An ectopic pregnancy is one that implants outside the womb — most often in a fallopian tube. It cannot continue safely, and if left untreated it can cause serious internal bleeding. Early recognition genuinely saves lives.

Get help immediately if you have these symptoms

If you are or could be pregnant and you develop any of the following, go to hospital without delay:

  • Severe or one-sided abdominal or pelvic pain
  • Pain in the tip of your shoulder — a distinctive sign of internal bleeding irritating the diaphragm, and one that should never be ignored
  • Feeling faint, dizzy, or collapsing
  • Vaginal bleeding, which may be lighter or darker than a normal period
  • Sudden pain when opening your bowels, or unexplained diarrhoea and vomiting with pain

Do not wait for an appointment, and do not wait to see whether it settles. If you are far from help, tell someone what you are experiencing rather than travelling alone.

How common is it?

Ectopic pregnancies occur in roughly 1 in 100 pregnancies. Most women who have one have no risk factors at all.

What increases the risk

  • Previous ectopic pregnancy
  • Previous pelvic infection (pelvic inflammatory disease)
  • Previous surgery on the fallopian tubes, or previous abdominal surgery
  • Endometriosis
  • Smoking
  • Some fertility treatments
  • Becoming pregnant with an intrauterine device in place — note that coils do not increase your overall risk of ectopic pregnancy; they are very effective contraception. But in the rare event of pregnancy with one in place, that pregnancy is more likely to be ectopic.

How it is diagnosed

Diagnosis usually combines:

  • A transvaginal ultrasound scan — looking for a pregnancy in the womb, and for signs of one elsewhere
  • Blood tests for hCG, often repeated after 48 hours, because the way the level changes is informative
  • Examination and your history

Sometimes the location cannot be established immediately — this is called a pregnancy of unknown location, and it means close monitoring over a few days rather than that something has been missed. Occasionally a laparoscopy is needed to see directly.

A question people always ask

No, an ectopic pregnancy cannot be moved into the womb, and it cannot develop into a baby. There is no treatment that saves the pregnancy. This is often the hardest part to accept, and it is worth stating plainly rather than leaving it unsaid.

Treatment

Which approach is right depends on your symptoms, how stable you are, the size and location of the pregnancy, and your hCG levels.

Expectant management

Where the pregnancy is small, hCG levels are low and falling, and you have no significant symptoms, it may be safe to monitor closely and allow the pregnancy to resolve on its own. This involves repeated blood tests and clear instructions on when to seek help.

Surgery

Surgery is the common route in practice, and is necessary if you are unwell, in significant pain, or if there is bleeding into the abdomen. It is usually done by laparoscopy (keyhole surgery). Either the affected tube is removed, or the pregnancy alone is removed and the tube preserved — your surgeon will explain which is appropriate and why.

Medical treatment

Methotrexate, given as an injection, stops the pregnancy tissue growing. It exists as an option but is used only rarely here; most women are managed expectantly or surgically. If it is used, it requires follow-up blood tests, avoidance of pregnancy for a period afterwards, and clear advice about what to watch for.

Future fertility

This is the question most women want answered, and the honest answer is reassuring.

Most women who have had an ectopic pregnancy go on to have a normal pregnancy afterwards. Even if one fallopian tube is removed, the remaining tube is usually enough — many women conceive naturally with a single tube.

The risk of a further ectopic pregnancy is higher than average, so tell whoever cares for you about your history and arrange an early scan in your next pregnancy to confirm the location. That is a precaution, not a prediction.

Afterwards

An ectopic pregnancy is two things at once: a medical emergency and the loss of a pregnancy. Many women find the second part is barely acknowledged in the rush of the first.

Grief, shock, anger and a period of feeling unlike yourself are all normal. Give yourself time, and talk to someone — your partner, someone you trust, or a professional. If low mood persists, please tell your doctor; this is part of your care, not a separate matter.

The bottom line

Ectopic pregnancy affects about 1 in 100 pregnancies and needs urgent attention. Severe or one-sided pain, shoulder-tip pain, or feeling faint in early pregnancy means going to hospital now. Treatment here is usually expectant or surgical. Most women go on to have a healthy pregnancy afterwards, and an early scan next time is a sensible precaution.

References

  1. National Institute for Health and Care Excellence. Ectopic pregnancy and miscarriage: diagnosis and initial management. NG126. London: NICE; 2019. Available from: https://www.nice.org.uk/guidance/ng126
  2. National Health Service. Ectopic pregnancy [Internet]. NHS; [cited 2026 Jul 22]. Available from: https://www.nhs.uk/conditions/ectopic-pregnancy/
  3. Royal College of Obstetricians and Gynaecologists. Patient information leaflets [Internet]. London: RCOG; [cited 2026 Jul 22]. Available from: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/