Ectopic pregnancy: symptoms, warning signs, treatment and care
What an ectopic pregnancy is, the early symptoms and emergency signs, how it is diagnosed and treated, and what it means for future pregnancies.
Also known as: Abdominal Pregnancy; Cervical Pregnancy; Tubal Pregnancy
What an ectopic pregnancy is
In a normal pregnancy, the fertilised egg travels down the fallopian tube and settles in the lining of the womb (uterus). In an ectopic pregnancy, it implants somewhere else — almost always in one of the fallopian tubes, and rarely in the ovary, the neck of the womb (cervix), the abdomen or a caesarean scar. Ectopic means out of place.
Sadly, an ectopic pregnancy cannot continue. There is no way to move it into the womb, and as it grows it can burst (rupture) the tube and cause serious internal bleeding. That is why early diagnosis matters so much: found early, it can usually be treated safely, often without major surgery. It is not caused by anything the woman did, such as working, travelling, lifting or having sex.
Symptoms
Symptoms usually appear between the fourth and twelfth week of pregnancy. Some women have no symptoms until the pregnancy is found on a scan. Others notice:
- A missed period and a positive pregnancy test, sometimes before you knew you were pregnant
- Vaginal bleeding or brown watery discharge, which may be different from a normal period
- Pelvic pain or pain low in the tummy, often on one side, which may come and go or be constant
- Shoulder tip pain — an unusual pain where the shoulder ends and the arm begins, which can be a sign of internal bleeding
- Discomfort when passing urine or stools, or diarrhoea
- Dizziness, feeling faint, or fainting
These symptoms can also happen with a threatened miscarriage, a urine infection or other problems, so they need to be checked by a doctor rather than waited out. If you have a positive pregnancy test and any pain or bleeding, see a gynaecologist promptly.
When it is an emergency
Who is at higher risk
An ectopic pregnancy can happen to any woman who is sexually active, and many women who have one have no known risk factor. The chance is higher in women who:
- Have had an ectopic pregnancy before
- Have had damage to the fallopian tubes from infection, such as pelvic inflammatory disease, sexually transmitted infections or tuberculosis affecting the reproductive organs
- Have had surgery on the tubes or in the pelvis, including a sterilisation operation
- Become pregnant while using a copper-T or hormonal coil — pregnancy is uncommon with a coil, but if it happens, the chance of it being ectopic is higher
- Conceived with fertility treatment such as IVF, or have a history of infertility
- Smoke
How it is diagnosed
Diagnosis brings together your symptoms, an examination and a few tests:
- Pregnancy test — a urine test confirms that you are pregnant
- Transvaginal ultrasound — a slim probe placed gently in the vagina gives a clearer view of the womb and tubes than a scan over the tummy. It may show a pregnancy outside the womb, or an empty womb when a pregnancy would be expected to be visible
- hCG blood test — measures the pregnancy hormone. It is often repeated after two days, because the way the level changes helps show whether the pregnancy is growing normally in the womb, miscarrying or ectopic
Very early on, the scan may not show where the pregnancy is. This is called a pregnancy of unknown location. It can be stressful, but it does not mean something is wrong; your doctor will repeat the blood test and scan until the answer is clear. Keep all follow-up appointments, and come back at once if pain or bleeding gets worse in between.
Treatment
The choice of treatment depends on how far the pregnancy has progressed, the hormone level, what the scan shows, whether there is bleeding inside, and your own wishes. Your gynaecologist will explain the options:
- Watchful waiting — some very early ectopic pregnancies stop growing and are reabsorbed by the body without treatment. This is only offered when you are well, the hormone level is low and falling, and you can attend regular blood tests.
- Methotrexate — a medicine given by injection that stops the pregnancy from growing, so the body can absorb it. It avoids an operation, but needs blood tests over the following weeks, and sometimes a second dose or surgery. After methotrexate you will be advised to avoid pregnancy for a few months and to avoid alcohol and some medicines for a while; your doctor will give exact advice.
