What is an ectopic pregnancy?
Around 1 in 90 pregnancies in the UK are ectopic. The huge majority (over 95%) happen in a fallopian tube, known as a “tubal pregnancy”. They can also occur in an ovary, in the abdominal space or in the cervix, but this is rare.
Ectopic pregnancy creates a potentially life-threatening situation for a mother, so it is very important that it is treated quickly.
Signs and symptoms of ectopic pregnancy
If you are pregnant and you experience the following symptoms, you should urgently seek medical attention at your nearest Accident and Emergency department as it could be a sign of ectopic pregnancy.
- Bleeding from the vagina which is dark and watery
- Pain on one side of your tummy
- Sudden severe pain spreading across your tummy
- Shoulder tip pain
- Fainting, dizziness, and paleness
- Diarrhoea and pain when going to the toilet
These symptoms are not always caused by an ectopic pregnancy – they can sometimes be caused by other things, such as a tummy bug, but if you are pregnant and you have any of the signs and symptoms listed above get advice right away as ectopic pregnancy is a medical emergency.
How does an ectopic pregnancy happen?
In a normal pregnancy, the egg is fertilised by the sperm in one of the two fallopian tubes connecting the ovaries to the womb. This fertilised egg is “wafted” along the fallopian tube by tiny hairs, until it enters the womb. There it implants and develops into the embryo and the placenta.
An ectopic pregnancy occurs when a fertilised egg attaches itself somewhere outside of the womb. An ectopic pregnancy results in a miscarriage because this sort of pregnancy cannot survive.
You are more likely to have an ectopic pregnancy if:
- You are using a contraceptive coil (IUD) or if you are taking the ‘mini pill’ (also known as the progesterone only pill)
- Your fallopian tubes are damaged from previous surgery
- You have had pelvic inflammatory disease (PID) which can harm the tiny hairs which move the egg into the womb
- You have had a previous ectopic pregnancy
- You have become pregnant by IVF
- You smoke
- You are over 40
However, a third of women who experience an ectopic pregnancy have no known risk factors.
Treatment for ectopic pregnancy
If an ectopic pregnancy is suspected, you will be given an ultrasound scan to see where the pregnancy has attached.
If the scan shows that the womb is empty, a blood test may be helpful to guide further treatment. Sometimes the ectopic pregnancy will show up on the scan and there is no need for any blood testing to confirm the diagnosis.
If an ectopic pregnancy is diagnosed, there are three ways of treating it.
Sometimes, with careful monitoring, the fertilised egg may simply dissolve and expel itself naturally. This is sometimes called “expectant management”. If expectant management is not successful, there are two options. One will probably be recommended, based on your symptoms and test results.
You may be offered an injection of a medicine called methotrexate which stops the pregnancy from growing further.
It may be that you require keyhole surgery (laparoscopy) to remove the fertilised egg. This is done under a general anaesthetic and often includes removal of the affected fallopian tube.
Will I still be able to have a baby in the future?
How easy it will be to conceive again after an ectopic pregnancy will depend on a number of factors, including the health of the remaining fallopian tube(s).Most women who have had an ectopic pregnancy will be able to get pregnant again, even if they have had a fallopian tube removed. In fact 65 percent of women achieve a successful pregnancy within 18 months of having an ectopic pregnancy.
For most women an ectopic pregnancy is a one-off event; the overall chance of a repeat ectopic pregnancy is 7 to 10 percent, depending on the type of treatment.
It is worth waiting for a couple of normal periods after treatment of an ectopic pregnancy before trying again because it is important to give yourself time to heal emotionally as well as physically. If you have been given the drug methotrexate it is recommended to wait at least 3 months, because the medication could harm your baby.
When you do get pregnant again following an ectopic pregnancy, tell your GP right away in order that an early scan may be performed to ensure the pregnancy is healthy.
A chemical pregnancy is the term given to a pregnancy which ends in miscarriage before the fifth week of gestation.
Missed miscarriage can come as a big shock as there are none of the usual signs of miscarriage, such as bleeding or pain.
If you start to miscarry naturally, and experience some bleeding, this indicates that the pregnancy is over and the process of losing your baby is underway.
Around one percent of all women experience recurrent miscarriage. Doctors define this as the loss of three or more consecutive pregnancies.
Most miscarriages occur during the first 12 weeks of pregnancy. Miscarriages that happen in this period are called early miscarriages.
