Published on:
March 23, 2026
An ectopic pregnancy occurs when a fertilised egg implants itself outside the uterus — most commonly in one of the fallopian tubes. Because the egg cannot develop normally in this location, the pregnancy cannot continue, and without prompt treatment, the consequences can be life-threatening. Understanding what an ectopic pregnancy is, how to recognise it, and what to expect from treatment is essential knowledge for anyone who is pregnant or trying to conceive.
This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. If you are experiencing severe abdominal pain, dizziness, or signs of collapse and there is any possibility you could be pregnant, call 999 or attend your nearest accident and emergency department immediately.
In a healthy pregnancy, a fertilised egg travels from the fallopian tube into the uterus, where it implants into the uterine lining and begins to develop. In an ectopic pregnancy, this journey is interrupted. The egg implants somewhere it should not — most frequently within the fallopian tube itself, which is why ectopic pregnancies are often called tubal pregnancies.
Less commonly, implantation occurs in the ovary, the cervix, or the abdominal cavity. Regardless of location, the pregnancy cannot survive. The uterus is the only organ structurally designed to accommodate a growing pregnancy. If the fallopian tube is the site of implantation, the growing tissue will eventually cause the tube to rupture — a medical emergency that can result in severe internal bleeding.
Ectopic pregnancies account for roughly 1 in 80 to 1 in 100 pregnancies in the UK. While that figure may sound small, it represents a significant number of women each year, and it remains one of the leading causes of pregnancy-related death in the first trimester.
The vast majority of ectopic pregnancies — around 95% — are tubal, meaning the egg implants within a fallopian tube. Of these, most occur in the ampullary section, which is the wider, outer portion of the tube. However, implantation can also occur in the narrower isthmic section of the tube, which tends to rupture earlier and with less warning.
Non-tubal ectopic pregnancies are rare but do occur. An ovarian ectopic pregnancy develops on the ovary rather than inside the tube. An abdominal ectopic pregnancy, rarer still, involves implantation somewhere within the abdominal cavity — occasionally on the bowel or liver. Cervical ectopic pregnancies implant within the cervical canal. Each of these carries its own risks and requires specific management by a specialist.
An ectopic pregnancy happens when the fertilised egg cannot complete its journey to the uterus in time — or when it is misdirected entirely. Anything that damages or disrupts the fallopian tube can raise the likelihood of this occurring.
Previous pelvic inflammatory disease (PID), often caused by sexually transmitted infections such as chlamydia or gonorrhoea, is one of the most significant risk factors. Infection can scar the lining of the fallopian tubes, making it harder for the egg to travel freely. A prior ectopic pregnancy also substantially increases the risk of having another one. Women who have undergone surgery involving the fallopian tubes — whether for a previous ectopic, for fertility treatment, or for other reasons — may have adhesions or structural changes that interfere with egg movement.
Endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus, can affect tubal function and increase ectopic risk. Conception via in vitro fertilisation (IVF) or other assisted reproductive techniques carries a slightly elevated risk, as does becoming pregnant whilst an intrauterine device (IUD) is in place. The Ectopic Pregnancy Trust notes that emergency contraception may be associated with a higher proportion of ectopic pregnancies among cases where contraception has failed, though the overall evidence on whether hormonal emergency contraception independently increases ectopic risk remains uncertain. If you have used emergency contraception and subsequently have a positive pregnancy test, it is important to seek early medical review to confirm the location of the pregnancy.
It is worth noting that ectopic pregnancies can and do occur in women with none of these risk factors. Having no identified risk does not mean you are immune.
Symptoms of an ectopic pregnancy can closely resemble those of a normal early pregnancy — missed period, breast tenderness, nausea, and a positive pregnancy test. This overlap makes early identification particularly difficult and highlights why prompt medical review matters so much.
As the ectopic pregnancy progresses, more specific warning signs tend to emerge. Pelvic or abdominal pain, often one-sided, is one of the most common. Vaginal bleeding that is lighter or different in character to a normal period is another. Some women experience shoulder tip pain, which is caused by internal bleeding irritating the diaphragm — a symptom that should prompt immediate medical attention.
If the fallopian tube ruptures, the pain becomes sudden, severe, and often accompanied by dizziness, fainting, and signs of shock. This is a surgical emergency. If you experience these symptoms and there is any possibility you could be pregnant, call 999 or go to your nearest accident and emergency department without delay. You can also read more about common pregnancy issues that may arise in early pregnancy to better understand what is and is not typical.
