The symptoms of an ectopic pregnancy will usually develop after week 6 of pregnancy.
In some cases, this could be at the same time you notice you have missed a period. You may not even be aware you're pregnant.
- pain in your tummy, especially low down and on one side
- bleeding from your vagina
- pain when peeing or pooing
- upset tummy or diarrhoea
- a missed period or some pregnancy symptoms like morning sickness or sore breasts
- constant pain at the tip of your shoulder that does not go away when you rest or take painkillers
In some cases of ectopic pregnancy there might not be any symptoms.
Urgent advice: Contact your GP or maternity hospital urgently if:
- you have any of these symptoms, particularly bleeding from your vagina or pain in your tummy
Shoulder pain can be a sign you have internal bleeding. Go to your GP or an emergency department immediately if you experience this.
When to get emergency help
Emergency action required: Go to the ED of your nearest maternity hospital or call 999 or 112 if
you are pregnant or could be pregnant and experience:
- severe, sudden or sharp pain in your tummy
- collapsing, or feeling very dizzy or faint
- feeling unwell or pale, cold and clammy
These symptoms could be a sign that you have internal bleeding or your fallopian tube has burst.
Diagnosis of ectopic pregnancy
Sometimes ectopic pregnancies have no symptoms. This means an ectopic pregnancy can be difficult to diagnose.
At the hospital a doctor or midwife will ask you questions about your symptoms. They'll want to know the date of your last period. Your doctor will also examine your tummy by pressing on it.
Your doctor may need to do a vaginal (internal) exam. They will ask you for your consent to do this. You can bring your partner with you to the examination if you wish.
You might have the following tests to help diagnose an ectopic pregnancy:
It can take more than one visit to a maternity hospital to make a diagnosis.
Sometimes when you first visit the hospital it's not possible for your obstetrician or midwife to see exactly where the pregnancy is. This is called a 'pregnancy of unknown location'.
The doctor will do a urine pregnancy test. You can bring a sample with you. The doctor may also test your urine for signs of infection or bleeding.
You may need blood tests to check your level of the pregnancy hormone hCG (human chorionic gonadotrophin). Sometimes you may need to return after a few days to have your level measured again. A change in the level of this hormone may help to diagnose what is wrong.
You may also need blood tests to check the level of another hormone called progesterone.
Most women who are suspected of having an ectopic pregnancy will be offered a transvaginal scan.
During this scan the doctor, ultrasonographer or midwife gently places an ultrasound probe into your vagina. This scan gives a clearer image of your womb.
Laparoscopy (keyhole surgery)
If the diagnosis remains unclear you may need an operation called a laparoscopy, also known as 'keyhole surgery'. It usually takes place under a general anaesthetic - this means you are asleep during the surgery.
During keyhole surgery, the surgeon makes a small cut on your tummy. A small camera passes through the hole. This camera can see your womb, fallopian tubes, and ovaries. The surgical team can examine the area in detail.
The surgeon can treat an ectopic pregnancy during the operation. In most cases, the doctor will discuss these steps with you before you go for the operation. If it is an emergency situation there may not be time to discuss these steps.