You’ve been trying for a baby for a while and finally, that extra red line you’ve been waiting for shows up on the pregnancy strip - you’re pregnant! But after visiting your doctor, you discover that the pregnancy is ectopic.

It can be such a disappointment, not to mention heartbreaking to find out your pregnancy is ectopic.

An ectopic pregnancy is when a fertilised egg plants itself outside of the uterine cavity, usually in one of the fallopian tubes, ovary, or cervix.

It is estimated that about 1 - 2% of pregnancies are ectopic worldwide. In the UK, about 11,000 pregnancies are diagnosed ectopic every year.

Unfortunately, it is not possible to save an ectopic pregnancy so it has to be removed with medication or an operation.

What are the causes of an ectopic pregnancy?

Although any woman is capable of having an ectopic pregnancy, the risk is increased if:

You have a pelvic infection.

You become pregnant with an intrauterine device (IUD) in place.

You’re taking the mini pill.

You’re having fertility treatment.

You have endometriosis.

You’ve had a Caesarean or another abdominal surgery.

You’ve had a previous ectopic pregnancy.

So let’s take a look at what the symptoms are of an ectopic pregnancy.

What are the symptoms of an ectopic pregnancy?

Most women experience pain on one side of the lower abdomen and light bleeding at around 6 - 8 weeks (2 - 4 weeks after a missed period). The pain may be severe and persistent. If an ectopic pregnancy is not detected early enough and an embryo is growing in one of the fallopian tubes, this can cause rupturing in one of the tubes followed by severe pain that spreads across the abdomen. You may also experience shoulder-tip pain, which is a result of diaphragm irritation from internal bleeding. If your pain is severe, immediately go to A&E or an early pregnancy unit.

How is an ectopic pregnancy detected and what can be done?

If one of the fallopian tubes has ruptured, then you must go straight to the emergency department for surgery. But usually, an ectopic pregnancy is detected before it gets to this point.

An ectopic pregnancy is usually diagnosed with a vaginal ultrasound scan, which involves inserting a small probe into your vagina. The scan will show that there is no baby in the uterus and sometimes the ectopic pregnancy itself can be seen.

You may be required to have blood tests to monitor the levels of hCG (the pregnancy hormone) to determine whether the pregnancy is ectopic. If these levels plateau or slightly rise, it means the pregnancy is ectopic.

If after these investigations it is still not clear whether your pregnancy is ectopic, then you will be sent for a laparoscopy, which is a procedure where a telescope is inserted through the belly button through a small incision.

An ectopic pregnancy is removed either by keyhole surgery or through a small cut on the bikini line. However, if the ectopic pregnancy is detected early enough, it can be removed by using a drug called methotrexate, which stops the pregnancy from developing. But this is only suitable if the tube hasn’t ruptured and the hCG levels are low enough.

Although medication is less invasive than surgery, it does not always work and can be associated with severe pain. So following up post-treatment is essential.

What is an ectopic pregnancy?

Unii looks at this often heartbreaking phenomenon.