Ectopic pregnancy - Symptoms 

Symptoms of ectopic pregnancy 

Some women who have an ectopic pregnancy do not have any symptoms. They may not find out it is ectopic until an early scan shows the problem or a woman’s fallopian tube has ruptured.

If there are symptoms, they usually appear between weeks 5 and 14 of the pregnancy. These are outlined below.

Common symptoms

One-sided abdominal pain

You may experience pain, typically on one side of your abdomen (tummy), which can be persistent and severe.

Vaginal bleeding

Vaginal bleeding is a different type of bleeding from your regular period. It often starts and stops, and can be bright or dark red in colour. Some women mistake this bleeding for a regular period and do not realise they are pregnant.

Less common symptoms

Shoulder tip pain

Shoulder tip pain is felt where your shoulder ends and your arm begins. It's not known exactly why shoulder tip pain occurs, but it usually happens when you're lying down and is a sign that the ectopic pregnancy is causing internal bleeding.

The bleeding is thought to irritate the phrenic nerve, which is found in your diaphragm (the muscle used during breathing that separates your chest cavity from your abdomen). Irritation of the phrenic nerve causes referred pain (pain that is felt elsewhere) in the shoulder blade.

Bowel pain

You may experience pain when passing urine or stools.

Diarrhoea and vomiting

An ectopic pregnancy can cause similar symptoms to a gastrointestinal disease and is often associated with diarrhoea and vomiting.

When to seek medical advice

You should always contact your GP if:

  • you notice a change to your normal pattern of menstruation
  • you have unusual vaginal bleeding and/or
  • you have persistent abdominal pain

When to seek emergency medical treatment

The most serious symptom of an ectopic pregnancy is known as "collapse". This occurs when an ectopic pregnancy has split open the fallopian tubes (tubal rupture) and is causing dangerous internal bleeding.

People who have experienced collapse describe feeling lightheaded (dizzy) and faint. You may also:

  • experience a sharp, sudden, intense abdominal pain
  • feel sick
  • have an increased heart rate
  • look pale
  • have diarrhoea

If your fallopian tubes rupture, you will need emergency surgery to prevent blood loss. Dial 999 immediately and ask for an ambulance.

In rare cases, a ruptured fallopian tube can be fatal. However, this is very uncommon and in most cases, the fallopian tube can be successfully repaired or removed.

Page last reviewed: 09/04/2014

Next review due: 09/04/2016

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The 2 comments posted are personal views. Any information they give has not been checked and may not be accurate.

kirstyw93 said on 18 November 2013

I didn't have a clue I was pregnant. For weeks I felt really sick and very hot, I had extremely horrible pain in my right side that kept coming and going. I had what I thought was a regular period for over 2 weeks. The doctors had done pregnancy tests and they came up negative until I finally had a position one. That day I hsd to go to hospital for what seemed like the longest day of my life, I had scans and tests and my HCG levels were very low I had keyhole surgery to confirm my ectopic pregnancy and then a c-section operation to remove it they also took part of my tube along with it. My ovaries and tubes are very healthy on both sides and I can still have children im just glad I kept pushing the doctors to find it

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Caroline_27 said on 06 July 2013

After a contraception failure I took the morning after pill. 2 weeks later I had a very normal period, heavy and clots like I normally have.
2 weeks later on from that I had sudden severe stomach pain. It subsided after an hour or so and later that day I saw my doctor who confirmed a pregnancy. Understandinly shocked as I had a period since the morning after pill I was sent to early pregnancy assessment as they suspected ectopic pregnancy.
My HGC levels were over 2000 although nothing could be seen via ultrasound or internal scan, and consultant recommended energency surgery. The next day in hospital I saw a different consulatant who told me I could NOT have an ectopic pregnancy as my pain had subsided. He wanted new HGC levels done 24 hours later which they expected would be 1000 (dropping and miscarried) or 4000 (growing)...I had 3000. I had emergency keyhole surgery within the hour where one fallopian tube was removed and at my request the other was clipped (I already had a referral for sterilisation although only 27 years with 2 children)

My only symptom was one hour of stomach pain and thank god I had it checked out. No shoulder pain, no internal bleeding, no vaginal bleeding and I was told my tube already had a small rupture.

My surgery was performed yesterday afternoon and I'm back home although a little uncomfortable.

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Typical symptoms of pregnancy

Even though the pregnancy is ectopic, you will still experience many of the hormonal changes that occur during a pregnancy.

This means you may also experience the typical symptoms of an early pregnancy, such as:

  • feeling sick (nausea)
  • breast tenderness
  • your regular period stopping
  • needing to pass urine more frequently
  • feeling unusually tired

A pregnancy test can sometimes provide a positive result, even if the pregnancy is ectopic.