Ectopic pregnancy

A pregnancy implanting outside the womb. It can rupture and cause fatal internal bleeding, and the symptoms are easily mistaken.

What it is

Around 1 in 90 pregnancies in the UK is ectopic, meaning the fertilised egg implants outside the womb, almost always in a fallopian tube.

The pregnancy cannot survive, and the tube can rupture, causing severe internal bleeding. It remains a leading cause of pregnancy-related death in the first trimester.

The reason it is dangerous is that the early symptoms are non-specific and easily attributed to something else: a stomach bug, a urine infection, or ordinary period pain. Some women do not yet know they are pregnant.

Any woman of reproductive age with abdominal pain should have a pregnancy test. That single rule prevents deaths, and it is still not universally applied.

Signs you might notice

One-sided lower abdominal pain, often persistent and worsening.

Vaginal bleeding, often different from a normal period: darker, or watery.

A missed or late period, though not always.

Shoulder tip pain, which is caused by blood irritating the diaphragm and is a serious sign.

Pain on opening the bowels, or urinary symptoms.

Collapse, dizziness, pallor, and a fast pulse mean rupture. That is a 999 call.

How it can affect day-to-day life

Delay happens because the symptoms are attributed to gastroenteritis or a UTI, and because people do not connect abdominal pain to pregnancy when they were not expecting to be pregnant.

Shoulder tip pain in a woman of reproductive age with abdominal pain should always prompt a pregnancy test.

The emotional aftermath is a bereavement, and it is frequently handled as a medical event only. Loss of a tube also raises anxiety about future fertility, though most people who want to conceive again do.

Supporting someone well

Do a pregnancy test in any woman of reproductive age with abdominal pain. Every time.

Treat one-sided pain with a positive pregnancy test as an ectopic until proved otherwise, and get to an early pregnancy unit.

Recognise shoulder tip pain as significant rather than musculoskeletal.

Call 999 for collapse, severe pain, or a fast pulse with pallor.

Afterwards, treat it as a bereavement, and offer support rather than reassurance about future fertility alone.

Higher risk: previous ectopic, previous pelvic infection, tubal surgery, or conception with an IUD in place or after IVF.

Where to get help

Contact an early pregnancy assessment unit directly; most accept self-referral in early pregnancy with pain or bleeding.

The Ectopic Pregnancy Trust run a helpline on 020 7733 2653.

999 for collapse or severe pain.