In most pregnancies, the fertilized egg travels through the fallopian tube to the womb (uterus). Anything that blocks or slows the movement of this egg through these tubes can lead to ectopic pregnancy:
If the area around the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include:
Fainting or feel faint
Intense pressure in the rectum
Low blood pressure
Pain in the shoulder area
Severe, sharp, and sudden pain in the lower abdomen
Signs and tests
The health care provider will do a pelvic exam. This may show tenderness in the pelvic area.
A pregnancy test and vaginal ultrasound will be done.
HCG is a hormone normally produced during pregnancy. Checking the blood level of this hormone (quantitative HCG blood test) can diagnose pregnancy. If the blood level of HCG is not rising fast enough, your doctor may suspect an ectopic pregnancy.
Ectopic pregnancy is life-threatening. The pregnancy cannot continue to birth (term). The developing cells must be removed to save the mother's life.
You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to bleeding and shock, an emergency condition. Treatment for shock may include:
Fluids given through a vein
Raising the legs
If there is a rupture, surgery is done to stop blood loss and remove the pregnancy. In some cases, the doctor may have to remove the fallopian tube.
If the ectopic pregnancy has not ruptured, treatment may include:
Medicine that ends the pregnancy, along with close monitoring by your doctor
One out of three women who have had one ectopic pregnancy are later able to have a baby. Another ectopic pregnancy is more likely to occur. Some women do not become pregnant again.
The likelihood of a successful pregnancy after an ectopic pregnancy depends on:
The woman's age
Whether she has already had children
Why the first ectopic pregnancy occurred
Calling your health care provider
Call your doctor or nurse if you have:
Abnormal vaginal bleeding
Lower abdominal or pelvic pain
An ectopic pregnancy can occur even if you use birth control.
Most forms of ectopic pregnancy that occur outside the fallopian tubes are probably not preventable. But a tubal pregnancy may be prevented in some cases by avoiding conditions that might scar the fallopian tubes. The following may reduce your risk:
Practicing safer sex by taking steps before and during sex, which can prevent you from getting an infection
Getting early diagnosis and treatment of all infections caused by sexual relations (STDs)
American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No.94: Medical management of ectopic pregnancy. Obstet Gynecol. 2008;111:1479–1485. Reaffirmed 2012.
Barnhart KT. Ectopic pregnancy. N Engl J Med. 2009;361:379-387.
Houry DE, Salhi BA. Acute complications of pregnancy. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Elsevier Mosby; 2009:chap 176.
Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.