Ectopic Pregnancy: Complete Guide
An ectopic pregnancy happens when a fertilised egg implants outside the womb, most often in a fallopian tube. It cannot develop into a viable pregnancy and needs prompt medical treatment, so knowing the warning signs and acting on them quickly matters.
What an ectopic pregnancy is
In a typical pregnancy, the fertilised egg travels down the fallopian tube and implants in the lining of the womb. In an ectopic pregnancy, it implants somewhere else instead — almost always in a fallopian tube, though rarely elsewhere in the pelvis. Because these locations can't support a growing pregnancy and aren't built to stretch the way the womb is, the pregnancy cannot continue and carries a risk of the tube rupturing if not treated.
Signs to watch for
Ectopic pregnancy symptoms typically appear between around weeks 5 and 8, though timing can vary. A positive pregnancy test alongside any of the following warrants urgent medical attention.
- Persistent, one-sided lower abdominal or pelvic pain
- Vaginal bleeding that may look different from a normal period — often darker or watery
- Pain in the tip of the shoulder, which can happen if internal bleeding irritates nearby nerves
- Feeling lightheaded, faint, or unusually weak
- Discomfort when going to the toilet, or pain when moving your bowels
Not everyone experiences all of these symptoms. If you have a positive pregnancy test and any combination of one-sided pain, unusual bleeding, or shoulder tip pain, contact your GP, early pregnancy unit (EPU), or NHS 111 straight away. If you develop severe pain, feel faint, or collapse, call 999 or go to A&E immediately, as this can indicate a ruptured ectopic pregnancy.
Diagnosis and treatment
Doctors typically use a transvaginal ultrasound scan, which can often show whether a pregnancy is inside or outside the womb, alongside blood tests tracking hCG levels over 48 hours, since these tend to rise differently than in a typical pregnancy. If the location still isn't clear, a laparoscopy may confirm the diagnosis. Treatment depends on how early it's caught: close monitoring if levels are falling on their own, a methotrexate injection to stop the pregnancy developing, or keyhole surgery to remove it — sometimes along with the affected tube. A ruptured tube is a medical emergency requiring immediate surgery.
Frequently Asked Questions
What are the signs of an ectopic pregnancy?
The main signs are one-sided lower abdominal pain, vaginal bleeding that may differ from a normal period, pain at the tip of the shoulder, and feeling weak or dizzy. These most commonly develop between weeks 5 and 8 of pregnancy. Because ectopic pregnancy is a medical emergency, contact your GP or early pregnancy unit immediately if you notice any of these signs, or go to A&E if the pain is severe or you feel faint.
Can an ectopic pregnancy survive?
No, an ectopic pregnancy cannot continue to develop and result in a live birth, because the fallopian tube (or other location outside the womb) cannot support ongoing growth. Treatment is needed to end the pregnancy safely and protect the parent's health, using medication or surgery depending on the individual situation. This is understandably very difficult news, and support is available through your healthcare team and specialist pregnancy loss organisations.
Can I get pregnant again after an ectopic pregnancy?
Many people go on to have a successful pregnancy after an ectopic pregnancy, even if one fallopian tube was removed or affected, since the remaining tube can often still allow conception. Your care team may recommend an early scan in a future pregnancy to check the location, given the slightly increased risk of a further ectopic pregnancy. It's worth discussing your individual circumstances and any concerns with your GP or gynaecology team when you're ready to try again.
This article is for informational purposes only and does not constitute medical advice.
Related articles: