Ectopic pregnancy

An ectopic pregnancy is when a fertilised egg implants itself outside of the womb, usually in one of the fallopian tubes.

This means the egg will not develop into a baby, which can be devastating to the pregnant woman.

Occasionally, an ectopic pregnancy doesn't cause any noticeable symptoms and is only detected during routine pregnancy testing. However, most women do have symptoms, and these usually become apparent between week 5 and week 14 of pregnancy.

They include:

abnormal vaginal bleeding
abdominal pain, typically just in one side, which can range from mild to severe
an absent period (amenorrhoea), and other symptoms of pregnancy

Read more about the symptoms of an ectopic pregnancy.

How is an ectopic pregnancy treated?

If an ectopic pregnancy is detected at an early stage, a medication called methotrexate is sometimes needed to stop the egg developing. The pregnancy tissue is then absorbed into the woman’s body.

However, methotrexate is not always needed – in around half of cases, the egg dies before it can grow.

Ectopic pregnancies detected at a more advanced stage will require surgery to remove the egg.

If an ectopic pregnancy is left to develop, there is a risk that the fertilised egg could continue to grow and cause the fallopian tube to split open (rupture), which can cause life-threatening internal bleeding.

Signs of a ruptured fallopian tube are:

sudden, severe, sharp pain
feeling faint and dizzy
feeling or being sick
diarrhoea
shoulder tip pain

A ruptured fallopian tube is a medical emergency. If you think that you or someone in your care has experienced this complication, call 999 and ask for an ambulance.

Read more about treating ectopic pregnancy.

Why does an ectopic pregnancy happen?

In a normal pregnancy an egg is fertilised by sperm in one of the fallopian tubes, which connect the ovaries to the womb. The fertilised egg then moves into the womb and implants itself into the womb lining (endometrium), where it grows and develops.

An ectopic pregnancy occurs when a fertilised egg implants itself outside the womb. It most commonly occurs in a fallopian tube (this is known as a tubal pregnancy), usually as the result of damage to the fallopian tube or the tube not working properly.

Less commonly (in around 2 in 100 cases), an ectopic pregnancy can occur in an ovary, in the abdominal space or in the cervix (neck of the womb).

Things that increase your risk of ectopic pregnancy include:

pelvic inflammatory disease (PID) – an infection of the female reproductive system, typically caused by chlamydia
smoking
having a previous history of other ectopic pregnancies

In around half of all cases, there are no obvious risk factors.

Support

Losing a pregnancy can be devastating and many women feel the same sense of grief as if they had lost a family member or partner.

It is not uncommon for feelings of grief and bereavement to last for 6-12 months, although these feelings usually improve with time.

Many women affected by an ectopic pregnancy benefit from counselling. Read more about dealing with loss and the emotional impact of ectopic pregnancy.

Trying for another pregnancy

How long it is advisable to wait before you try for another pregnancy will depend on your specific circumstances. Your doctor should be able to advise you when (or if) it will be safe to do so.

In most cases it is recommended that you wait for at least two full menstrual cycles before trying for another pregnancy, as this will allow time for your fallopian tubes to recover. However, if you were treated with methotrexate, it is usually recommended that you wait at least three months.

However, many women are not emotionally ready to try for another pregnancy so soon.

Your chances of having a successful pregnancy will depend on the underlying health of your fallopian tubes. In general, 65% of women achieve a successful pregnancy 18 months after having an ectopic pregnancy.

If you cannot conceive in the normal way, then fertility treatment such as in-vitro fertilisation (IVF) may be an option.

IVF treatment is where an egg is fertilised by a sperm outside the womb (usually in a test tube) and, after fertilisation, the embryo is surgically implanted into the womb.

Who is affected

It is estimated that around 1 in 90 pregnancies in the UK develops into an ectopic pregnancy. This is around 10,700 pregnancies a year.

Nowadays, deaths from ectopic pregnancies are extremely rare.

Cervix: The cervix is at the lower end of the womb. It connects the womb with the vagina.
Fallopian tubes: Fallopian tubes (also called oviducts or uterine tubes) are the two tubes that connect the uterus to the ovaries in the female reproductive system.
Ovaries: Ovaries are the pair of reproductive organs that produce eggs and sex hormones in females.