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Ectopic Pregnancy

When a woman becomes pregnant, the fertilized egg (ovum) attaches to the inside of the uterus (womb) where it grows. But in some cases, the egg can attach outside the uterus, most often in the fallopian tube. This is called an ectopic pregnancy. You might also hear this called a tubal pregnancy. But the egg can attach in other places, too. These areas may include the ovary, cervix, or belly (abdomen). An ectopic pregnancy in these areas is rare.

During pregnancy, the fertilized egg grows in the uterus. But with an ectopic pregnancy, the growing egg in the fallopian tube can cause the tube to burst (rupture). This can lead to severe bleeding if it is not found early and treated.

Closeup cross section of fallopian tube with embryo growing inside in ectopic pregnancy.

What causes ectopic pregnancy?

Most often, there is a problem with the fallopian tube that stops the egg from moving through it and into the uterus. This could be due to injury to the tube, such as from an infection or surgery. A woman’s chances for an ectopic pregnancy can increase if she has had:

  • An ectopic pregnancy in the past

  • Pelvic infections that keep coming back

  • Endometriosis

  • Problems getting pregnant (infertility)

  • Surgery on her tubes

  • A pregnancy while using certain birth control pills or an intrauterine device (IUD)

A woman may also be at higher risk if she:

  • Smokes

  • Is over age 35

  • Douches on a regular basis

What are the symptoms of ectopic pregnancy?

The symptoms of an ectopic pregnancy most often occur during the first 12 weeks of pregnancy (first trimester). A woman may have symptoms of early pregnancy, such as a missed menstrual period. Her breasts may be tender. She may urinate often and feel sick to her stomach (nausea). But in some cases, a woman may have no symptoms.

If a woman has symptoms, bleeding from the vagina early in the pregnancy is common. The woman may also have pain in the pelvis or lower back. The pain can come on quickly or slowly. It can be mild or severe. It can be dull or sharp and can come and go or last for a while.

As an ectopic pregnancy grows, symptoms may increase. If the tube bursts, a woman may have:

  • Severe, sudden pain in the abdomen or pelvis that does not go away

  • Pain that travels to the shoulder

  • Weakness and fainting

If an ectopic pregnancy bursts, it can lead to severe internal bleeding that can threaten the woman’s life. Immediate treatment is needed.

What is the treatment for ectopic pregnancy?

An ectopic pregnancy can be treated in several ways. Treatment may include:

  • Medicine. Injection of one or more doses of medicine may be used to stop the fertilized egg cells from growing. Then the body absorbs these cells. Hormone levels are also tested at specific times. This testing is used to make sure that hormone levels have gone back to normal.

  • Surgery. Surgery is done to remove the part of the tube where the ectopic pregnancy is found or remove the whole tube

  • Watchful waiting. This treatment is used for only a small group of women who would be at a very low risk for rupture. It includes close checking of symptoms hormone level testing, and ultrasound scans to check the woman’s status.

If a woman is showing signs that the ectopic pregnancy might burst or has signs that the tube has burst, the woman needs immediate surgery.

Online Medical Reviewer: Donna Freeborn, PhD, CNM, FNP
Online Medical Reviewer: Irina Burd, MD, PhD
Date Last Reviewed: 7/1/2019
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