Miss Heena Mehra, MRCOG
Early Pregnancy Specialist Consultant
Pregnancy is usually a time of hope and excitement, but sometimes complications can arise. One of these is an ectopic pregnancy, where a fertilised egg implants outside the womb.
This can be frightening, but it’s important to remember you are not alone. With prompt diagnosis and care, your health and future fertility can often be protected.
What is an Ectopic Pregnancy?
An ectopic pregnancy occurs when the fertilised egg grows somewhere other than the womb. Most commonly, this happens in the fallopian tube (sometimes called a “tubal pregnancy”). Less commonly, it can occur in the ovary, cervix, or abdomen.
Unfortunately, an ectopic pregnancy cannot survive, and it can be dangerous if left untreated – but with early care, serious complications are often preventable.
Symptoms to Look Out For
Ectopic pregnancy symptoms usually appear between 4–12 weeks of pregnancy. They may include:
- One-sided abdominal or pelvic pain (which can be sharp or severe).
- Vaginal bleeding (lighter or heavier than a period).
- Shoulder tip pain (caused by internal bleeding irritating the diaphragm).
- Feeling faint, dizzy, or unwell (a sign of more serious bleeding).
It’s important to seek urgent medical advice if you experience these symptoms, especially if you know or suspect you might be pregnant.
Who is at Higher Risk?
Ectopic pregnancy can happen to anyone, but risk factors include:
- Previous ectopic pregnancy
- Damage to the fallopian tubes (e.g. from infection, surgery, or endometriosis)
- Use of an intrauterine device (IUD)
- Smoking
- Fertility treatments
However, many women with ectopic pregnancy have no clear risk factors.
How is it Diagnosed?
Doctors usually use a combination of:
- Blood tests: to check pregnancy hormone (hCG) levels.
- Ultrasound scan: to look at the womb and fallopian tubes.
Sometimes, diagnosis is only confirmed during a laparoscopy (keyhole surgery).
How is it treated?
The right treatment depends on your symptoms, hormone levels, and scan findings:
- Watch and Wait: If hormone levels are low and falling, sometimes the body resolves the ectopic naturally. Careful monitoring with blood tests and scans is needed.
- Medication (Methotrexate): An injection that stops the pregnancy cells from growing, allowing the body to absorb them. This avoids surgery in many cases.
- Surgery: If the ectopic is large, ruptured, or causing heavy bleeding, surgery is necessary. This is usually laparoscopic (keyhole). Depending on the situation, the affected fallopian tube may be removed or repaired.
Emotional Impact
An ectopic pregnancy can feel devastating. You may experience grief, shock, or fear about the future. These feelings are completely normal. Support from loved ones, counselling, or support groups (such as The Ectopic Pregnancy Trust) can be very helpful.
Does it affect Future Fertility?
The good news is that many women go on to have healthy pregnancies after an ectopic. Even with one fallopian tube removed, natural conception is often still possible. Your doctor can guide you about when it’s safe to try again.
Key messages from eGynaecologist
- An ectopic pregnancy cannot survive, but with early diagnosis, your health and fertility can often be protected.
- Symptoms like one-sided pain, bleeding, or shoulder tip pain should never be ignored.
- Support is available – both medical and emotional – to help you recover and move forward.
