If you think you might have an ectopic pregnancy, it can feel scary and overwhelming. An ectopic pregnancy happens when a fertilized egg implants outside the uterus, most often in a fallopian tube, instead of growing in the place where it would normally implant in the uterus. It can also occur in the ovary, cervix, abdomen, or a cesarean scar.
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After fertilization, the pregnancy normally travels through a fallopian tube and implants in the uterus. When that does not happen, the pregnancy may begin growing outside the uterus, which can become dangerous and requires prompt medical care. An ectopic pregnancy cannot be moved or transplanted into the uterus.
Symptoms and When to Seek Emergency Care
Early ectopic pregnancy symptoms can feel like a normal early pregnancy at first, which is why it is important to pay attention to changes in your body.
- A missed period
- A positive pregnancy test, including a need for free pregnancy testing
- Light vaginal bleeding or spotting
- Pelvic pain
- Lower abdominal pain, especially if it is one-sided
A person can still have a positive pregnancy test and later be diagnosed with an ectopic pregnancy.
- Severe one-sided pain
- Shoulder pain
- Dizziness
- Fainting
- Heavy bleeding
If you have severe one-sided pain, shoulder pain, fainting, dizziness, or heavy bleeding, seek immediate emergency care right away. A ruptured ectopic pregnancy can cause life-threatening internal bleeding within hours, which is why these symptoms are critical signs of when to see a doctor.
Causes and Risk Factors
There are several risk factors for ectopic pregnancy, and sometimes it can happen even when no clear cause is found. Risk factors can include previous ectopic pregnancy, Pelvic Inflammatory Disease (PID), scar tissue or damage in the fallopian tubes from chlamydia or gonorrhea, tubal surgery, IVF, having an IUD in place at the time of conception, smoking, age over 35, and endometriosis.
Diagnosis
You can still have a positive pregnancy test with an ectopic pregnancy. To confirm where the pregnancy is located, medical evaluation may include pregnancy testing, human chorionic gonadotropin (hCG) bloodwork, and an ultrasound. Confirming the location of a pregnancy is important before any abortion decision because an undiagnosed ectopic pregnancy will not be treated by abortion pills and can become a medical emergency.
| Topic | Summary |
| Common symptoms | Missed period, positive pregnancy test, light bleeding, pelvic pain, lower abdominal pain, shoulder pain, dizziness, fainting, or heavy bleeding |
| How it is diagnosed | Pregnancy testing, hCG bloodwork, and ultrasound to see where the pregnancy is implanted |
| When medication may be used | Methotrexate may be used when the ectopic pregnancy is found early and the person is medically stable |
| When surgery may be needed | Surgery may be necessary if there are signs of rupture, heavy internal bleeding, severe symptoms, or if medication is not appropriate |
Treatment
Treatment depends on how early the ectopic pregnancy is found, your symptoms, and whether there are signs of rupture.
- Methotrexate: Methotrexate is a medication that may be used when the ectopic pregnancy is diagnosed early, hCG levels and symptoms are appropriate for medication management, and emergency surgery is not needed.
- Surgery: Surgery may be necessary if the fallopian tube has ruptured, if there is heavy internal bleeding, if symptoms are severe, or if methotrexate is not the safest option. Surgery may remove the ectopic pregnancy and, in some cases, part or all of the affected tube.
Future pregnancy is often still possible after treatment, especially if the other fallopian tube is healthy. However, the risk of another ectopic pregnancy is higher after a previous ectopic pregnancy.
Request an appointment for free and confidential support.
Prevention / Risk Reduction
You may not be able to prevent every ectopic pregnancy, but reducing infection-related tubal damage can help lower risk. Chlamydia and gonorrhea can contribute to PID and damage the reproductive tract, and chlamydia is sometimes called the Silent STI because many women do not notice symptoms.
STI testing is important for sexually active women, and avoiding smoking, getting early pregnancy care, and seeking evaluation quickly if you have pain or bleeding can also help.
At Life Centers of Ventura County, we offer confidential support, medically accurate information, and space to talk through your next steps without pressure. You can explore pregnancy resources and real stories and support as you decide what to do next.
FAQ
What are the first signs of an ectopic pregnancy?
The first signs can include a missed period, a positive pregnancy test, light vaginal bleeding, pelvic pain, or lower abdominal pain.
Can you have a positive pregnancy test with an ectopic pregnancy?
Yes. An ectopic pregnancy can still cause a positive pregnancy test, which is why follow-up with hCG bloodwork and ultrasound may be needed.
What causes an ectopic pregnancy?
An ectopic pregnancy can happen when the fertilized egg does not reach the uterus. Risk factors include previous ectopic pregnancy, PID, tubal damage or surgery, IVF, an IUD in place at conception, smoking, age over 35, and endometriosis.
How is ectopic pregnancy treated?
Treatment may involve methotrexate or surgery, depending on how early it is found, your symptoms, and whether there are signs of rupture.
Can you get pregnant again after an ectopic pregnancy?
Yes, many women can get pregnant again after an ectopic pregnancy, but the recurrence risk is higher after a previous ectopic pregnancy.
Request an appointment for free and confidential support.
Susan Jones, Nurse Manager
Community Pregnancy Clinic
1)"Ectopic Pregnancy." OMICS International,https://www.omicsonline.org/united-states/ectopic-pregnancy-peer-reviewed-pdf-ppt-articles/. Accessed 28 December 2021.
2)Dr. Home, Andrew. "Diagnosis and management of ectopic pregnancy." PubMed Central, 11 July 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3213855/.
3)"Pelvic Inflammatory Disease (PID) Statistics." Centers for Disease Control and Prevention, 29 March 2021, https://www.cdc.gov/pid/about/index.html.
4)"Chlamydia." Centers for Disease Control and Prevention, 22 July 2021, https://www.cdc.gov/chlamydia/about/index.html.
Published with permission from CPCSV