What are the symptoms of an ectopic pregnancy?

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Last updated: February 21, 2025View editorial policy

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From the Guidelines

Seek immediate medical attention if you suspect an ectopic pregnancy, as it is a life-threatening emergency that requires prompt diagnosis and treatment. Common symptoms of an ectopic pregnancy include:

  • Severe, sharp pelvic pain, often on one side
  • Vaginal bleeding or spotting
  • Shoulder pain
  • Dizziness or fainting
  • Nausea and vomiting These symptoms typically occur 6-8 weeks after the last menstrual period, as noted in the study by 1. Ectopic pregnancies occur when a fertilized egg implants outside the uterus, most commonly in the fallopian tube. If diagnosed early, medication (methotrexate) may be used to terminate the pregnancy, as discussed in the study by 1. In more advanced cases or if there's a rupture, emergency surgery is necessary. Risk factors for ectopic pregnancy include previous ectopic pregnancy, pelvic inflammatory disease, smoking, and certain fertility treatments, as mentioned in the study by 1. However, ectopic pregnancies can occur without any risk factors, so all sexually active women should be aware of the symptoms. The diagnosis of an ectopic pregnancy is typically made using ultrasound, which can show the location of the pregnancy and the presence of any bleeding, as described in the study by 1. It is essential to seek medical attention immediately if symptoms of an ectopic pregnancy occur, as a ruptured ectopic pregnancy can cause severe internal bleeding and shock, highlighting the importance of prompt diagnosis and treatment, as emphasized in the study by 1.

From the Research

Symptoms of Ectopic Pregnancy

The symptoms of an ectopic pregnancy can vary, but common symptoms include:

  • Pelvic or abdominal pain 2, 3, 4
  • Vaginal bleeding 2, 3, 4, 5, 6
  • Amenorrhea (missed period) or abnormal period 3, 4
  • Abdominal or pelvic tenderness 4
  • Rebound tenderness 4
  • Abdominal distension 4

Diagnosis and Presentation

Ectopic pregnancy should be considered in any patient presenting early in pregnancy with vaginal bleeding or lower abdominal pain in whom intrauterine pregnancy has not yet been established 2. The diagnosis of ectopic pregnancy can be made with ultrasound visualization of a yolk sac and/or embryo in the adnexa, but most ectopic pregnancies do not reach this stage 2. Patient symptoms combined with serial ultrasonography and trends in beta human chorionic gonadotropin levels are often used to make the diagnosis 2, 3, 5.

Risk Factors

Risk factors for ectopic pregnancy include:

  • History of pelvic inflammatory disease 2, 4
  • Cigarette smoking 2
  • Fallopian tube surgery 2
  • Previous ectopic pregnancy 2, 4
  • Infertility 2, 4
  • Abnormalities of the fallopian tube 3
  • Age over 35 years 3
  • Endometriosis 4
  • Previous pelvic surgery 4
  • Presence of a coil 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Ectopic Pregnancy: Diagnosis and Management.

American family physician, 2020

Research

Updates in emergency medicine: Ectopic pregnancy.

The American journal of emergency medicine, 2024

Research

Ectopic pregnancy: diagnosis and management.

Women's health (London, England), 2008

Research

Ectopic Pregnancy.

Obstetrics and gynecology clinics of North America, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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