Ectopic pregnancy is a complication of pregnancy where the fertilised ovum is implanted in tissue other than the uterine wall, such as the cervix, fallopian tubes or ovaries.

If you think you could possibly be pregnant and experience one or more of the following symptoms, then you should go and see your doctor as soon as possible as they can be considered a sign of ectopic pregnancy.

Pregnancy tests
These may be positive but not always, in some cases home pregnancy tests (HPT's) will show up as negative for a few weeks or appear to be faint. Repeated use of sensitive blood pregnancy tests can help tell doctors how the pregnancy is going on even if your urine pregnancy test is not positive or has stopped being positive. Beta HCG levels double during a normal pregnancy failure to do so indicates there is something very wrong.

Many HPT's claim they can tell if you're pregnant on the day you expect your period. But a recent study shows that most don't give accurate results this early in pregnancy. Waiting one week after a missed period will usually give a more accurate answer.

Ultrasounds
In cases of ectopic pregnancies no sign of a baby is found in the uterus, you may told that you have miscarried or it is too early to tell but an ectopic pregnancy could still be present.

Lower abdominal or pelvic pain
Cramping pain with tenderness, usually in the lower abdomen - on one side initially, though the pain can radiate throughout the abdomen and can feel simular to having a stitch. In some cases woman have describe only having mild niggling twinges, having pain that radiates from the hip down the leg, having a tummy ache and feeling pressure in the bottom. Pain may worsen on straining of bowels (feeling of constipation), coughing or moving. If tubal rupture occurs, pain becomes very sharp and steady for a short time before diffusing throughout the pelvic region. Many feel they are having a miscarriage but this may not be the case. If you feel pain when you have your bowels open or when you pass water and think you may be pregnant you should mention this when you go for a check-up.

Abnormal bleeding
Bleeding does not completely rule out an ectopic pregnancy. Vaginal bleeding is the first symptom in 20% of ectopic pregnancies. In most cases of ectopic pregnancies vaginal bleeding has been described as brownish, pink-tinged or bright red spotting, some say it looks simular to prune juice (slight, dark and watery). However there are cases in ectopic pregnancies where bleeding is heavy, this is usually because the tube has ruptured.

Though there can be many other reasons for vaginal bleeding in pregnancy it should not be ignored. In this case serial blood tests should be taken in suspected pregnancy or pregnancy. If vaginal bleeding occurs you should contact your GP, OB or local Emergency department.

Nausea and faintness
Nausea and vomiting occurs in 25 to 50% of ectopic pregnancies this may be hard to distinguish from morning sickness. If tube ruptures weakness, dizziness, and a sense of passing out upon standing can represent serious internal bleeding. Other signs such as paleness (clammy skin), increasing pulse rate, diarrhoea and falling blood pressure may also be present.

Shoulder pain
This may be due to internal bleeding irritating the diaphragm when you breathe in and out. Pain has been described being around the tips of the shoulders and running up the neck. If it is accompany with any of the above symptoms please see your doctor as immediately.

Who's at risk?
In most cases ectopic pregnancy there may be no apparent reason that it has occurred, there is nothing that could be done differently or done to prevent it. Ectopic pregnancy can go on from 3 weeks to 12 or in some cases even longer. If you suspect the pregnancy is ectopic and have any above symptoms please seek medical attention ASAP. As ectopic pregnancy can lead to death if not picked up.

There however been links to the following:
- Most cases are a result of scarring caused by a past infection in the fallopian tubes, surgery of the fallopian tubes, or a previous ectopic pregnancy. Up to 50% of women who have ectopic pregnancies have had inflammation of the fallopian tubes (salpingitis) or pelvic inflammatory disease.
- Some ectopic pregnancies can be due to birth defects of the fallopian tubes, endometrious, complications of a ruptured appendix, or scarring caused by previous pelvic surgery.
- Sometimes, a woman will become pregnant after having her tubes tied. Women who have had successful surgery to reverse tubal sterilization in order to become pregnant also have an increased risk of ectopic pregnancy.
- Taking hormones, specifically estrogen and progesterone (such as those in birth control pills), can slow the normal movement of the fertilized egg through the tubes and lead to ectopic pregnancy.
- Women who have in vitro fertilization or who have an intrauterine device (IUD) using progesterone also have an increased risk of ectopic pregnancy.
- The "morning after pill" (emergency contraception) has been linked to some cases of ectopic pregnancy.

Please note:
Lack of signs doesn't rule an ectopic pregnancy or you may think this is not you. So if your bleeding is heavier or lighter than usual and prolonged, or if, unlike your normal monthly period or you are just concerned consult your GP, OB or local emergency department. And remember in cases of ectopic pregnancies there is nothing you could done differently and in most cases there is no medical reason it has occurred.

This information was collated using medical information and the personal experiences of Essential Baby members who have experienced ectopic pregnancy. It was collected to inform and in hope of early detection to prevent tubal loss or even death. Please note it is not a substitute for medical advice and as stated above, please see a doctor if you have any concerns. Frequently asked questions can be found here.

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