ectopic pregnancy
About Marie Stopes International
information & advice
Marie Stopes International (MSI) is a specialist
reproductive healthcare organisation and a registered
charity, working in both the UK and overseas.
In the UK we are a leading provider of sexual and
reproductive healthcare services, operating out of 26
centres and clinics.
Each year over 100,000 women and men contact us
for a range of sexual and reproductive healthcare
services including:
• unplanned pregnancy counselling
• medical termination of pregnancy to nine weeks
gestation
• surgical termination of pregnancy to the legal limit of
24 weeks
• vasectomy
• female sterilisation
• contraception, including long acting reversible
contraception (LARC)
• STI and HIV testing
Any financial surplus generated in the UK helps us
provide reproductive healthcare services to women
and their families in some of the poorest communities
in the world.
The organisation campaigns for better awareness of
sexual health issues and open access to services for
everyone. Our aim is to provide a high quality service,
tailored to individual need. Whichever service you
require, we offer convenient appointments and
experienced teams who are supportive and
professional.
Marie Stopes International
1 Conway Street
Fitzroy Square
London W1T 6LP
United Kingdom
Information and appointments 24 hours
+44 (0)845 300 8090
Telephone
+44 (0)20 7636 6200
Fax
+44 (0) 20 7034 2369
Email
[email protected]
Website
www.mariestopes.org.uk
Registered charity no.
265543
Company no.
1102208
A9/rev3/CW/10.12
• emergency hormonal contraception (“the morning
after pill”)
ectopic pregnancy
What is an ectopic pregnancy?
An ectopic pregnancy is one found outside
the womb (uterus). Most develop in one of
the Fallopian tubes, hence the term tubal
pregnancy. When the afterbirth attaches
(implants) itself in an abnormal place the
pregnancy cannot survive. It is estimated
that an ectopic pregnancy happens in 1 in
150 pregnancies.
What are the symptoms of an ectopic
pregnancy?
The typical signs and symptoms reflect internal
bleeding from the ectopic pregnancy and include:
• Sharp or stabbing pains in the low abdomen. Initially,
these may come and go and vary in intensity. The
pain may be predominantly on one side and may
become constant. Pain or discomfort may also be felt
in the shoulder area due to leaking blood reaching the
upper abdomen
• Feelings of weakness and dizziness, and fainting,
usually reflect severe pain and internal bleeding
What causes an ectopic pregnancy?
An ectopic pregnancy is a natural event, but may be
preceded by one or more of the following:
• Scar tissue in the tubes and/or adhesions in the
pelvis left behind from a previous infection or previous
surgery; this may impede the movement of the
fertilised egg
• An abnormality of the genital organs, such as a
uterine horn or other birth defect
• Rarely, a pregnancy may implant on the scar from a
previous caesarean section.
Who is at risk for having an ectopic
pregnancy?
This risk of having an ectopic pregnancy is increased in
the following circumstances:
• Above 35 years of age
• Previous ectopic pregnancy
• Previous pelvic or abdominal surgery
• Pelvic Inflammatory Disease (PID) or endometriosis
• Women using an IUD (coil) for contraception.
• Feeling very unwell and collapse may occur if the
ectopic ruptures internally. This is an emergency lifethreatening situation
• Vaginal bleeding is usually dark and resembles a
miscarriage, due to the fact that there is no pregnancy
in the womb.
Ectopic pregnancy and abortion
If an ectopic pregnancy is suspected it will not be
appropriate to carry out an abortion until further
investigations have confirmed that the pregnancy is in
the womb.
How is an ectopic pregnancy treated?
If an ectopic pregnancy is strongly suspected then
surgery is usual. The ectopic can be dealt with in one of
several ways:
• Laparoscopy (keyhole surgery) to confirm the
diagnosis and assess options for treatment. If early
(small) then it may be possible to keep the tube. An
injection into the tube with methotrexate may be
considered. If ruptured then the tube will probably
need to be removed, and this may or may not be
possible by keyhole surgery.
• Laparotomy (open surgery) may be necessary if
keyhole surgery is not possible.
How is an ectopic pregnancy diagnosed?
An ectopic pregnancy can be difficult to diagnose.
Abdominal pain after a positive pregnancy test, is an
indication for an ultrasound scan to see if there is
evidence of a pregnancy in the womb. If a pregnancy
cannot be identified this may be because the
pregnancy is too early or has miscarried.
What about the future?
However, an ectopic pregnancy must always be
considered until positively excluded. We will:
• You are more likely to have another ectopic
1. Arrange for a special (TV) scan (trans vaginal) to see
if the pregnancy can be seen in the uterus. If not,
If you get pregnant again, be sure your doctor
knows that you had an ectopic pregnancy before.
2. Refer to a local NHS Early Pregnancy Unit (EPU) for
blood test monitoring. Repeated measurements of
the blood level of the pregnancy hormone Beta hCG
will help determine the likelihood of an ectopic
pregnancy.
If you feel unwell and have bad abdominal pain in
early pregnancy then you need to seek medical
advice urgently. You should attend your local
hospital Accident & Emergency department.
It is common to worry about your fertility after an
ectopic pregnancy but most women go on to
have a normal pregnancy. However:
• You may have trouble getting pregnant
pregnancy