What is an ectopic pregnancy?
In an ectopic pregnancy, a fertilised egg starts to grow somewhere other than in the normal lining of the womb, usually in 1 of the fallopian tubes. Ectopic pregnancy affects around 1 in 100 pregnancies.
An ectopic pregnancy creates a potentially life-threatening situation for the mother, so it is very important that it is treated quickly. Unfortunately, it is not possible to save the pregnancy if it is ectopic. This can be difficult to come to terms with. You can talk to a Tommy’s midwife about what you’re going through for free. You can call them on 0800 0147 800 (Monday-Friday, 9am-5pm) or email them at [email protected] All our midwives are trained in bereavement support.
What causes ectopic pregnancy?
Any woman can have an ectopic pregnancy. In fact, about a third of women who experience an ectopic pregnancy have no known risk factors. But there are some things that may increase your risk of having an ectopic pregnancy. These include:
- pelvic inflammatory disease (inflammation of the female reproductive system, usually caused by a sexually transmitted infection)
- previous ectopic pregnancy (the risk of having another ectopic pregnancy is around 10%)
- previous surgery on your fallopian tubes, such as unsuccessful female sterilisation
- fertility treatment, such as IVF
- getting pregnant while using contraception such as an intrauterine device (IUD) or intrauterine system (IUS) for contraception
- age (the risk is highest for pregnant women aged 35 to 40).
What are the symptoms of an ectopic pregnancy?
Contact your GP or call NHS 111 if you have a combination of any of the below symptoms and you think you might be pregnant, even if you haven't had a positive pregnancy test.
Vaginal bleeding in pregnancy tends to be a bit different to your regular period. It often starts and stops, and may be watery and dark brown in colour.
Vaginal bleeding in pregnancy can be common and isn't necessarily a sign of a serious problem, but you should always get medical advice if you have it.
You may have stomach pain, typically low down on 1 side. It can develop suddenly or gradually, and may be persistent or come and go.
Any stomach pain may just be caused by a stomach bug, trapped wind or something unknown. But it is important to get medical advice if you have it.
Shoulder tip pain
Shoulder tip pain is an unusual pain felt where your shoulder ends and your arm begins. You should get medical advice right away if you experience this.
We don’t fully understand why this pain happens. It is thought to be linked to the presence of fluid or blood leaking into the pelvis or lower abdomen, which happens in an ectopic pregnancy. There are nerves in this area that are linked to your shoulder. Irritation of these nerves can lead to shoulder tip pain.
Discomfort when going to the toilet
You may have pain when going for a wee or poo. You may also have diarrhoea or constipation.
Some changes to your normal bladder and bowel patterns are normal during pregnancy. These symptoms can be caused by urinary tract infections and stomach bugs. But it's still a good idea to get medical advice.
Symptoms of a rupture
In some cases, an ectopic pregnancy can grow large enough to split open the fallopian tube. This is known as a rupture.
Ruptures are very serious. Surgery to repair the fallopian tube needs to be carried out as soon as possible.
Signs of a rupture include a combination of:
- a sharp, sudden and intense pain in your tummy
- feeling very dizzy or fainting
- feeling sick
- looking very pale.
How is ectopic pregnancy treated?
Unfortunately, the only way to treat an ectopic pregnancy is to end the pregnancy. This can be very distressing, and you may need support afterwards to come to terms with what has happened.
Your healthcare team will talk to you about your options and what this means for you. Not all these options will be suitable and will depend on:
- how many weeks pregnant you are
- your symptoms (for example, how much pain you are in)
- if there is a lot of bleeding in your stomach
- your hCG levels (the pregnancy hormone)
- what is available at your local hospital.
It’s important that you understand all your options and what this may mean for you and your ability to get pregnant again (if you want to). Don’t be afraid to ask as many questions as you need to and raise any concerns you have about what is happening.
There are 3 treatment options for an ectopic pregnancy.
Expectant management means waiting for the pregnancy to end by itself naturally (miscarriage), without treatment. It is usually only possible when the pregnancy is still in the early stages and when you have a few or no symptoms.
Your doctor will need to check your hCG levels (pregnancy hormones) every few days until they go back to normal. This is to make sure that the pregnancy has completely ended. You may need more ultrasound scans.
Find out more about expectant management.
You will be given medication as an injection. This stops the pregnancy from developing and it will gradually disappear. If you are given medication, your fallopian tube is not removed.
You may need to stay in hospital overnight. Many women are in some pain for the first few days, but this should settle if you take paracetamol.
You will need to go back to hospital in the first week and then once a week to check your hCG levels. It may take a few weeks make sure the pregnancy has completely ended and you may need further ultrasound scans. During this time, you should not have sex. You should also avoid getting pregnant by using reliable contraception for at least 3 months.
Some women who take medication may still need surgery.
The aim of surgery is to remove the ectopic pregnancy. The surgery will be either be a laparoscopy (a type of keyhole surgery) or a laparotomy (open surgery). It may take longer to recover if you have open surgery.
