Ectopic pregnancy

What is an ectopic pregnancy?

Ectopic means “out of place.” An ectopic pregnancy is when an embryo grows in the wrong place outside the womb.

Once an egg is fertilized, it usually travels down a fallopian tube and attaches to the lining of your uterus (also called womb). Fallopian tubes are the tubes between your ovaries (where your eggs are stored) and the uterus. 

In most ectopic pregnancies, the embryo attaches to a fallopian tube before it reaches the uterus. Less often, it attaches to an ovary, the cervix or your abdomen (belly). The cervix is the opening to the uterus that sits at the top of the vagina. These areas don’t have enough space or the right tissue for the embryo to grow.

Without treatment, an ectopic pregnancy can cause serious problems like heavy bleeding, your fallopian tubes to burst, or even death. An ectopic pregnancy always ends in pregnancy loss. Most women who have an ectopic pregnancy can go on to have a healthy pregnancy later.

What are the signs and symptoms of ectopic pregnancy?

An ectopic pregnancy may start out with usual signs and symptoms of pregnancy, like missing your period or having nausea (feeling sick to your stomach) or tender breasts. Or you may not have any signs or symptoms and not even know you’re pregnant.

Call your health care provider right away if you have any of these signs or symptoms of ectopic pregnancy: 

• Bleeding from the vagina
• Feeling faint or dizzy. This can be caused by blood loss which can cause low blood pressure.
• Pain in your lower back pain or even your shoulder
• Pain in your pelvic area (the part of your body between your stomach and legs). This pain may be mainly on one side. It can come and go, start out mild and then become sharp and stabbing.

How is an ectopic pregnancy diagnosed?

Your health care provider may do these tests to look for an ectopic pregnancy: 

• A pelvic exam
• Blood tests to measure the levels of a pregnancy hormone called human chorionic gonadotropin (also called hCG). An ectopic pregnancy can cause hCG levels to rise more slowly than a healthy pregnancy.
• Ultrasound. This test uses sound waves and a computer screen to show a picture of your baby inside the womb. During an ultrasound, your health care provider uses a wand-like tool called a transducer on your belly (also called a transabdominal ultrasound) or inside the vagina (also called a transvaginal ultrasound). Providers often use transvaginal ultrasound to find an ectopic pregnancy because it can show a pregnancy earlier than a transabdominal ultrasound.

If your provider thinks you have an ectopic pregnancy but isn’t able to see it, you might have these tests repeated. It’s hard to see a pregnancy less than 5 weeks after your last period.

How is an ectopic pregnancy treated?

There are two treatments for ectopic pregnancy: 

1. Medicine. 
2. Surgery. 

After treatment, your provider regularly checks your hCG levels until they return to zero. This can take a few weeks. If your levels stay high, it may mean that you still have ectopic tissue in your body. If so, you may need more treatment or surgery.

Who is at risk for having an ectopic pregnancy?

Any woman can have an ectopic pregnancy. But the risk is higher if you:

• Are older than 35
• Smoke
• Have more than one sexual partner. This can put you at risk for getting a sexually transmitted infection (also called STI). STIs can lead to pelvic inflammatory disease (also called PID), an infection that can damage the fallopian tubes, uterus and other organs.

Medical conditions that increase your risk for having an ectopic pregnancy include:

• You‘ve had a previous ectopic pregnancy.
• You’ve had surgery on a fallopian tube, or you have problems, like a birth defect, in a fallopian tube.
• You have scars inside the pelvic area from a (ruptured) burst appendix or from past surgeries. Your appendix is part of your digestive tract that helps you process the food you eat.
• You’ve had endometriosis. This is when tissue from the uterus grows somewhere outside the uterus.
• You had trouble getting pregnant, or you had fertility treatment to help you get pregnant.
• You got pregnant while using an intrauterine device (also called IUD) or after tubal ligation (also called having your tubes tied).

If you’ve had an ectopic pregnancy before, can you go on to have a healthy pregnancy?

It's important to discuss future pregnancies with your healthcare provider after being treated for an ectopic pregnancy. Even if one fallopian tube is removed, you can usually still have a baby. Most people have two fallopian tubes, but only one is required for pregnancy, as eggs can still move through the remaining tube. There are also fertility treatments options you can ask your provider about..

More information:

From hurt to healing (free booklet from the March of Dimes for grieving parents)

Share Your Story (March of Dimes online community for families to share experiences with prematurity, birth defects or loss)

Centering Corporation (general grief information and resources)

Share Pregnancy & Infant Loss Support (resources for families with pregnancy or infant loss)

Last reviewed: October, 2024