Watch for Symptoms of Ectopic Pregnancy

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Ectopic pregnancy, sometimes called tubal pregnancy, is a situation in which the fertilized egg implants somewhere other than in the uterus, most commonly the fallopian tubes. Ectopic pregnancies are not viable and can sometimes be life-threatening to the mother if not treated.

While statistics vary from country to country, most estimates suggest that ectopic pregnancies occur in around one of every 50 pregnancies.

Understanding Your Risk of Ectopic Pregnancy

There are a number of factors that can place a woman at risk of an ectopic pregnancy, some of which we can change and others we can't.

Ectopic Pregnancy Risk Factors

  • Previous ectopic pregnancy
  • Scarring to the fallopian tubes (possibly from a ruptured appendix or previous pelvic surgery)
  • Endometriosis (the abnormal growth of uterine tissue outside of the uterus)
  • Progestin-only birth control pills
  • Pelvic inflammatory diseases (PID), such as from chlamydia or gonorrhea
  • Birth defects involving the fallopian tubes
  • Smoking (which is believed to damage the fallopian tubes' ability to move the egg to the uterus)
  • A history of infertility
  • In-vitro fertilization
  • Use of an intrauterine device (IUD)
  • Tubal sterilization (or reversal)

It's important to note that in women who have had tubal sterilization or use IUDs, the risk of ectopic pregnancy is still lower than in women who use no birth control at all.

Spotting the Signs of Ectopic Pregnancy

In the early stages of an ectopic pregnancy, there may not be any notable symptoms other than what would normally be expected during the first trimester. While some women may experience spotting or mild cramping toward one side of the lower abdomen, a great many have no symptoms at all.

The more obvious clinical symptoms tend to appear around seven weeks' gestation. This coincides with an ever-increasing the risk of rupture. If at this stage, blood begins to leak from the fallopian tube, you may begin to feel shoulder pain or have a continued urge to have a bowel movement.

If the tube ruptures, heavy bleeding will likely be accompanied by severe abdominal pain followed by lightheadedness and fainting. This is when the condition is considered an emergency. If treatment is delayed in any way, it can lead to severe shock and even death.

What to Do If You Suspect an Ectopic Pregnancy

If you experience any worrying symptoms or believe yourself to be at higher risk of an ectopic pregnancy, raise these concerns to your doctor. There are tests a doctor can use to either confirm or rule out the condition.

By and large, a physical exam is not enough to diagnose an ectopic pregnancy; most are typically confirmed using blood tests and imaging analyses.

Standard ultrasounds may also not be enough in the early stages since the uterus and fallopian tubes will be closer to the vagina than the abdominal surface. As such, a wand-like transvaginal ultrasound (inserted into the vagina) may produce a more accurate result.

Even then, an ultrasound may have trouble detecting a problem until at least four to five weeks into the pregnancy. In such case, blood tests will typically be used to monitor your condition until you are further along.

In a situation where there are heavy bleeding and the likelihood of a rupture, an ectopic pregnancy will be treated surgically under emergency care.

2 Sources
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  1. American Pregnancy Association. Ectopic Pregnancy.

  2. Crochet JR, Bastian LA, Chireau MV. Does This Woman Have an Ectopic PregnancyJama. 2013;309(16):1722. doi:10.1001/jama.2013.3914.

By Krissi Danielsson
Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage.