Ectopic pregnancy - Symptoms of ectopic pregnancy

Some women who have an ectopic pregnancy do not have any symptoms. They may not find out it is ectopic until an early scan shows the problem or a woman’s fallopian tube has ruptured.

If there are symptoms, they usually appear between weeks 5 and 14 of the pregnancy. These are outlined below.

Common symptoms

One-sided abdominal pain

You may experience pain, typically on one side of your abdomen (tummy), which can be persistent and severe.

Vaginal bleeding

Vaginal bleeding is a different type of bleeding from your regular period. It often starts and stops, and can be bright or dark red in colour. Some women mistake this bleeding for a regular period and do not realise they are pregnant.

Less common symptoms

Shoulder tip pain

Shoulder tip pain is felt where your shoulder ends and your arm begins. It's not known exactly why shoulder tip pain occurs, but it usually happens when you're lying down and is a sign that the ectopic pregnancy is causing internal bleeding.

The bleeding is thought to irritate the phrenic nerve, which is found in your diaphragm (the muscle used during breathing that separates your chest cavity from your abdomen). Irritation of the phrenic nerve causes referred pain (pain that is felt elsewhere) in the shoulder blade.

Bowel pain

You may experience pain when passing urine or stools.

Diarrhoea and vomiting

An ectopic pregnancy can cause similar symptoms to a gastrointestinal disease and is often associated with diarrhoea and vomiting.

When to seek medical advice

You should always contact your GP if:

• you notice a change to your normal pattern of menstruation
• you have unusual vaginal bleeding and/or
• you have persistent abdominal pain

When to seek emergency medical treatment

The most serious symptom of an ectopic pregnancy is known as "collapse". This occurs when an ectopic pregnancy has split open the fallopian tubes (tubal rupture) and is causing dangerous internal bleeding.

People who have experienced collapse describe feeling lightheaded (dizzy) and faint. You may also:

• experience a sharp, sudden, intense abdominal pain
• feel sick
• have an increased heart rate
• look pale
• have diarrhoea

If your fallopian tubes rupture, you will need emergency surgery to prevent blood loss. Dial 999 immediately and ask for an ambulance.

In rare cases, a ruptured fallopian tube can be fatal. However, this is very uncommon and in most cases, the fallopian tube can be successfully repaired or removed.