Ectopic pregnancy

What is an ectopic pregnancy?

In the UK, there are about 11,000 ectopic pregnancies every year. An ectopic pregnancy happens when a fertilised egg does not travel down to the womb, which is where it needs to embed itself to grow. Instead, it implants itself outside the womb, often in one of the fallopian tubes. Fallopian tubes connect the womb to the ovaries. 

When an egg gets stuck in a fallopian tube, it won’t be able to grow into a baby. And because the fallopian tube can split open, there’s a significant risk to your health. It is not possible for a baby to develop and it’s usually removed.

What causes ectopic pregnancy?

Although it’s not always known what causes ectopic pregnancy, there are a few reasons you might be more likely to have one. These are: 

• Having had an ectopic pregnancy in the past 

• Having had a sexually transmitted infection like chlamydia or gonorrhoea in the past, which can cause inflammation and scar tissue to develop

• Having previous surgery on your fallopian tubes 

• Having treatment for infertility, like IVF

• Becoming pregnant when you have a contraceptive device in your womb, like a coil

• Being a smoker

• Increasing age – your risk is highest between 35 and 40

Do ectopic pregnancies show up on pregnancy tests?

Yes. Ectopic pregnancies show up on pregnancy tests like a normal pregnancy. You may also have some of the typical early pregnancy symptoms, like sore breasts or nausea. 

Ectopic pregnancy symptoms usually appear between 4 and 12 weeks.

What are the symptoms of ectopic pregnancy?

Initial signs of ectopic pregnancy are:

• Vaginal bleeding – This can be darker blood than a normal period

• Abdominal pain– This can include low tummy pain, particularly on one side, and pelvic pain

• Shoulder tip pain

• Discomfort when you go to the toilet 

• Dizziness

Although a minor condition like a tummy bug could cause some of these symptoms, it is important that you see a doctor.

Ruptured ectopic pregnancy symptoms

If the ectopic pregnancy grows large enough, it can rupture your fallopian tube. This means that your fallopian tube has split open. Although it doesn’t happen very often, this is very serious, and you’ll need immediate treatment.

Signs of a ruptured ectopic pregnancy could be:

• Sudden intense tummy pain

• Looking pale

• Dizziness and fainting

• Feeling sick, vomiting or diarrhoea

If you get these symptoms, call 999 or go to A&E.

Diagnosing an ectopic pregnancy

If you’re showing signs of ectopic pregnancy, the doctor will probably arrange for some more tests quite quickly. 

• You’ll have a urine test to confirm that you’re pregnant

• You may have an ectopic pregnancy scan with an ultrasound

• Your pregnancy hormone levels will be measured with a blood test

How are ectopic pregnancies treated?

Depending on your symptoms and the results of your tests, you may be given a medicine, called methotrexate, that stops the cells from growing, or you may have surgery to remove the fertilised egg. 

Sometimes doctors take a ‘watch and wait’ approach because some ectopic pregnancies end safely on their own. You will have regular blood tests to monitor the level of pregnancy hormone, hCG, in your blood and to ensure it is reducing. 

Most women will be able to get pregnant after an ectopic pregnancy. But some of the treatments may mean that you’re less likely to conceive naturally.

Becoming pregnant again

The doctor may suggest that you wait for two periods after treatment before trying for another baby. If you had methotrexate, a medicine that stops the ectopic pregnancy from growing, you should wait for 3 months before trying again. That’s to make sure the medication is safely out of your body.

65% of women become pregnant within 18 months of an ectopic pregnancy. But there’s a 10% risk of having another ectopic pregnancy if you’ve had one before. 

Talk to a GP if you’re pregnant again after ectopic pregnancy for extra support. You may also be offered some early scans to check on the progress of the pregnancy.