Different types of ectopic pregnancy

A tubal ectopic pregnancy may sit in the widest part of the tube, near the ovary, or close to the womb. Less commonly, implantation occurs in the cervix, ovary, a caesarean-section scar or the abdominal cavity. A pregnancy can also be located in a tube while another pregnancy is in the womb, known as a heterotopic pregnancy. These locations matter because bleeding and rupture can develop quickly as tissue grows where there is limited room.

Symptoms can include one-sided pelvic pain, vaginal bleeding, shoulder-tip pain, dizziness or fainting. Some people have few symptoms at first. A positive pregnancy test with pain or bleeding needs prompt clinical assessment; symptoms alone cannot identify the location.

Assessment commonly combines pregnancy-hormone blood tests with repeat testing and an ultrasound. A [Transvaginal Ultrasound](/treatments/diagnostics-and-imaging/transvaginal-ultrasound/) can help locate a pregnancy and look for internal bleeding, although an early scan may not show the location immediately. Treatment may involve careful monitoring, medicine that stops pregnancy tissue growing, or surgery. A [Salpingectomy](/treatments/gynaecological-surgery/salpingectomy/) removes an affected fallopian tube when surgery is needed. The choice depends on symptoms, scan findings, hormone results and future fertility plans.

Go to emergency care immediately for sudden or severe abdominal pain, fainting, marked weakness, shoulder-tip pain, heavy bleeding or breathlessness after a positive pregnancy test. These can signal internal bleeding. Do not drive yourself if you feel faint. For background information, see [Ectopic Pregnancy](/conditions/ectopic-pregnancy/) and [Pelvic Pain](/symptoms/pelvic-pain/).

Ask where the pregnancy appears to be, whether internal bleeding is present, how often follow-up is needed, which treatment fits your findings, and how the plan may affect a future pregnancy. Mention any history of [Pelvic Inflammatory Disease](/conditions/pelvic-inflammatory-disease/), previous ectopic pregnancy or tube surgery.