An ectopic pregnancy happens when the embryo settles anywhere other than the womb’s inner lining. This can lead to life-threatening complications and may be fatal without prompt intervention. Treatments can include surgery or drug therapy.

Most ectopic pregnancies involve an embryo settling in a fallopian tube, but it can also happen in an ovary or the abdominal cavity.

An ectopic pregnancy can be fatal for the pregnant person without prompt intervention. The fallopian tube, for example, may burst, leading to shock and serious blood loss. Swift treatment is crucial. It cannot, however, preserve the embryo.

Around 1–2% of all pregnancies are ectopic. This issue is the cause of 3–4% of pregnancy-related deaths.

In this article, we describe the symptoms, complications, and risk factors for an ectopic pregnancy, as well as the treatment options.

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There may be no early indications that a pregnancy is ectopic.

Learn about the early signs of pregnancy here.

Symptoms of an ectopic pregnancy may develop as early as week 4 and as late as week 12 of the pregnancy, though they are more common in weeks 6–9.

The symptoms may include:

  • Pain in the abdomen: This often occurs in the low pelvis area.
  • Vaginal bleeding: The blood may be lighter or darker than the fluid of a menstrual period. It may also be less viscous.
  • Shoulder pain: This can indicate internal bleeding. The bleeding may irritate the phrenic nerve, which causes the pain.
  • Fainting or collapse: This a medical emergency can result from significant bleeding.

Without swift diagnosis and treatment, ectopic pregnancy can be life threatening for the pregnant person. Treatment cannot save the pregnancy.

Possible complications for the person include:

Internal bleeding: This can lead to shock and serious outcomes. The risk is higher when treatment is delayed.

Damage to fallopian tubes: This can lead to difficulty becoming pregnant in the future. The person’s other fallopian tube may function sufficiently for pregnancy.

After the removal of one damaged fallopian tube, pregnancy remains possible in the future. If both are removed, in-vitro fertilization remains an option for people hoping to become pregnant.

The following factors can lead to a higher risk of ectopic pregnancy:

  • Previous ectopic pregnancy: Anyone who has had an ectopic pregnancy has a higher risk of another.
  • Age: The older a person is, the higher the risk of an ectopic pregnancy.
  • Infection: A history of inflammation and infection of the fallopian tubes, uterus, or ovaries can increase the risk of ectopic pregnancies.
  • Sexually transmitted infections: Some sexually transmitted infections (STIs), such as gonorrhea or chlamydia, increase the risk of developing pelvic inflammatory disease (PID). Having PID can increase the risk of an ectopic pregnancy.
  • Smoking: This may also increase the risk.
  • Damaged or irregularly shaped fallopian tubes: Changes in the structure of a fallopian tube or an irregular structure can make it harder for eggs to travel through them. This may increase the risk of an embryo implanting outside of the womb.
  • Previous surgery: Having a past cesarean delivery or fibroid removal increases the risk of an ectopic pregnancy.

It is possible for a person to have an ectopic pregnancy without any of these risk factors. In fact, up to one-half of all diagnosed ectopic pregnancies occur in people who have no known risk factors.

Diagnosing an ectopic pregnancy can be difficult because the early symptoms can resemble those of other health issues.

First, a healthcare professional assesses the symptoms and tests for pregnancy. They then order a transvaginal ultrasound to confirm the diagnosis. This involves using sound waves to produce images of the uterus and surrounding areas.

If it is too early to detect an ectopic pregnancy, the doctor may order blood tests to monitor the person’s condition. This will continue until the doctor can confirm or rule out the ectopic pregnancy.

The options depend on the progression of the pregnancy and any complications that may have developed.


A surgeon may perform a laparoscopy, a type of keyhole surgery, to remove the ectopic pregnancy. It involves making a small incision in or near the navel and inserting a small camera and a thin tool.

If the ectopic pregnancy causes a fallopian tube rupture, a surgeon will perform emergency surgery to repair the damage. If this is not possible, they will remove the tube.

Drug therapy

When a healthcare professional diagnoses an ectopic pregnancy early, drug-based treatment may be an option.

This may involve methotrexate, a drug that stops the cells of an embryo from rapidly dividing and growing. Adverse effects of methotrexate can include nausea, vomiting, abdominal pain, and possibly mouth sores.

It is not possible to prevent an ectopic pregnancy, and up to one-half of these pregnancies occur in people with no prior risk factors.

However, a person can reduce their risk of PID, which can damage the fallopian tubes and increase the risk of an ectopic pregnancy.

STIs, such as chlamydia and gonorrhea, are a cause of PID. Using barrier methods of protection during sex, such as condoms, can help prevent the transmission of these infections.

Quitting smoking may also reduce the risk of an ectopic pregnancy.

Anyone who has had an ectopic pregnancy has an increased risk of experiencing this again. It is important for someone in this situation to use a reliable form of birth control until they are ready to conceive, particularly if one fallopian tube has been removed.

It is important to let doctors know about past ectopic pregnancies. This can help them detect any future ectopic pregnancy more quickly.

An ectopic pregnancy occurs when an embryo settles in tissue outside of the womb, often in a fallopian tube. Without swift treatment, this can cause life threatening complications for the pregnant person. Treatment cannot preserve the pregnancy, however.

The symptoms of an ectopic pregnancy may begin as early as week 4 and as late as week 12. Diagnosing the issue may involve a combination of pregnancy tests, symptom assessment, and ultrasound imaging.

Receiving an early diagnosis can reduce the likelihood of complications, including fallopian tube damage and internal bleeding. The treatment may involve surgery, but a drug-based treatment may be an option when a doctor detects an ectopic pregnancy early.