- Laparoscopic surgery — keyhole surgery under general anaesthesia, usually to remove the affected tube, or sometimes to remove only the pregnancy and leave the tube. If there is heavy internal bleeding, emergency surgery is needed, sometimes through a larger cut.
If your blood group is Rh negative, you may be offered an Anti-D injection in some situations, to protect future pregnancies. Ask your doctor whether this applies to you.
Recovery and future pregnancies
Physical recovery after keyhole surgery usually takes a few weeks. Emotional recovery can take longer. Losing a pregnancy is a loss, whether or not it was planned, and many women and their partners feel grief, guilt, anger or fear. These feelings are normal. Talking to your doctor, a counsellor or a clinical psychologist can help, and so can giving yourself time.
Most women who have had an ectopic pregnancy go on to have a healthy pregnancy later, including many who have only one working tube. The risk of another ectopic is higher than average, so in any future pregnancy contact your gynaecologist as soon as you have a positive test, so an early scan can confirm that the pregnancy is in the womb. Discuss contraception and when it is safe to try again before you leave hospital.
Which doctor to see
Ectopic pregnancy is diagnosed and treated by a gynaecologist, usually at a hospital with ultrasound, a laboratory and an operating theatre available round the clock. If you have severe pain, fainting or heavy bleeding, go straight to an emergency department, where emergency physicians will stabilise you and call the gynaecology team. For milder symptoms in early pregnancy, a same-day appointment with a gynaecologist or your general physician is the right first step.
You can find gynaecologists in Bengaluru or emergency physicians in Bengaluru on The Doctor Index, each with a registration you can check.
Questions to ask your doctor
- Where exactly is the pregnancy, and how sure are we?
- Which treatment options are safe for me, and what are the pros and cons of each?
- Will my tube be removed, and how will that affect my fertility?
- Which symptoms mean I should come back immediately?
- Do I need an Anti-D injection?
- How long should I wait before trying to conceive again, and what contraception should I use until then?
Common questions
Questions people ask
- Can an ectopic pregnancy be moved into the uterus?
- No. There is currently no medical procedure that can move an ectopic pregnancy into the womb so it can continue. Treatment focuses on ending the ectopic pregnancy safely and protecting the woman's health and, where possible, her future fertility.
- Can I still get pregnant after an ectopic pregnancy?
- Yes, most women can. Many go on to have a healthy pregnancy, even with only one fallopian tube. Because there is a higher chance of another ectopic, see your gynaecologist early in any future pregnancy for a scan to confirm where it is.
- Can a urine pregnancy test show an ectopic pregnancy?
- A home urine test usually turns positive in an ectopic pregnancy, just as in a normal one, but it cannot show where the pregnancy is. Only an ultrasound scan, together with hCG blood tests, can tell whether the pregnancy is in the womb or outside it.
- Did I cause my ectopic pregnancy?
- No. An ectopic pregnancy is not caused by stress, work, lifting, travel, sex or anything you ate. Some risk factors, such as past infection or tube surgery, increase the chance, but often no cause is found. It is not your fault, and it is fine to ask for emotional support.
This condition is usually assessed by a gynaecologist. Every profile shows the doctor’s registration and what has been checked.
Gynaecologists in Bangalore
A few gynaecologists listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Ectopic Pregnancy; ask the clinic whether the doctor sees it.
Related conditions
- Endometriosis
- High Blood Pressure in Pregnancy
- Miscarriage
- Ovarian Cysts
- Pelvic Inflammatory Disease
- Premenstrual Syndrome
- Uterine Fibroids
- Vaginitis
All obstetrics and gynaecology conditions →
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Ectopic Pregnancy
- Emergency Response Support System, Government of India — 112
- MedlinePlus, National Library of Medicine — Ectopic Pregnancy — Public-domain health-topic summary
- Human Phenotype Ontology Consortium — terminology definitions — HPO licence; definitions reproduced without alteration
Ectopic pregnancy: symptoms, warning signs, treatment and care is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-0813.