What Is an Ectopic Pregnancy?

Finding out you're pregnant can bring a flood of emotions. But when a pregnancy develops outside the uterus, it becomes a medical emergency. An ectopic pregnancy is a serious, potentially life-threatening condition — and knowing how to recognize the warning signs can save your life.

At Dr. Emily Women's Health Center, we believe every woman in our community deserves to understand this condition. While ectopic pregnancy requires treatment in a hospital setting, your OB-GYN plays an important role in early detection through routine prenatal care — and that early detection can make all the difference.

What Is an Ectopic Pregnancy?

In a normal pregnancy, a fertilized egg travels through the fallopian tube and implants in the lining of the uterus, where it grows and develops. In an ectopic pregnancy, the fertilized egg implants somewhere outside the uterus — most commonly in one of the fallopian tubes. This is sometimes called a "tubal pregnancy."

In rarer cases, an ectopic pregnancy can occur in other locations, including the ovary, the cervix, the abdominal cavity, or a previous cesarean section scar.

Unfortunately, an ectopic pregnancy cannot develop into a viable birth. The fallopian tube and other structures outside the uterus are not designed to support a growing embryo. If left untreated, the growing tissue can cause the fallopian tube to rupture, leading to severe internal bleeding that can be fatal.

Warning Signs and Symptoms

In the earliest stages, an ectopic pregnancy can feel just like a normal pregnancy. You may experience a missed period, breast tenderness, nausea, or a positive home pregnancy test. That's one of the reasons early prenatal care is so important — confirming that the pregnancy is developing in the right location is a key part of your first visits.

As an ectopic pregnancy progresses — usually between 4 and 12 weeks — symptoms become more noticeable. Watch for these warning signs:

• Pelvic or abdominal pain — This may be sharp, stabbing, or a dull ache. It often occurs on one side but can be felt on both sides.
• Vaginal bleeding or spotting — The bleeding may be lighter or darker than a normal period. Some women mistake it for a menstrual period.
• Shoulder pain — This unusual symptom can occur if blood from a ruptured tube irritates the diaphragm. It feels constant and is not relieved by movement.
• Pain during urination or bowel movements — Pressure from the ectopic pregnancy can cause discomfort in the pelvic region.
• Dizziness, lightheadedness, or fainting — These can indicate internal bleeding and require immediate emergency care.
• Nausea and vomiting — Especially when accompanied by sharp abdominal pain.

What Causes an Ectopic Pregnancy?

An ectopic pregnancy typically occurs when something prevents or slows the fertilized egg's journey through the fallopian tube to the uterus. In many cases, this is due to damage or inflammation in the tube. However, it's important to know that about half of women who experience an ectopic pregnancy have no known risk factors at all.

Risk Factors Include:

• Previous ectopic pregnancy — Having one ectopic pregnancy increases the chance of another.
• Pelvic inflammatory disease (PID) — Infections, particularly from chlamydia or gonorrhea, can cause scarring in the fallopian tubes.
• Prior fallopian tube surgery — Including tubal ligation ("having your tubes tied") or surgical reversal.
• Endometriosis — This condition can cause tissue growth that affects the tubes.
• History of infertility or fertility treatments — IVF and other assisted reproductive technologies are associated with a slightly higher risk.
• Smoking — Tobacco use has been linked to an increased risk of ectopic pregnancy.
• IUD in place at time of conception — While IUDs are very effective at preventing pregnancy, in the rare event that pregnancy occurs with an IUD, the risk of it being ectopic is higher.
• Age over 35 — The risk increases with age.

How Is an Ectopic Pregnancy Detected?

This is where early prenatal care plays a critical role. An ectopic pregnancy cannot be detected by symptoms alone — and in the early stages, it can look and feel exactly like a normal pregnancy. That's why scheduling an appointment with your OB-GYN as soon as you know you're pregnant is so important.

