What should you know?
An ectopic pregnancy implants outside the uterine cavity, most often in a fallopian tube. As it grows, the tube can rupture and cause life-threatening internal bleeding.
Early symptoms may resemble a normal pregnancy. Diagnosis combines transvaginal ultrasound, serial beta-hCG and clinical status; repeat evaluation is sometimes necessary.
Common symptoms and signs
- Missed period and positive pregnancy test
- One-sided lower abdominal or pelvic pain
- Vaginal bleeding or brown discharge
- Shoulder pain, dizziness or weakness with rupture
Diagnosis and the role of ultrasound
Transvaginal ultrasound looks for an intrauterine pregnancy, an adnexal mass and free fluid. Pregnancy of unknown location is not a final diagnosis and requires a clear follow-up plan.
- Presence of an intrauterine gestational sac
- Tubal or adnexal abnormality
- Free pelvic or abdominal fluid
- Correlation with beta-hCG trends
Treatment and next steps
An ectopic pregnancy cannot move into the uterus. Depending on stability, hCG, size and symptoms, treatment may involve carefully selected observation, methotrexate or surgery.
When is urgent care needed?
- Sudden severe abdominal or pelvic pain
- Shoulder pain, fainting, dizziness or marked weakness
- Positive pregnancy test with pain and bleeding