When to Be Concerned About Possible Ectopic Pregnancy Symptoms

Content medically reviewed by Claire Mallof, MD

A pregnancy is usually a joyous occasion. With an ectopic pregnancy, your life could be at risk, which is why it’s important to recognize ectopic pregnancy symptoms.

“Ectopic pregnancy is rare—occurring in 1% to 2% of pregnancies—but it is serious,” said Dr. Claire Mallof, OB/GYN at Essentia Health. 

What Is Ectopic Pregnancy?

An ectopic pregnancy, sometimes called a tubal pregnancy, occurs when a fertilized egg implants somewhere besides the uterus. Around 90% of the time, an ectopic pregnancy occurs in one of the fallopian tubes. Rarely the egg will implant elsewhere, such as in the cervix or scar tissue from a previous cesarean section. If the fertilized egg grows larger, it can cause your fallopian tube (or, rarely, uterus) to rupture, which is a life-threatening emergency.

Risk Factors for Ectopic Pregnancy

You cannot prevent ectopic pregnancy, but there are risk factors that slightly increase the likelihood of one happening, including –

• Age of 35 or older
• Endometriosis
• History of certain sexually transmitted infections
• Pelvic inflammatory disease
• Previous ectopic pregnancy 
• Prior abdominal or uterine surgery
• Prior surgery on your fallopian tubes 
• Smoking

If an ectopic pregnancy happens, it is not your fault, but it’s important to be aware if you are at risk.

“If you’re a patient who underwent fertility treatment with in vitro fertilization or if you get pregnant when you have an intrauterine device in place, you are also at increased risk,” Dr. Mallof said.

Ectopic Pregnancy Symptoms

Ectopic pregnancies can be asymptomatic, and they can also have the same symptoms as a healthy pregnancy – exhaustion, morning sickness, and missed periods. In this case, you would have a positive pregnancy test with high levels of the pregnancy hormone human chorionic gonadotropin (hCG), but an ultrasound would not show a pregnancy.

You can have signs of an ectopic pregnancy before you even know you’re pregnant or later in your first trimester. Ectopic pregnancy symptoms include –

• Dizziness, fatigue, or fainting
• Lower back pain
• Mild pelvic or abdominal pain, often on one side
• Pain while using the bathroom
• Shoulder pain
• Severe, sudden abdominal pain or cramping
• Vaginal bleeding

Severe pain, sudden pain, or shoulder pain can all be signs of a possible rupture, and you should seek emergency care immediately.

Treatment for Ectopic Pregnancy 

An ectopic pregnancy cannot be carried to term, and the fertilized egg cannot be moved to your uterus. Treatment for ectopic pregnancy will vary depending on where it is and how far along you are.

“For some people, observation is appropriate because the ectopic pregnancy will resolve on its own,” Dr. Mallof said. “For other people, they need medication called methotrexate, which will stop the cells from growing further. Other people will need surgery to remove the ectopic pregnancy from their abdomen.”

Most women recover from ectopic pregnancy within a few days to a few weeks, depending on whether surgery is needed. If you need to take methotrexate, you will have to have several follow-up visits to monitor your hCG levels to make sure the pregnancy is ending.

Don’t Delay Seeking Care

If you think you could be experiencing symptoms of ectopic pregnancy, seek care immediately. 

“If you are newly pregnant and having significant abdominal pain, you should contact your healthcare provider, especially if you have any risk factors,” Dr. Mallof said.