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Ectopic Pregnancy

An ectopic pregnancy is a pregnancy that begins to develop outside of the normal uterine cavity. Most develop in the fallopian tubes (the tubes that carry the eggs from the ovary to the uterus). An ectopic pregnancy that develops in the fallopian tubes is also called a tubal pregnancy. Ectopic pregnancies can also develop in the ovary, uterine cervix, uterine wall or abdominal cavity.

A pregnancy that develops outside of the normal uterine cavity is not expected to survive, and if it is left untreated, the mother’s life can be in danger. Therefore, all ectopic pregnancies must be treated.

Symptoms of an ectopic pregnancy

Some women do not have any symptoms of an ectopic pregnancy early on, and some may have symptoms similar to those of early pregnancy, such as missing a period or experiencing nausea and breast tenderness. Women who have ectopic pregnancies still produce pregnancy hormones, so a home pregnancy test will likely come back positive.

As an ectopic pregnancy progresses, women may feel additional symptoms, such as:

  • abdominal or pelvic pain
  • vaginal bleeding
  • shoulder pain
  • the urge to have a bowel movement

Fallopian tube rupture is a medical emergency. If the fallopian tubes rupture, heavy internal bleeding, lightheadedness, fainting and shock are likely to follow.

Call your health care provider if you have any of the above symptoms while you are pregnant or trying to get pregnant. If you ever have severe abdominal pain or pelvic pain and vaginal bleeding, or you experience extreme lightheadedness or fainting, seek emergency help immediately.

Treating an ectopic pregnancy

If you have an ectopic pregnancy, your doctor will have to remove the fertilized egg from your body. There are a number of ways to do this.

  • Drug treatment. If your ectopic pregnancy is detected early enough, it can be treated with an injection of methotrexate, which is a drug that should stop cell growth and dissolve existing cells. After the injection, your health care provider would monitor the level of pregnancy hormones in your blood to make sure the cells are not continuing to grow. If the hormone levels remain high, you may need a second injection. Some women who have surgery to remove ectopic tissue may also need an injection of methotrexate.
  • Minimally invasive, laparoscopic surgery. Your doctor may choose to remove ectopic tissue without removal of the fallopian tube. If your fallopian tube is too damaged, your surgeon may have to remove it.
  • Emergency abdominal surgery. If your fallopian tube has ruptured or you are having heavy bleeding or other complications, you may need emergency surgery to open your abdomen, remove ectopic tissue and repair any internal damage.

Seeking help after an ectopic pregnancy

We understand how difficult it can be to lose a pregnancy, even in the very beginning of pregnancy. You’ve lost a child, which can lead to feelings of sadness and loss and even depression. Because an ectopic pregnancy is very similar to a miscarriage, it’s important to remember that all of the feelings you’re having are normal, and you should allow yourself time to process your emotions and to grieve. There is no shame in mourning your loss, and it’s important to deal with your feelings. We encourage you to talk with people you trust. If you’re having difficulty, you might find it helpful to join a support group or see a grief counselor or other mental health counselor.