An ectopic pregnancy develops outside the cavity of the uterus (womb), most often in a fallopian tube. It needs medical assessment because it can cause dangerous internal bleeding. It cannot be moved into the uterus to continue the pregnancy.
When to get emergency help
In Australia, call triple zero (000) for an ambulance if you have severe abdominal pain, heavy bleeding, collapse, fainting or feel very unwell. Do not drive yourself if you feel faint or unwell.
Go to an emergency department immediately for shoulder-tip pain, worsening or one-sided lower abdominal pain, or dizziness when you are pregnant or could be pregnant. You do not need to have a positive pregnancy test first. Internal bleeding may occur with little vaginal bleeding, so do not wait for heavy bleeding or your next appointment. These symptoms need assessment even if an earlier test was inconclusive.
Healthdirect explains ectopic symptoms and emergency care.
What symptoms can occur?
Some people initially feel as they would in any early pregnancy; others have no obvious symptoms. Spotting, vaginal bleeding or lower abdominal pain may be the first sign. Symptoms alone cannot tell you where the pregnancy is growing.
For light bleeding without pain or feeling unwell, contact your GP or midwife straight away for advice and assessment. If you cannot reach them, seek urgent medical advice rather than waiting for a routine antenatal visit.
How is an ectopic pregnancy diagnosed?
Your clinician will assess your symptoms and may arrange an ultrasound, often through the vagina, and blood tests measuring the pregnancy hormone hCG. A home pregnancy test cannot show where a pregnancy is located.
Sometimes a positive test is followed by a scan that cannot locate the pregnancy. This is called a pregnancy of unknown location. It can be too early to see a pregnancy in the uterus, a pregnancy may have ended, or it may be ectopic. Follow-up is essential.
Repeat blood tests and scans help clarify what is happening. A single hCG result, or a fall in hCG, does not on its own rule out an ectopic pregnancy. Ask when to return, who will explain your results and where to get help overnight. New or worsening symptoms need urgent assessment while you wait.
What treatment might I need?
Your team will recommend care based on your health, scan and blood-test results. The options are:
- Close monitoring: suitable only for selected people who are stable and can attend follow-up. It is a supervised care plan, not a decision to wait at home without assessment.
- Medicine: methotrexate may stop the pregnancy growing. It is not suitable for everyone and does not always work; further treatment or surgery may be needed.
- Surgery: this may be urgent if there is internal bleeding. It is often keyhole surgery, although open surgery or removal of a fallopian tube may be necessary.
Attend every arranged follow-up until your team confirms that the pregnancy has resolved. Bleeding internally remains possible during monitoring or after medicine. Follow the team’s instructions about medicines, activity, contraception and when it is safe to try for another pregnancy.
Support and future pregnancy
An ectopic pregnancy is a pregnancy loss as well as a medical event. You can ask your GP or hospital team for counselling or pregnancy-loss support. There is no required way to feel.
Many people have no known risk factors. A previous ectopic pregnancy increases the chance of another; tell your clinician early in a future pregnancy so they can arrange a scan to check its location. Fertility and recovery depend on your individual circumstances.
Related information: bleeding in early pregnancy.
Sources and further reading
- Healthdirect: Ectopic pregnancy
- Queensland Clinical Guidelines: Early pregnancy loss
- The Royal Women’s Hospital: Ectopic pregnancy
- Queensland Health: Ectopic pregnancy (patient information)
- Queensland Health: Methotrexate for ectopic pregnancy
- RANZCOG: Miscarriage, recurrent miscarriage and ectopic pregnancy (clinical guideline)
This is general information for Australian readers, not a diagnosis or individual treatment plan.