A late miscarriage is also called a second trimester miscarriage.
- Sources: NHS Choices, Ectopic Pregnancy, Last reviewed: 03/02/16, next review: 03/02/18.
ℹLast reviewed on August 1st, 2016. Next review date August 1st, 2019.
By Midwife @Tommys on 7 Sep 2017 - 09:28
Thank you for your comment and sharing your story. This must have been such a worrying time for you and your family, so you would have been very relieved that everything worked out ok.
Wishing you all the best for the future
By Holly (not verified) on 25 Mar 2017 - 14:37
I had my tubes untied may of 2016. Found out i was preg Nov 15 2016 an on the 23rd i was told i was miscarrying an on the 28th i started bleeding. Thot i passed it. On Dec 10th i still had a positive preg test an on the 13th i was told i was preg. It was in my right tube. I was bleeding internally an had it surgically removed. I didnt think i couod get preg that fast after a miscarriage. I sent my medical records w the doc that untied my tubes an she said i never lost the baby n november. That the 1 in my tube in dec was the baby i thot i lost n nov. Even tho i was relieved i didnt lose 2 the pain in my heart n the mental pain of thinking i lost 2 doesnt help now. My left tube had closed up so i only have the right tube. I still have hope n faith an believe god will give me a blessing of a tiny lil human that me n my husband can love n adore. Dye test n may 2 see if theres any blockage. I pray there isnt any. The scar on my stomach is a consist reminder of the baby i dreamed of an wanted so badly n breaks my heart everyday but it gets easier everyday
By Midwife @Tommys on 27 Mar 2017 - 09:21
Thank you so much for sharing your story with us Holly. I really hope that you get the family that you and your husband are hoping for. Please take good care of yourself.
By Midwife @Tommys on 21 Dec 2016 - 15:33
Hi, I'm sorry to hear about your ectopic pregnancy and hope you are healing well now. If you were hoping to become pregnant again I would suggest seeing your GP so that you can be referred to a specialist to discuss your previous sterilisation and the chances of conceiving if your right fallopian tube is now patent.
You may also wish to look at this link http://www.ectopicpregnancy.co.uk/
Best wishes Tommy's Midwives
By Anonymous (not verified) on 23 Dec 2016 - 21:34
Hi thanks for advise I am booked in on 4th jan to ask the doctor
By Sonia (not verified) on 20 Dec 2016 - 22:31
Hi has this happened to anyone else. I got my tubes cut 9 years ago after deciding I didn't want more children a few weeks ago I went to Dr's over pain in my tummy sent me to hospital for laparoscopy last Tuesday and they discovered an ectopic pregnancy in my right tube and that my right tube had re- connected again does this mean I could conceive again and it happen again or is there a chance I could have normal pregnancy
By Anonymous (not verified) on 11 Dec 2016 - 13:11
after having tubes tied with a bicornuate uterus is there still a chance to get pregnat
By Midwife @Tommys on 12 Dec 2016 - 09:33
It may be possible, but you would need to make an appointment with an Obstetric/Gynecology Consultant to be sure - they would need to review your notes and case history to give you a definitive answer. Good luck and please take care
By Sonia (not verified) on 20 Dec 2016 - 22:25
Hi read your question I got my tubes cut 9 years ago went to hospital last Tuesday for laparoscopy because of pain in tummy only to discover I had an ectopicpregnancy and my right tube had re- connected itself I'm hoping I can get pregnant again good luck to you
By Haley (not verified) on 3 Dec 2016 - 04:28
In May I was so happy to find out I was pregnant only to find out that the incredible sickness and pain was an ectopic in the right tube. Luckily my tube didn't rupture but surgery was tough and the mental emotions, like blame and heartache were hard. Just this week I found out that I'm again PG. This site was very helpful to reasssure me that my body can heal and grow.
By Midwife @Tommys on 5 Dec 2016 - 09:04
So sorry to hear about your ectopic pregnancy Haley, but the news of your current pregnancy is truly wonderful! Congratulations!!!
Thank you for your support - so pleased to hear that our information is useful to you!
By Anonymous (not verified) on 24 Aug 2016 - 03:07
I had an ectopic pregnancy and had emergency surgery a week ago, it was my first pregnancy and was the hardest thing I have ever been through. This page really answered a lot of questions. Thank You.
By Anonymous (not verified) on 8 Aug 2016 - 10:41
Its a greatful page and it helps