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July 24, 2025
Pregnancy is often seen as a time of excitement and anticipation. But for some women, it can become a journey marked by confusion, pain, and medical emergencies. One such serious condition is an ectopic pregnancy. While relatively rare, it affects about 1-2% of all pregnancies and can be life-threatening if not diagnosed and treated promptly.
In this blog, we explore ectopic pregnancy in detail.
An ectopic pregnancy happens when a fertilized egg attaches and starts developing outside the uterus, usually within the fallopian tube. The uterus is the only place a pregnancy can develop safely. When the embryo implants elsewhere, it cannot thrive and poses a significant risk to the mother’s health.
While the fallopian tubes account for more than 90% of ectopic pregnancies, implantation can also occur in the cervix, ovary, abdominal cavity, or C-section scar (rarely).
Several factors increase the risk of an ectopic pregnancy. Here’s a breakdown of the most common causes and contributing factors:
A woman who has had one ectopic pregnancy is more likely to experience another.
Any surgery or infection (e.g., pelvic inflammatory disease caused by chlamydia or gonorrhoea) that affects the fallopian tubes can cause scarring, which increases the likelihood of ectopic implantation.
Assisted reproductive techniques like IVF can slightly increase the risk of ectopic pregnancy, especially in women with damaged fallopian tubes.
The use of tobacco increases the risk of ectopic pregnancy manifold. Smoking can damage the fallopian tubes and affect the movement of the fertilised egg.
Interestingly, if pregnancy occurs while using an intrauterine device (IUD) or after undergoing tubal ligation (surgical sterilization), there is a higher likelihood that it may be ectopic.
Hormones regulate the movement of the egg through the fallopian tubes. Disrupted hormone levels can interfere with this process, increasing the chances of abnormal implantation.
This is one of the most frequent causes. If the fallopian tube is damaged, scarred, or blocked, the fertilised egg may not reach the uterus and instead implant in the tube.
Ectopic pregnancy symptoms usually begin between the 4th and 12th week of pregnancy. That’s often before many women even realize they are pregnant. Since an ectopic pregnancy can become dangerous quickly, understanding the timing and warning signs is critical for early detection and treatment.
Diagnosing an ectopic pregnancy can be difficult due to similar symptoms to a normal pregnancy or miscarriage. Early and accurate diagnosis is crucial to prevent severe complications. Doctors rely on symptoms, tests, and imaging to confirm the condition.
The doctor will ask about symptoms, pregnancy history, and risk factors, and may perform a pelvic exam to check for tenderness, masses, and an enlarged uterus.
The hormone produced during pregnancy is hCG. In a normal pregnancy, hCG levels double every 48-72 hours. In an ectopic pregnancy, hCG levels may rise slowly or plateau. A positive pregnancy test does not confirm an ectopic pregnancy.
Transvaginal ultrasound is the top choice for diagnosing ectopic pregnancies, as it allows doctors to examine the uterus, fallopian tubes, and ovaries for abnormalities like a mass in the fallopian tube or free fluid indicating internal bleeding.
If the diagnosis isn’t clear, doctors may repeat the hCG blood test and ultrasound after 48–72 hours. If hCG levels are rising but there’s still no sign of an intrauterine pregnancy, ectopic pregnancy becomes more likely.
In emergency cases where rupture is suspected, this test may be done to detect blood in the abdominal cavity. It’s a needle aspiration done behind the uterus through the vaginal wall.
A laparoscopy may be performed if a diagnosis is uncertain or the patient is unstable. This minimally invasive surgery uses a camera to view the fallopian tubes and uterus, allowing confirmation and potential treatment of an ectopic pregnancy at the same time.
In most cases, your belly does not noticeably grow with an ectopic pregnancy. This is because the fertilised egg implants outside the uterus – usually in the fallopian tube – where there isn’t enough space or proper conditions for the embryo to develop. As a result, the pregnancy cannot progress normally, and the foetus does not grow large enough to cause the typical abdominal enlargement seen in a healthy uterine pregnancy. Any bloating or abdominal swelling that occurs in an ectopic pregnancy is more likely due to internal bleeding or inflammation, especially if the fallopian tube ruptures.
Treatment for an ectopic pregnancy is crucial to safeguard the mother’s health and life. The approach taken depends on factors such as the size, location, and risk of rupture of the pregnancy, as well as hCG levels.
Methotrexate is a medication used to treat early, small ectopic pregnancies with low hCG levels. It stops the growth of pregnancy tissue through injections and requires monitoring of hCG levels to ensure absorption. While non-surgical and quick to recover from, it is not suitable for ruptured ectopic pregnancies and may cause side effects like nausea, fatigue, and abdominal pain that need close monitoring with follow-up tests. Although it avoids surgery, methotrexate treatment requires close monitoring and may take weeks for hCG levels to return to normal.
Surgery may be needed for a large ectopic pregnancy, a ruptured fallopian tube, or if methotrexate is not an option. The two main types of surgical procedures are:
In some rare cases, an ectopic pregnancy can resolve on its own if the woman shows no symptoms, hCG levels are going down, and there are no signs of rupture or bleeding. Close monitoring of hCG levels and symptoms is necessary in case complications develop. This is only considered in very early pregnancies with falling hCG levels and no symptoms.
An ectopic pregnancy is a medical emergency that can cause emotional trauma due to the sudden loss of pregnancy, leading to grief, confusion, and emotional turmoil for those who were looking forward to the pregnancy or trying to conceive.
Women may feel shock, sadness, guilt, anger, fear, anxiety, and depression after experiencing an ectopic pregnancy. They may also experience grief, fear about future fertility, and isolation due to a lack of discussion and understanding about this type of pregnancy.
Partners and loved ones may feel unsure how to support the person affected after an ectopic pregnancy. Counselling, therapy, and support groups can help women process their loss. Emotional healing is just as important as physical recovery, and everyone grieves in their own way with no set timeline.
Experiencing an ectopic pregnancy may lead to concerns about future fertility, but many women can have healthy pregnancies afterwards. Fertility prospects are influenced by the treatment of the ectopic pregnancy, the health of remaining reproductive organs, and any underlying conditions.
Natural conception is possible even if one fallopian tube is removed and if one tube is preserved, chances are good but there may be a slightly increased risk of another ectopic pregnancy. If both tubes are damaged or removed, pregnancy through IVF is still an option.
Doctors usually recommend waiting at least 2 to 3 menstrual cycles (or around 3 months if treated with methotrexate) before trying to conceive again. This gives your body time to heal and helps ensure healthy hormone levels.
About 60%-65% of women who had one ectopic pregnancy will go on to have a normal intrauterine pregnancy. If you’ve had multiple ectopic pregnancies, the risks do increase, but with the help of fertility specialists, many still conceive successfully.
The risk of having another ectopic pregnancy is about 10%-15% after the first one. That’s why early monitoring (hCG levels and ultrasound) in future pregnancies is essential for early detection.
Steps can be taken to reduce the risk of an ectopic pregnancy, which is often caused by damage to the fallopian tubes. Understanding and addressing risk factors can lower the chances of experiencing this complication.
Pelvic inflammatory disease can be caused by untreated STIs and can lead to scarring and blockage in the fallopian tubes. To prevent PID, use condoms, get regular STI screenings, and seek treatment for any pelvic infections promptly.
Smoking can harm the fallopian tubes, raise the risk of ectopic pregnancy, and impact fertility. To prevent this, quit smoking, cut down on cigarettes, and seek help through counselling or medications.
Endometriosis is a condition where tissue grows outside the uterus, causing scarring and adhesions in pelvic organs and raising the risk of ectopic pregnancy. Early detection and treatment can help in obtaining timely treatment and avoiding serious complications.
If you’re experiencing abnormal bleeding or pelvic pain, see a doctor as soon as possible. This is especially important if you have such symptoms after a miscarriage, fertility treatment, or any pelvic issue.
Fertility treatments like IVF or IUI increase the risk of ectopic pregnancy slightly. To prevent this, work with a fertility specialist for close monitoring and early detection. Get a thorough pre-treatment assessment to check for any fallopian tube issues.
Previous tubal surgery can increase the risk of an ectopic pregnancy due to scarring. Consider other birth control options and speak with a healthcare provider if you have concerns about past surgeries.
An ectopic pregnancy is a heartbreaking and often traumatic experience. However, awareness, early detection, and prompt treatment can make a significant difference.
Modern medicine offers excellent care options – from medication to surgery – and many women go on to have healthy pregnancies afterwards. Remember that your health comes first. Don’t ignore unusual symptoms. Trust your instincts. Seek help early.
An ectopic pregnancy is diagnosed through blood tests to measure hCG levels and ultrasound to locate the pregnancy outside the uterus.
Yes, many women can still have children after an ectopic pregnancy, especially if one fallopian tube remains healthy.
An ectopic pregnancy is caused by factors like damaged fallopian tubes, pelvic infections, previous ectopic pregnancies, or fertility treatments.
No, an ectopic pregnancy is not a miscarriage; it occurs when the fertilized egg implants outside the uterus, posing a serious health risk.
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