grief, similar to the loss of a family member or partner.

It's not uncommon for these feelings to last several months, although they usually improve with time. Make sure you give yourself and your partner time to grieve.

If you or your partner are struggling to come to terms with your loss, you may benefit from professional support or counselling. Speak to your GP about this.

Support groups for people who have been affected by loss of a pregnancy can also help. These include:

• The Ectopic Pregnancy Trust
• The Ectopic Pregnancy Foundation
• The Miscarriage Association
• Cruse Bereavement Care

• Grief after bereavement or loss

Trying for another baby

You may want to try for another baby when you and your partner feel physically and emotionally ready.

You'll probably be advised to wait until you've had at least two periods after treatment before trying again, to allow yourself to recover.

 If you have been treated with methotrexate, it's usually recommended that you wait at least three months, because the medicine could harm your baby if you become pregnant during this time.

Most women who have had an ectopic pregnancy will be able to get pregnant again, even if they've had a fallopian tube removed.

If you do become pregnant again, it's a good idea to let your GP know as soon as possible. This is so early scans can be carried out to check everything's OK.

Causes of an ectopic pregnancy

In many cases, it's not clear why a woman has an ectopic pregnancy.

Sometimes it happens when there's a problem with the fallopian tubes, such as them being narrow or blocked.

The following are all associated with an increased risk of ectopic pregnancy:

• previous ectopic pregnancy – the risk of having another ectopic pregnancy is around ten per cent
• pelvic inflammatory disease (PID) – inflammation of the female reproductive system, usually caused by a sexually transmitted infection (STI)
• previous surgery on your fallopian tubes – such as an unsuccessful female sterilisation procedure
• fertility treatment, such as IVF – taking medication to stimulate ovulation (the release of an egg) can increase the risk of ectopic pregnancy
• becoming pregnant while using an intrauterine device (IUD) or intrauterine system (IUS) for contraception – it's rare to get pregnant while using these, but if you do you're more likely to have an ectopic pregnancy
• smoking
• increasing age – the risk is highest for pregnant women who are aged 35-40

You can't always prevent an ectopic pregnancy, but you can reduce your risk by using a condom when not trying for a baby, to protect yourself from STIs, and by stopping smoking. 

• Ectopic pregnancy

More useful links

• How to use your health services