Diagnosis typically involves a combination of blood tests and ultrasound imaging. A blood test measuring levels of human chorionic gonadotrophin (hCG) — the hormone produced in pregnancy — can raise suspicion if levels are lower than expected or rising abnormally slowly. Serial hCG measurements taken 48 hours apart give clinicians a clearer picture of how the pregnancy is developing.
A transvaginal ultrasound scan is the most useful imaging tool in early pregnancy. It allows a clinician to look inside the uterus for a gestational sac and to examine the fallopian tubes and surrounding structures for abnormalities. If you are having early pregnancy concerns assessed, a gynaecological scan and consultation can provide detailed imaging alongside specialist review. In some cases, particularly when the scan is inconclusive, a laparoscopy — a keyhole surgical procedure — may be needed to confirm the diagnosis.
There are three main approaches to treating an ectopic pregnancy: expectant management, medical treatment, and surgery. The right choice depends on the size and location of the ectopic, your hCG levels, whether the tube has ruptured, and your overall clinical picture.
Expectant management involves careful monitoring without active intervention. This may be appropriate when the ectopic is very small, hCG levels are low and falling, and there are no signs of rupture. The aim is to allow the pregnancy tissue to resolve on its own. This approach requires close follow-up with repeat blood tests.
Medical treatment uses a drug called methotrexate, which stops the rapidly dividing cells of the ectopic pregnancy from growing. It is given by injection and is most effective when hCG levels are below a certain threshold and the ectopic has not ruptured. Following methotrexate treatment, women are advised to avoid pregnancy for a period of time — typically a minimum of three months — due to the drug's potential to harm a developing foetus. Your doctor will advise you on the appropriate waiting period based on your individual circumstances, including when your hCG levels have returned to normal.
Surgery is required when the tube has ruptured, when the ectopic is large, or when other treatments are unsuitable. A salpingectomy (removal of the affected tube) is the most common surgical approach. In some cases, a salpingotomy (opening the tube to remove the ectopic tissue while preserving the tube) may be considered, particularly if the other tube is damaged and future fertility is a concern; however, this approach carries a risk of persistent trophoblastic tissue and is not always preferred. As noted by UT Southwestern Medical Center, a ruptured tube significantly increases the risk of losing the tube entirely, which underlines why early detection and treatment matter.
Many women go on to have healthy pregnancies after an ectopic pregnancy. If one fallopian tube has been removed, the remaining tube can still function normally, and natural conception remains possible. However, the risk of a further ectopic is higher, so any subsequent pregnancy should be monitored carefully from the outset.
If you are concerned about fertility following an ectopic pregnancy, a specialist can assess your situation and discuss your options. Our page on infertility provides further information on what investigations and support are available. Psychological recovery is also an important part of the process — losing a pregnancy in this way, combined with a potentially frightening medical experience, can take a significant emotional toll, and support should be sought wherever needed.
No. There is currently no medical technique that can safely transfer an ectopic pregnancy into the uterus. The egg cannot survive outside the uterus, and attempting to move it is not possible. Treatment focuses on ending the ectopic pregnancy safely to protect the mother's health.
Not always, particularly in the very early stages. Some women have minimal symptoms until the ectopic grows large enough to cause significant pressure or rupture. This is why any confirmed or suspected pregnancy with unusual symptoms — especially one-sided pelvic pain or shoulder tip pain — warrants urgent medical assessment.
Yes. A standard home pregnancy test will show a positive result because hCG is still produced in an ectopic pregnancy. A positive test does not confirm that the pregnancy is in the right location. If you have a positive test alongside pain or bleeding, seek medical advice promptly.
This depends on your treatment. Following surgery, most doctors advise waiting at least two to three menstrual cycles before trying to conceive. After methotrexate treatment, a longer wait — typically a minimum of three months — is recommended due to the drug's potential effects on a developing foetus, and your doctor will advise when it is safe to try again based on your hCG levels and individual circumstances. Your doctor will give you personalised guidance based on your circumstances.
They are different, though both involve the loss of a pregnancy. A miscarriage occurs when a pregnancy in the uterus ends spontaneously. An ectopic pregnancy is implanted outside the uterus and cannot develop normally regardless of circumstances. The medical management and risks involved are also quite different, with ectopic pregnancy carrying the additional risk of internal haemorrhage.
The information provided in this article is for educational purposes only and is based on NHS recommendations. It is not a substitute for professional medical advice. Always consult your doctor or a qualified healthcare provider for advice on medical conditions or treatments.
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