Although an ectopic pregnancy does not occur in the uterus, your body will present with many of the typical signs of pregnancy anyways. [3] X Trustworthy Source American College of Obstetricians and Gynecologists Professional association of OB/GYNs focused on education and public outreat initiatives Go to source If you have an ectopic pregnancy, the pregnancy test would hypothetically always be positive. [4] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source However, remember that these tests do have the possibility of false positive results or false negative tests, so if in doubt it is always a good idea to visit your doctor for a blood test for a confirmation.
breast tenderness frequent urination nausea, with or without vomiting[6] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source absence of menstruation (as previously mentioned). [7] X Research source
The pain mainly occurs due to the pressure exerted by the growing fetus on the surrounding tissue, which in the case of an ectopic pregnancy does not have enough room to accommodate the fetus (the fallopian tubes for instance, the most common site of ectopic pregnancy, are not by any means designed to accommodate a growing baby). The abdominal pain can be sharp and severe, or in some cases there may be no pain. The pain often increases on movement and straining, and is often localized to one side of the abdomen. Shoulder pain can also present due to the presence of blood in the abdomen, which can irritate the nerve that travels up to your shoulder. Know, however, that round ligament pain is very common in pregnancy. This pain, similarly, is located on one side or the other (or both) and can come in intervals (which usually last a few seconds each). The main difference is that round ligament pain tends to occur in the second trimester. The pain from an ectopic pregnancy will usually emerge sooner than that. [9] X Research source
Severe bleeding from ruptured fallopian tubes (which can occur as a result of an ectopic pregnancy) can lead to significant blood loss, fainting, and in very rare instances death if not treated promptly by a medical professional. [11] X Trustworthy Source Cleveland Clinic Educational website from one of the world’s leading hospitals Go to source Other serious symptoms (apart and aside from bleeding) which warrant prompt medical attention include severe abdominal pain, lightheadedness, dizziness, sudden paleness, or mental confusion, all of which could indicate a ruptured ectopic pregnancy. [12] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source Note that something called “implantation bleeding” is entirely normal. This occurs one week prior to your first missed menstrual period (3 weeks after your last menstrual period) and is a pinkish/brownish discharge that should fill more than a few pads. Bleeding from an ectopic pregnancy usually occurs later than this, after the embryo has implanted and begun to grow in a space that cannot accommodate very much growth. However, if bleeding at any time is bright red in color, taking up several pads, and not improving within a day or so, it is important to seek prompt medical attention.
Generally, women who have had an ectopic pregnancy in the past are more likely to experience such pregnancies in the future too. [13] X Research source Other risk factors include: pelvic infections (sexually transmitted infections), multiple sexual partners (as this increases the chance of unknown STI’s), fallopian tube tumors or abnormalities, previous abdominal or pelvic surgery, having an IUD, endometriosis, or smoking. [14] X Trustworthy Source Centers for Disease Control and Prevention Main public health institute for the US, run by the Dept. of Health and Human Services Go to source [15] X Research source Also, if a woman has had “sterilization” (also known a “tubal ligation” surgery, when her “tubes are tied” in an effort to prevent future pregnancy), although this is normally very successful in preventing pregnancy if one were to become pregnant the risk of it being an ectopic pregnancy is notably higher. [16] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source
β-HCG is a hormone that is secreted by the developing embryo and placenta, so it rises as the pregnancy progresses and is a more definitive (and reliable) form of pregnancy test. If the β-HCG level is above 1500 IU/L (often between 1500-2000 IU/L is suspicious), but no pregnancy is seen with ultrasound, doctors will worry about you having an ectopic pregnancy. This is because the β-HCG levels are normally higher in ectopic pregnancy than in normal intrauterine pregnancies, so it is certainly a cause for suspicion. [18] X Trustworthy Source American Academy of Family Physicians Organization devoted to improving the health of patients, families, and communities Go to source If an ectopic pregnancy is suspected due to your β-HCG levels, your doctor will follow this up with a transvaginal ultrasound to see if she can visualize a pregnancy, and its location. [19] X Research source
Note that a negative ultrasound does not rule out an ectopic pregnancy. A positive ultrasound (one that confirms the presence of a pregnancy in the fallopian tubes or elsewhere outside the uterus), however, is enough to make the diagnosis. [21] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source If the ultrasound is negative (i. e. inconclusive), but the β-HCG level is high and your symptoms are enough to concern your doctor that you may have an ectopic pregnancy, your doctor will likely recommend a “diagnostic laparoscopy,” which is a simple surgery with very small incisions where they can insert cameras into your abdomen to have a clearer look. [22] X Research source
This procedure usually lasts for 30 minutes to an hour.
After the injection of methotrexate is given, you will receive repeat blood tests to check your β-HCG level. If it drops to near zero (undetectable in the blood test), the treatment will be deemed successful; if not, you will receive more methotrexate injections until this goal is reached, and if it still not attained you may need surgery. [25] X Research source
Severe blood loss requiring urgent treatment. Failure of methotrexate treatment.