Blood tests (hCG levels): Human chorionic gonadotropin (hCG) is the hormone your body produces during pregnancy. In a healthy pregnancy, hCG levels typically double every 48–72 hours. If levels are rising more slowly than expected or declining, it may suggest a problem, including the possibility of an ectopic pregnancy. Your provider may repeat this test over several days to monitor the trend.

Transvaginal ultrasound: This is the primary imaging tool used to locate a pregnancy. A small ultrasound probe is gently inserted into the vagina to create detailed images of the uterus, fallopian tubes, and surrounding structures. If no gestational sac is visible in the uterus despite a positive pregnancy test, an ectopic pregnancy may be suspected.

If your OB-GYN suspects an ectopic pregnancy based on your bloodwork or ultrasound results, they will refer you to a hospital or emergency facility where specialized treatment can be provided.

How Is an Ectopic Pregnancy Treated?

Ectopic pregnancy requires treatment in a hospital setting, where medical teams have the specialized equipment and surgical capabilities needed to manage this condition safely. Treatment cannot be provided in an outpatient doctor's office.

Depending on how early the ectopic pregnancy is detected, its size and location, and the patient's overall health, hospital-based treatment generally falls into one of these categories:

• Medication — In some early cases where the fallopian tube has not ruptured, doctors may use an injectable medication to stop the growth of the pregnancy tissue, allowing the body to absorb it over time. This requires close follow-up monitoring.
• Surgery — If the ectopic pregnancy is further along or the tube has ruptured, surgery is necessary. This is often performed laparoscopically (through small incisions), though emergency situations may require more extensive surgery.
• Monitoring — In very early cases where hormone levels are low or already declining, hospital doctors may recommend careful observation to see if the pregnancy resolves on its own.

If a fallopian tube has ruptured, emergency surgery is performed immediately to stop internal bleeding. This is why recognizing warning signs and getting to the hospital quickly is so critical.

Recovery and Emotional Health

Physical recovery from ectopic pregnancy treatment varies depending on the approach used. Recovery from medication-based treatment may involve some abdominal discomfort and spotting over several weeks. Surgical recovery typically takes a few weeks, with full healing in four to six weeks.

Can I Get Pregnant Again After an Ectopic Pregnancy?

The good news is that many women go on to have healthy, full-term pregnancies after an ectopic pregnancy. Even if one fallopian tube is damaged or removed, pregnancy is still possible through the remaining tube. If both tubes are damaged or removed, in vitro fertilization (IVF) remains an option.

However, having had one ectopic pregnancy does increase the risk of having another. That's why early prenatal care is especially important for future pregnancies. When you become pregnant again, let your provider know about your ectopic pregnancy history right away so they can confirm early on that the new pregnancy is developing in the uterus.

How to Reduce Your Risk

While you can't completely prevent an ectopic pregnancy, there are steps you can take to lower your risk:

• Practice safe sex — Using condoms and getting regular STI screenings helps prevent infections like chlamydia and gonorrhea that can damage the fallopian tubes.
• Quit smoking — If you smoke, quitting can lower your risk of ectopic pregnancy along with many other health benefits.
• Schedule early prenatal care — Seeing your OB-GYN as soon as you know you're pregnant gives your provider the best chance to confirm the pregnancy is in the right location and catch any problems early.
• Know your risk factors — If you have a history of PID, tubal surgery, endometriosis, or a prior ectopic pregnancy, talk to your provider about a monitoring plan for your next pregnancy.

Key Takeaways

An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in a fallopian tube. It is a life-threatening emergency that requires hospital-based treatment — it cannot be managed in a doctor's office. Early symptoms can mimic a normal pregnancy, but warning signs like one-sided pelvic pain, unusual vaginal bleeding, shoulder pain, dizziness, or fainting should never be ignored. If you experience these symptoms, call 911 or go to the emergency room immediately. The best thing you can do to protect yourself is to schedule early prenatal care so your OB-GYN can confirm your pregnancy is in the right place from the very start.