An ectopic pregnancy is not only devastating, it’s dangerous too and can have an impact on future fertility.  In the UK, 1 in 90 pregnancies develops into an ectopic pregnancy, around 10,700 pregnancies a year.  What are the signs, the symptoms and what should you do if you suspect that your pregnancy may be ectopic?

What is an ectopic pregnancy?

An ectopic pregnancy starts the same as any other normal pregnancy.  An egg is fertilised and the cluster of cells that will grow into a baby start their journey towards the uterus.  However, in this kind of pregnancy, rather than implanting in the uterus, these cells will be implanted somewhere outside the womb. In 95 per cent of cases this will be in one of the tubes (fallopian tubes) that link the ovaries to the womb, but it can occur in an ovary, the abdominal space or in the cervix. The embryo continues to develop, but the fallopian tube cannot stretch to allow it to grow. If the embryo is in the widest part of the tube, at the end, blood will start to leak out through the end. If it’s in the narrow part, the tube will burst. This is a serious medical emergency.

Am I more likely to have an ectopic pregnancy?

There are several things that may increase your risk:

  • pelvic inflammatory disease (PID), often caused caused by chlamydia
  • smoking
  • having a previous history of other ectopic pregnancies

What are the signs?

In the early stages, an ectopic pregnancy produces signs no different from those of a normal pregnancy – missed periods, tender breasts and so on. The major difference is that this type of pregnancy will eventually – usually between 6-10 weeks – causes pain in the lower abdomen, usually on one side, which may be accompanied by dark brown bleeding.

If you experience pain, with or without bleeding, consult your doctor right away. If you have sharp, severe and sudden pain, especially if you also have nausea, diorrhoea, shoulder top pain, feel dizzy or faint, go very pale, and your pulse rate becomes very fast, it’s possible that you have an ectopic pregnancy that has burst a Fallopian tube. This is a life-threatening emergency, and you’ll need to be taken to hospital immediately.

What’s the treatment?

An ectopic pregnancy isn’t always easy to diagnose, especially if there’s only slight, or no, bleeding. The first thing the doctor is likely to do if you’re experiencing pain is to examine you internally. If the diagnosis still isn’t clear you may need to have an ultrasound scan. In some cases, further tests may be needed to confirm the diagnosis.

If an ectopic pregnancy is detected at an early stage, a medication called methotrexate can be given to stop the egg developing. The pregnancy tissue is then absorbed into the woman’s body.  In around half of cases, the egg dies before it can grow.

At a more advanced stage, the usual treatment for an ectopic pregnancy is for it to be removed under a general anaesthetic. The tube may have to be removed too, although this isn’t always necessary.

What are the causes?

Research suggest that around half could be due to tubal damage from pelvic inflammatory disease such as chlamydia. The risk is also increased by fertility treatment, use of the coil, endometriosis and taking the mini pill or if you have had surgery on your Fallopian tubes. Sometimes an ectopic pregnancy occurs for no apparent reason.

Will I be able to have another baby?

If you have to have one of your tubes removed for an ectopic pregnancy, as long as the remaining one is healthy, there’s no reason for you not to have another normal pregnancy in the future, though it may take longer to conceive.

It’s recommended that you wait for two full menstrual cycles before trying again to give your body, specifically your fallopian tubes time to recover.  This period may be longer if you were treated with methotrexate, and your doctor will advise you about this.

In this video, an expert gives their advice and Katherine describes her experience of it. 

If you are worried or need advice, you can call the ectopic pregnancy helpline 0845 070 4636 provided by the Ectopic Pregnancy Foundation or email info@theepf.org