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.
I didn't need ten days, I passed my baby the next day, I knew I was no longer pregnant, the second scan confirmed a blighted ovum, but to me that wasn't a blighted ovum, that was my baby.
On that Monday I remember saying to the nurse, "I'm worried it might be ectopic." Her reply was that it probably wasn't. And that was that.
We had to carry on with normality despite a broken heart as we had my stepdaughter with us and it was Christmas after all.
The pure excitement I had over my first pregnancy isn't there but only a glimmer of hope, daring not to breathe in case something goes wrong or its too good to be true.
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 Clare (not verified) on 3 Apr 2018 - 13:31
I had an ectopic pregnancy April 2017 which resulted in removal of my right tube. If there was a problem with my left tube would the doctors be able to see when they took my right tube away.
By Midwife @Tommys on 6 Apr 2018 - 11:31
If there was any concern about your left tube then the doctors should have informed you of this, however depending on what may have caused your ectopic pregnancy (often an unknown) then they may not check. It maybe worth for you to speak with your GP to review your medical notes before trying for another pregnancy.
Best wishes, Tommy's midwives x
By Claire (not verified) on 5 Mar 2018 - 01:21
Good evening all,
5 years ago i suffered 2 tubal ectopic pregnancies in the space of 8 months. Both tubes are still intact, with no blockages.
First one was managed by methotrexate. The 2nd one was managed by expectant management.
Now. 5 years on i want to try to conceive again via AI from May.
I used to smoke before 2013 but in 2014 i quit smoking via cold turkey.
I do believe that smoking played a part in the ectopics, aswell an infection due to ici insemination procedure.
Now what is the likeyhood of conceiving and having a healthy pregnancy now after 5 years? I am nervous and scared.
Also can the damage to my tubes be reversed (if there was any damage due to smoking)
I did have a hsg test done in 2014 and this came out normal
Thanks in advance
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