If you suspect that you, or someone else, are suffering from an ectopic pregnancy then read below to find out what the symptoms are.

In the first place you should go to your doctor and explain to him/her the symptoms you are feeling. If you are away from home you should go to the nearest hospital with an Accident and Emergency department. On UK road signs these are indicated by a large white letter H on a RED-coloured background. Click here to find your nearest Accident and Emergency department.

If you are a woman of childbearing age and have recently been sexually active, then a pain in your lower tummy area may be due to an ectopic pregnancy and you should take it seriously until proved otherwise.

The pain may have begun suddenly and there may or may not have been slight bleeding from your vagina.

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:

One-sided pain in your tummy

This can be persistent and severe, but may not be on the same side as an ectopic pregnancy.

Shoulder-tip pain

Shoulder tip pain is the typical pain of ectopic pregnancies. This may be due to internal bleeding irritating the diaphragm when you breathe in and out. It is exactly where it says - not the neck or the back but the tip of your shoulder. If you look to the left over your shoulder and then cast your eyes down, the tip of your shoulder is where your shoulder ends and your arm starts.

Shoulders cause pain when we are stressed because we hold our selves more rigidly, and muscles in the back and neck go in to spasm - this is not shoulder tip pain.

Shoulder tip pain is very distinctive and you know when you have it because it is a very 'weird' pain you have never had in your life before (unless you had pain of this nature with gall stones).

If you take 2 paracetamol, which are known to be safe in pregnancy and providing you have taken this medicine in the past without problems, apply a cold pack to your shoulder for 10 minutes, and 30 minutes later your shoulder pain has eased, that is unlikely to be ectopic related shoulder pain, however if in any doubt consult your doctor about it.

Bladder or Bowel Problems

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.

Collapse

You may be feeling light-headed or faint, and often this is accompanied by a feeling of something being very wrong. Other signs such as paleness, increasing pulse rate, sickness, diarrhoea and falling blood pressure may also be present.

Pregnancy Test

This may be positive but not always. Specialised hCG blood tests are sometimes required to confirm this.

Abnormal bleeding

If you don't know whether you are pregnant but find yourself having an unusual period, it may be due to a number of causes, one of which might be an ectopic pregnancy, particularly if you have had a coil (IUCD) fitted.

If your bleeding is heavier or lighter than usual and prolonged, or if, unlike your normal monthly period, this bleeding is slight, dark and watery, sometimes described as looking like 'prune juice', then you should tell your doctor as soon as possible.

A missed or late period

If you have missed one or more periods, the most likely reason is that you are normally pregnant. However the fact that you may experience normal pregnancy symptoms e.g. nausea, painful breasts or a swollen abdomen but no bleeding does not completely rule out an ectopic pregnancy.

If you also experience one or more of the symptoms and pains described in the first four bulleted paragraphs above, you should certainly tell your doctor about them.

GPs and hospital doctors may have difficulty reaching a diagnosis because symptoms may occur from almost immediately you are pregnant (3 weeks) up to 12 weeks or even later. There are many other causes of lower tummy pain.

Early Pregnancy Assessment Units

Diagnosis in hospital is improving all the time particularly because more and more district Trusts are setting up Early Pregnancy Assessment Units. Modern transvaginal (TVS) ultrasound scans (less than 5 years old) provide better images than a few years ago, and repeated use of sensitive blood pregnancy tests (hCG) can help tell doctors how the pregnancy is progressing, even if your urine pregnancy test (standard G.P. or chemist urine test) is not positive or has stopped being positive.

Treatment

Hospital Obstetric and Gynaecology doctors are becoming more and more expert at diagnostic laparoscopy, basing the decision on when to look inside a woman's abdomen on modern research-based evidence.

Most hospitals have experts who can perform treatment surgery using keyhole techniques, and many are able to use non-invasive medical treatment (methotrexate) in special circumstances to conserve precious tubal or uterine function. This, however, is still being researched and is not always available. It is increasingly common to manage an ectopic pregnancy expectantly. This means your blood will be regularly tested for hCG levels, if they are at safe levels and you appear well in yourself. Expectant management involves no active medical or surgical intervention; you are simply kept under observation and may be allowed to remain at home or offered a bed in hospital. It is sometimes necessary to treat your ectopic pregnancy with a major surgical operation to your tummy called a Laparotomy although the need to perform this operation is decreasing, as surgeons become competent with keyhole techniques. Your hospital will be able to determine the best treatment for you. If you have questions about the treatment you are being offered, speak to your health care providers about the options you know are available and ask them to help you understand why they have decided to treat you in a particular way. Understanding your treatment can help enormously, as you recover from the impact an ectopic pregnancy has on you, after you leave hospital.

 

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