You may have your fallopian tube removed (known as a salpingectomy). This will reduce the risk of having another ectopic pregnancy next time.
If you only have 1 tube or your other tube does not look healthy, you may be advised to have a salpingotomy. This operation aims to remove the pregnancy without removing the tube. This means that you have a higher risk of another ectopic pregnancy, but you will still be able to get pregnant naturally.
You may be offered a follow-up appointment with your gynaecologist, particularly if you have had an emergency operation. If you have not had your fallopian tube removed, you will need to have your hCG levels checked until they are back to normal.
In an emergency
If the fallopian tube has ruptured, you will need emergency surgery to remove the ruptured tube and pregnancy. Your doctors will need to act quickly, so they may have to decide to operate for you.
Will I still be able to have a baby in the future?
If you do get pregnant again, you may be offered an ultrasound scan at 6 to 8 weeks to confirm that the pregnancy is developing in the womb.
How you may feel about an ectopic pregnancy
Having an ectopic pregnancy can have a huge impact on your mental health. Everyone is different but you’ll likely need time to come to terms with the loss of a baby. Some women might also need time to accept that they could also have lost their life.
You may find it helpful to:
- talk to your partner, family or friends about how you feel
- ask your care team what support is available – they may refer you to a counsellor who specialises in support for people affected by ectopic pregnancies
- talk to a Tommy’s midwife free of charge from 9am–5pm, Monday–Friday on our helpline 0800 0147 800 or email [email protected]
- visit The Ectopic Pregnancy Trust for more support and information.
A chemical pregnancy is when a pregnancy ends in miscarriage before five weeks of pregnancy.
Missed miscarriage (also known as a delayed or a silent miscarriage) can come as a big shock as there are none of the usual signs of miscarriage, such as bleeding or pain.
An incomplete miscarriage is when a miscarriage begins, but the pregnancy doesn’t completely come away from the womb.
Around 1 in 200 women experience recurrent miscarriage. Doctors define this as the loss of 3 or more consecutive pregnancies.
Most miscarriages occur during the first 12 weeks of pregnancy. Miscarriages that happen in this period are called early miscarriages.
Late miscarriage refers to a miscarriage that happens when a baby dies between 14 and 24 weeks of pregnancy.
NICE (2019). Ectopic pregnancy and miscarriage: diagnosis and initial management. National Institute for health and care excellence https://www.nice.org.uk/guidance/ng126
Clinical Knowledge Summaries. Ectopic pregnancy https://cks.nice.org.uk/ectopic-pregnancy (Last reviewed: May 2018 Next review due: December 2023)
NHS Choices. Ectopic pregnancy https://www.nhs.uk/conditions/ectopic-pregnancy/ (Page last reviewed: 27/11/2018 Next review due: 27/11/2021)
Royal College of Obstetricians and Gynaecologists (2010) An ectopic pregnancy https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-an-ectopic-pregnancy.pdfHide details
ℹLast reviewed on March 12th, 2020. Next review date March 12th, 2023.
By Midwife @Tommys on 6 Mar 2018 - 12:32
Thanks for posting it is amazing that you have managed to quit smoking over 3 years ago and your 2014 hsg was normal. This makes it sound very hopeful for AI in May. Understandably you must be terrified Claire. I would suggest contacting ECT on the phone number listed below to ask specifically about your history and whether they would have any further suggestions before you commence on getting pregnant again.
https://www.ectopic.org.uk/ 0207 7332653
Please don't hesitate to get in contact with us again if we can help in any way.
Warmest wishes for the future
By Anonymous (not verified) on 28 Jan 2018 - 21:55
I had an ectopic pregnancy in September, I needed surgery and my left tube was removed. I'm now 9 weeks pregnant and so scared that something will go wrong. We had a scan at 7 weeks and saw the baby with a strong heartbeat but I can't help but constantly worry.
By Midwife @Tommys on 31 Jan 2018 - 09:21
Hi there. It is completely normal to feel anxious, you had a very scary time only a few months ago and this of course will leave you feeling worried about this pregnancy. The good news is that your scans sound normal and your baby is growing where and how it should for this gestation. So both of those are positive and reassuring for you. Please do feel free to call us if you would like to talk anything though with us on 0800 0147800
Take good care of yourself.
Sophie, Tommy's Midwife
By Anonymous (not verified) on 21 Jan 2018 - 06:48
In may 2017, had an ectopic rupture that they were able to clear and remove without taking the tube. It had caught and started bleeding on the very outside of the left tube and hadn’t actually went in. Now, just found out I’m about 5 weeks pregnant. Keep feeling mild pains and twinges on the lower left and so worried it might be ectopic again. Last time the pain had me doubled over and I was bleeding. Had super positive pregnancy test that time before I even missed my period. This time, the at home test was a very very light line. Retook 3 days later (5 days after missed period) and it was still light, but readable. Went to dr to confirm. They only did urine sample. Said it’s positive and are not doing any other testing or blood work. Ugh! In may, my hcg levels were ridiculous high for 3.5 weeks pregnant and then just barely went up. Wish they would track for me this time!
