What should you know about intramural ectopic pregnancy?

In a typical pregnancy, the embryo implants inside the uterine cavity. In an intramural ectopic pregnancy, implantation occurs within the muscle of the uterus rather than in the cavity. This is a form of [Ectopic Pregnancy](/conditions/ectopic-pregnancy/) and is different from a pregnancy in the fallopian tube.

Symptoms can include pelvic or abdominal pain, vaginal bleeding, dizziness, or fainting, but symptoms vary and may be absent early on. A history of uterine surgery, a condition affecting the pelvis such as [Pelvic Inflammatory Disease](/conditions/pelvic-inflammatory-disease/), or changes in the uterine wall may be relevant, although a clinician must assess the individual situation.

If pregnancy is possible and you have pain or bleeding, contact an urgent maternity or emergency service. Assessment may include pregnancy hormone testing, examination, and a [Transvaginal Ultrasound](/treatments/diagnostics-and-imaging/transvaginal-ultrasound/) to locate the pregnancy and check for bleeding. A scan may need expert review or repetition when the location is not clear.

Treatment is decided by the pregnancy size and location, symptoms, hormone results, bleeding, and overall stability. Options can include close specialist monitoring, medication in selected cases, or surgery. Surgery may involve removing the pregnancy and repairing the uterine area; a [Salpingectomy](/treatments/gynaecological-surgery/salpingectomy/) removes a fallopian tube and is relevant only when the tube is involved.

Go to emergency care immediately for severe or one-sided abdominal pain, shoulder-tip pain, fainting, marked weakness, heavy vaginal bleeding, or new confusion. These can indicate internal bleeding or circulatory problems. Do not drive yourself if you feel faint. If symptoms are milder but pregnancy is possible, seek same-day medical advice rather than waiting for them to settle.

Ask where the pregnancy is located, whether there is bleeding around the uterus, and what the ultrasound and hormone results show. Ask which treatment is safest for your current condition, how urgently it must start, what follow-up testing is needed, and which symptoms should send you back to emergency care. If future pregnancy matters to you, ask how each option may affect the uterus and when it may be reasonable to try again.