An ectopic pregnancy occurs when a fertilized egg implants itself outside of the uterus, usually in one of the fallopian tubes.

For this reason, some people refer to an ectopic pregnancy as a tubal pregnancy.

Ectopic (meaning ‘out of place’) pregnancies are rare and affect only around 1% of pregnancies.

However, other non-tubal ectopic pregnancies can occur, including cervical pregnancies, ovarian pregnancies (inside the ovary), which are rare and pregnancies that are inside the abdominal cavity.

Fertilized eggs have also been known to implant themselves in a uterine scar from a previous c-section.

Do ectopic pregnancies test positive?

Yes, they do. An egg has been fertilized and a pregnancy is developing. The woman’s body starts to go through all the processes of pregnancy development and there are the same hormonal shifts. In an ectopic pregnancy, the only thing different from a normal pregnancy is that the fertilized egg will not be able to implant itself in the inner lining of the uterus.

Ectopic pregnancy

Here are the most important things you need to know about ectopic pregnancy:

Causes of ectopic pregnancy

In approximately one third of all cases, doctors are unable to identify the cause of an ectopic pregnancy.

There are, however, certain risk factors that can increase your chances.

You are more at risk for an ectopic pregnancy if you:

Are 35 years of age or over
Are a smoker
Have previously suffered from a pelvic inflammatory disease
Conceived with the help of in vitro fertilization (IVF)
Had a contraceptive IUD (coil) when you conceived
Have a malformed fallopian tube
Have scar tissue in which the fertilized egg can become trapped. Scar tissue develops from:
- Having had a previous ectopic pregnancy
- Previous pelvic or abdominal surgery
- Sexually transmitted infections
- Endometriosis.

Ectopic pregnancy symptoms

A woman who is experiencing an ectopic pregnancy is very unaware of it at first.

The human chorionic gonadotropin hormone (hCG) keeps the pregnancy going. The woman has missed a period, the developing fetus keeps growing and, for the first few weeks, the woman will experience typical pregnancy symptoms, such as:

Mild cramping in the pelvis
Breast tenderness
Morning sickness.

As the ectopic pregnancy grows more serious, other symptoms might develop.

The two first warning signs and symptoms of an ectopic pregnancy are one-sided abdominal severe pain and vaginal bleeding.

Some women also report some of the following symptoms:

Shoulder pain, felt at the tip of the shoulder and usually most noticeable when lying down
Low back pain
Painful urination
Painful passing of stools
Diarrhoea and vomiting.

There is no blood test or manual pelvic exam that can diagnose an ectopic pregnancy. Do not underestimate any symptoms if you’ve had any signs of pregnancy and experience any emergency symptoms of ectopic pregnancy.

Ectopic pregnancy symptoms: when ectopic pregnancy symptoms start

Signs and symptoms of ectopic pregnancy most commonly appear from week five onwards.

Not all women experience symptoms of ectopic pregnancy. In fact, some women don’t discover the pregnancy is ectopic until the ultrasound scan or, in the worst case, when the fallopian tube ruptures. A ruptured ectopic pregnancy is considered an emergency and the woman needs to be promptly transferred to a facility where emergency surgery can be performed, if necessary.

A ruptured fallopian tube is very likely to bleed heavily and it might be necessary to cauterize the bleeding vessels .

Just 1% of pregnancies will be ectopic. Trust your body and believe you’ve achieved a normal pregnancy. At the same time, though, be mindful if you experience any pelvic pain or even dull discomfort in the same area.

Please look for help if you have any vaginal bleeding. Even if you see only light vaginal bleeding, major internal bleeding could be occurring.

Life threatening bleeding can be stopped if it’s managed promptly. Do not underestimate the severity of bleeding based only on the amount of blood you see. An ectopic pregnancy happens outside the uterus. Severe internal bleeding might be occurring without the blood draining out through the vagina.

Which side hurts with ectopic pregnancy?

Women have two ovaries – one at each side of the uterus. In each cycle one ovary releases an egg. When the egg is fertilized, it carries on its journey towards the uterus to implant.

In an ectopic pregnancy the fertilized egg doesn’t make it to the uterus; instead it gets stuck at some point between the ovary and the endometrium. As it keeps growing, it will cause pain in that area. If your left side hurts with an ectopic pregnancy that means your left ovary was the one that released the egg that has been fertilized.

How soon would you know if you had an ectopic pregnancy?

It’s important to diagnose an ectopic pregnancy as early as possible, to avoid further complications.

You should contact your healthcare provider if you:

Experience unusual vaginal bleeding
Have persistent abdominal pain (even if it’s dull).

Contact your healthcare provider as a matter of urgency if you:

Experience sudden, sharp abdominal pain
Feel dizzy or lightheaded
Look unusually pale
Suffer from sickness or diarrhoea
Have an increased heart rate.

In an increasingly rare number of cases, the fallopian tube can rupture, causing internal bleeding.

If this occurs, you will need immediate medical help.

Thanks to a better understanding of the condition and better diagnostics, the number of women experiencing fallopian tube rupture has been greatly reduced.

Ectopic pregnancy treatment

It’s not possible to save an ectopic pregnancy.

Sadly, there is not yet the medical knowledge about how to relocate the embryo to the uterus.

There are, however, a number of treatment options available.

Can ectopic pregnancy go away without treatment?

How an ectopic pregnancy is treated will depend upon your unique situation and the best possible care the health providers who look after you are able to give.

How is an ectopic pregnancy treated? Treatment options include:

Active monitoring. Some cases of ectopic pregnancy resolve themselves. Even when it’s happening in a fallopian tube, the pregnancy might be absorbed into your body tissue, leaving you free from the need for further treatment. This will usually be offered as a first treatment option if you are experiencing mild symptoms, or none

Medication. This is usually seen as a second option. It’s most commonly offered when an ectopic pregnancy has been diagnosed early. Once the medication has been administered, you will be closely monitored to ensure the pregnancy resolves itself. Your doctor will then advise you to use birth control for six months. This is because the medication (a medicine called methotrexate) can lead to a higher risk of developmental problems in babies conceived within six months of its use

Ectopic pregnancy surgery. This is the most common treatment for ectopic pregnancy. The type of surgery depends upon your unique situation. However, laparoscopy (keyhole surgery) is the favored option. The surgeon can insert a small camera through a keyhole incision, to investigate the fallopian tubes. In some cases, the pregnancy might be removed and the fallopian tube repaired. However, it’s also possible that the fallopian tube will be removed. Fallopian tubes have a very important role and, without them, the fertilized egg cannot reach the uterus for implantation to occur. Surgeons will always try to save the fallopian tube whenever possible.

What to do after an ectopic pregnancy

Pregnancy loss is devastating, no matter how or when the loss occurred.

You might wish to seek counselling to help you deal with your emotions. Your healthcare provider should be able to refer you to a counsellor.

You could also find a support group that helps you to cope with the loss. Ask your healthcare provider if there are any support groups in your local area.

Or you could look for an online group to join.

Be honest with your partner about how you are feeling and open up to trusted friends and family.

Nobody is expecting you to be okay immediately, so be sure to make the most of the support of your loved ones.

You might be wondering about trying for another baby. Speak to your healthcare provider to find out when it’s safe for you to start trying for future pregnancies.

Having an ectopic pregnancy diagnosed doesn’t mean you will have future ectopic pregnancies but, once you have experienced an ectopic pregnancy, you might feel best supported and accompanied by the right professionals.

This will depend on your unique case, so it’s always best to get advice. Change your healthcare providers if you feel you’re not receiving the best care.