Anyway, is it normal to have some mild pain where a previous ectopic happened? Or should I be very concerned? This pain has been happening during random times since surgery in may, as well. I don’t have any bleeding this time and the pain is very mild and not constant.
By Midwife @Tommys on 22 Jan 2018 - 15:04
This is a difficult one as I understand your very real concerns but also understand the doctor's stance that in the absence of pain and bleeding there is no clear rationale for blood testing and scanning. You indicate that the mild pain you have has been going on for a few months and is not recent. Is it getting worse? If you have any bleeding, worsening pain, feel faint, have shoulder tip pain when lying down or have pain when opening your bowels, I would advise that you are seen as soon as possible. I hope that you don't experience any of these symptoms and that your pregnancy continues to full term and a happy outcome. Best wishes
By Anonymous (not verified) on 22 Nov 2017 - 16:43
My wife is made two times surgery in the case of ectopic can she again pregnant?
By Midwife @Tommys on 23 Nov 2017 - 14:31
Hi, Thank you for your comment.
We are sorry to hear about you and your wife's experiences of ectopic pregnancy. With regards to the surgeries that she has had, it will all depend on what happened during these surgeries and if they had to remove a fallopian tube. It is possible to have a successful pregnancy after experiencing an ectopic pregnancy, but we would recommend that you speak to your GP who will be able to look at the medical records and advise you further on a future pregnancy. Hope that this has helped, take care Tommy's Midwives x
By Leesa (not verified) on 19 Nov 2017 - 18:04
I had an ectopic pregnancy 3 months ago, iv done a few tests this week as I'm feeling sick all the time how ever clear blue rapid responce brand tests are the only ones coming back positive and one early brand test the rest negative ?? If I am pregnant am I at rick of having another ectopic pregnancy??
By Midwife @Tommys on 20 Nov 2017 - 10:02
It sounds as if you are very early pregnant and many tests cannot pick up the low level of hcg, the pregnancy hormone that develops in pregnancy, and is excreted in your urine. Just give it another week and re-test if you want to be 100% sure. But you have had positive results, so that sounds good.
Having a previous ectopic pregnancy, does put your risk of another ectopic pregnancy up slightly i am afraid, as the scar tissue looks to be an inviting spot for the embryo to embed into. However, being at risk if something, does not mean that it is going to happen again.
Have a very low threshold for going into hospital if you have any pain and bleeding in the next few weeks of pregnancy. If you have any questions, please feel free to call us on 0800 0147800 or email us again on [email protected]
Please take good care of yourself!
By Jenny (not verified) on 15 Oct 2017 - 21:48
Like many of the women on here I have a turbulent history. Before the age of 21 I had faced two miscarriages and then an ectopic pregnancy which cause the tube to rupture when I was on holiday in Mexico. Following that I then went on to have a successful pregnancy resulting in my little girl being born and she is now 16.
Following Laurens birth, I then went on to have a further two miscarriages and then another ectopic in my other tube, which I had surgery to repair.
Miraculously i then went on to have another little girl who is now 12, despite only having 1 tube which had been damaged due to the ectopic and the surgery
Fast forward 12 years and I'm now in a new relationship after splitting with the girls dad 3 years ago. I am 38 and my boyfriend is 28. We want more children. He's Romanian which makes the translating of what has happened more difficult but I feel I need to be honest with him and share that there may be a chance that the next pregnancy will result in another ectopic and the doctors will then opt to remove the only tube I have left. I know my age is also going against me and I hate the thought of going all through this again and also disappointing the man who I want to spend the rest of my life with :(
By Midwife @Tommys on 16 Oct 2017 - 12:24
It sounds like you have been through such a lot and i agree that it is important that your new partner understands this too so that you can both make a choice together on how to best proceed with your future.
If you need anymore support and advice, please do feel free to email us or call us Mon to Fri, 9 am to 5pm.
Take good care of yourself and your family. All the best
By Anonymous (not verified) on 6 Sep 2017 - 22:42
We were over the moon to find out I was pregnant again after I had a miscarriage 10 months previously. However, after getting pain in my left side of abdomen I was worried so we paid to have an early scan at about 7weeks.
The sonographer showed me the sac, fetus & heartbeat so we were relieved but she then carried on scanning me and looked worried.
It appeared that I had a healthy uterine pregnancy & an also an ectopic . I was immediately referred to the hospital and after a lot of discussions we decided the best option for the health of my uterine pregnancy was to wait out and hope the ectopic naturally absorbed. I had regular scans to ensure the ectopic wasn't at risk of rupturing and luckily by 10weeks all was ok.
All worked out ok in the end and I have a beautiful 2 year old daughter.
It's something like 1:30,000 chance of happening so there is very little info and I struggled to find any success stories when desperately googling for reassurance- so I hope this helps others in the same situation.
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