Ectopic pregnancy: Signs, treatment and what to know

An ectopic pregnancy happens when a fertilized egg grows outside the uterus. It’s a serious condition that requires medical attention. Knowing the signs and when to seek help can protect your health and future fertility.

In this blog:

• What is an ectopic pregnancy?
• How common is ectopic pregnancy?
• Ectopic pregnancy vs. miscarriage
• Early signs and symptoms of ectopic pregnancy
• How is ectopic pregnancy diagnosed?
• Ectopic pregnancy treatment options
• Recovery and emotional health
• Future fertility and pregnancy after ectopic pregnancies
• Key takeaways

What is an ectopic pregnancy?

In most pregnancies, the fertilized egg implants in the uterus. In an ectopic pregnancy, the egg implants somewhere else, usually in a fallopian tube. This is why you may hear it called a “tubal pregnancy.” Less often, it can happen in the ovary, cervix or abdomen. 

An ectopic pregnancy can’t continue normally and cannot be carried to term. As the pregnancy grows, an ectopic pregnancy will eventually rupture, causing severe bleeding and potentially life-threatening complications. This is a medical emergency.

How common is ectopic pregnancy?

Ectopic pregnancies occur in about 1–2% of pregnancies, according to the American Academy of Family Physicians. While rare, they can happen to anyone and about half of women who have ectopic pregnancies don’t have any known risk factors. Your risk is higher if you’ve had:

• Certain fertility treatments
• Fallopian tube surgery 
• Pelvic infections
• Previous ectopic pregnancies

Other factors that can increase your risk of ectopic pregnancy include:

• Becoming pregnant with an intrauterine device (IUD)
• Being older than 35
• Cigarette smoking
• Having a history of infertility

Ectopic pregnancy vs. miscarriage

Both ectopic pregnancy and miscarriage involve a pregnancy loss, but they’re different conditions. A miscarriage happens when a pregnancy ends on its own, usually in the uterus. An ectopic pregnancy isn’t in the uterus at all.

Because ectopic pregnancies are outside the uterus, they can’t develop into a viable pregnancy and often require medication or surgery to prevent serious complications.

Early signs and symptoms of ectopic pregnancy

Symptoms often appear between 4 and 12 weeks of pregnancy. Some women notice signs before they even know they’re pregnant.

Common ectopic pregnancy symptoms include:

• Light vaginal bleeding
• Pelvic or abdominal pain, often on one side
• Shoulder pain (due to a nerve that runs from the diaphragm to the shoulder)
• Dizziness or fainting

If pain is sudden, severe or paired with heavy bleeding, call 911 or go to the emergency room. These signs may indicate a ruptured tube.

How is ectopic pregnancy diagnosed?

Doctors diagnose ectopic pregnancy through:

• Ultrasound: Checks if the pregnancy is in the uterus
• Blood tests: Measures levels of human chorionic gonadotropin (hCG), the pregnancy hormone 
• Pelvic exam: Looks for tenderness or a mass

Sometimes it takes more than one visit to confirm the diagnosis because early pregnancies can be hard to see on ultrasound.

Ectopic pregnancy treatment options

Ectopic pregnancy treatment depends on your health, symptoms and how far along you are. Common treatment options include:

• Medication (methotrexate): This medication stops the pregnancy from growing so your body can absorb it. This option helps some women avoid surgery.
• Surgery: Removes the pregnancy tissue, often through laparoscopy (small incisions). If the fallopian tube is damaged, it may need to be removed.

Both treatments require follow-up blood tests to make sure hCG levels return to zero.

Recovery and emotional health

Recovery after treatment may take a few weeks. Physical healing is usually quick, but emotional healing can take longer. It’s normal to feel grief, sadness or worry about future pregnancies. Support groups, counseling or talking with your doctor can help.

Future fertility and pregnancy after ectopic pregnancies

If you’ve had an ectopic pregnancy, you’re at higher risk of having another one. However, many women go on to have healthy pregnancies after an ectopic pregnancy. Your doctor will likely recommend waiting at least 2 to 3 months before trying again. If you’ve lost a fallopian tube, the remaining tube can still release eggs.

Your doctor may suggest testing if you’ve had more than one ectopic pregnancy. Texas Children’s Family Fertility Center can help. Our reproductive endocrinologists have been helping people grow their families for more than 30 years, with proven success.

Ectopic pregnancy key takeaways

• Ectopic pregnancy happens when an egg implants outside the uterus, most often in the fallopian tube.
• It’s a medical emergency if left untreated.
• Early symptoms include bleeding, pelvic pain and dizziness.
• Treatment options include medication or surgery.
• Many women have healthy pregnancies after an ectopic pregnancy.

If you think you may be pregnant and have symptoms of an ectopic pregnancy, seek medical help right away. Early diagnosis and treatment make a big difference for your health and your future family plans.