Ectopic pregnancy awareness

Overview

An ectopic pregnancy happens when a fertilized egg grows outside the main cavity of the uterus, most often in a fallopian tube. This is a serious condition because the growing tissue can cause bleeding that may be life-threatening if not treated early.

Ectopic pregnancy occurs in about 1 to 2 out of every 100 pregnancies. It is more common than many people realize, but with early care, outcomes are generally good.

It can happen to anyone who is pregnant, but it is more common in women and people with female reproductive organs who are over 35, have had previous ectopic pregnancies, have tubal damage, or use certain fertility treatments.

Symptoms

Common symptoms

• Sharp or stabbing pain in the lower belly, often on one side
• Vaginal bleeding that is lighter or heavier than a normal period
• Pain in the shoulder tip (caused by internal bleeding irritating the diaphragm)
• Pain or discomfort when urinating or having a bowel movement
• Feeling faint, dizzy, or lightheaded

Causes

Main causes

• Damage or blockage in the fallopian tubes, often from infection, inflammation, or previous surgery
• Hormonal factors that slow the movement of the fertilised egg through the tube
• Abnormal development of the fertilised egg itself

Risk factors

• Previous ectopic pregnancy
• History of pelvic inflammatory disease (PID)
• Smoking cigarettes
• Use of intrauterine device (IUD) for contraception at time of conception
• Fertility treatments such as in vitro fertilisation (IVF)
• Tubal surgeries or ligation (having your tubes tied)
• Age over 35

When to see a doctor

See a doctor urgently if:

• Any sharp or stabbing pain in the lower belly during early pregnancy
• Vaginal bleeding that is different from a normal period
• Fainting or severe dizziness

Book a routine appointment if:

• If you have risk factors and are planning a pregnancy, talk to your GP or fertility specialist beforehand
• If you experience any concerning symptoms, even if mild, make an appointment as soon as possible

Diagnosis

A doctor will first ask about your symptoms and do a pregnancy test. Then they will use a vaginal ultrasound to see where the pregnancy is growing. They may also check your blood levels of the pregnancy hormone hCG to see if they are rising as expected.

Tests that may be done

• Urine or blood pregnancy test
• Vaginal ultrasound (transvaginal scan)
• Serial blood tests for hCG (done every 2–3 days)

What to expect at your appointment

You will likely be seen in an early pregnancy assessment unit or emergency department. The process is thorough but designed to quickly find or rule out ectopic pregnancy. A healthcare professional will explain each step and answer your questions.

Treatment

Treatment depends on how early the ectopic pregnancy is found, your symptoms, and your overall health. There are three main approaches: careful monitoring, medication, or surgery. Your doctor will discuss the best option for you.

Self-care at home

• Follow your doctor's advice and attend all follow-up appointments
• Avoid heavy lifting or strenuous activity until your doctor says it's safe
• Get plenty of rest and eat a balanced diet to help your body recover

Medical treatments

If the ectopic pregnancy is detected early and you are stable, a doctor may give an injection of a medication that stops the pregnancy from growing. This is not the same as a medicine you can buy; it is given in a hospital or clinic. You will need regular blood tests afterwards to make sure the treatment is working.

When is surgery considered?

Surgery may be needed if there is internal bleeding, if the ectopic pregnancy has ruptured, or if medication is not an option. The surgeon will usually remove the affected fallopian tube (salpingectomy) but sometimes may remove only the pregnancy and save the tube (salpingostomy). This is done under general anaesthetic, often through small keyhole cuts.

Living with this condition

After treatment, you will need time to heal physically and emotionally. Recovery times vary, but most people can return to normal activities within a few weeks. Your doctor will tell you when it's safe to exercise, have sex, or try for another pregnancy.

Lifestyle tips

• Avoid smoking, as it can damage fallopian tubes and increase risk
• Use contraception until your doctor says it's safe to conceive again
• Attend all follow-up appointments and blood tests as scheduled

Diet and exercise

Eat a nutritious diet with plenty of fruits, vegetables, and protein to support healing. Gentle exercise like walking is usually fine after recovery, but check with your doctor before starting any new activity.

Mental health and emotional wellbeing

Losing a pregnancy, even an ectopic one, can be very upsetting. You may feel sad, anxious, or guilty. These feelings are normal. It is important to talk about them with your partner, family, or a counsellor. Many hospitals offer support groups or can recommend a therapist.

Prevention

Ectopic pregnancy cannot always be prevented, but you can lower your risk by not smoking, treating pelvic infections promptly, and using condoms to reduce the risk of sexually transmitted infections that can damage the tubes. If you have risk factors, talk to your doctor before trying to conceive.

Complications

If left untreated

• Rupture of the fallopian tube, leading to internal bleeding
• Severe blood loss that can cause shock and be life-threatening
• Loss of the affected fallopian tube, which may affect future fertility
• In rare cases, infection or damage to other organs

Long-term outlook

With prompt diagnosis and treatment, the outlook is very good. Most people recover fully and many go on to have healthy pregnancies later. Your healthcare team will support you through treatment and help you plan for the future.

Find support

Local organisations

• Ectopic Pregnancy Trust ↗ · UK

Helplines

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