Understanding ectopic pregnancy

After fertilisation, the pregnancy most often settles in a fallopian tube rather than inside the uterus. As it grows, it can stretch or rupture the tube and cause internal bleeding. Early symptoms may include one-sided pelvic pain, vaginal bleeding, shoulder-tip pain, dizziness or fainting, although some people have few symptoms at first. Pelvic inflammatory disease can damage the tubes and is one possible risk factor; it does not mean that every person with that condition will have an ectopic pregnancy.

Assessment may include a pregnancy test, blood tests and a transvaginal ultrasound. Very early in pregnancy, one scan may not locate the pregnancy, so repeat testing or scanning can be needed.

Contact a maternity or gynaecology service promptly if you have a positive pregnancy test with pain or bleeding. Treatment depends on symptoms, scan findings and hormone results. A clinician may recommend close monitoring, medicine that stops pregnancy tissue growing, or surgery. A salpingectomy removes the affected fallopian tube when surgery is needed; your clinician can explain how this relates to future fertility and the other tube.

Call emergency services or go to an emergency department for severe or rapidly worsening pelvic or abdominal pain, fainting, marked dizziness, shoulder-tip pain, unusual weakness, or heavy bleeding. These signs can indicate internal bleeding. Do not drive yourself if you feel faint, and tell the team that you may be pregnant.

Ask where the pregnancy appears to be, whether the hormone level and scan need repeating, which treatment fits your findings, what symptoms should trigger emergency help, and when it is medically reasonable to try for another pregnancy.