Ectopic pregnancy

An ectopic pregnancy is when a fertilised egg doesn't implant in your uterus (Opens in new tab) (womb). Instead, the pregnancy grows in the wrong place, usually in one of your fallopian tubes.

Ectopic pregnancy is a type of early pregnancy loss (Opens in new tab). It usually happens 6-8 weeks after your last normal period.

An ectopic pregnancy can happen in:

• your fallopian tubes
• your ovaries (Opens in new tab)
• other parts of your abdomen (tummy)
• your cervix
• a scar from a previous caesarean section (Opens in new tab)

Sadly, there is no way for an ectopic pregnancy to survive. Your pregnancy will end in miscarriage (Opens in new tab) or need to be terminated (Opens in new tab) (aborted).

If your ectopic pregnancy is in one of your fallopian tubes, it can cause the tube to tear or burst. If this happens, it can cause serious internal bleeding.

An ectopic pregnancy can be life-threatening if it causes heavy bleeding.

Ectopic pregnancies can cause the following signs and symptoms:

• vaginal bleeding (Opens in new tab) or spotting
• abdominal (tummy) pain
• back pain
• shoulder tip pain
• nausea and vomiting (feeling and being sick)
• a fast heart rate
• dizziness or faintness

These symptoms usually occur between week 4 (Opens in new tab) and week 12 of pregnancy.

If you have any of these symptoms while pregnant, go to the nearest emergency department or call triple zero (000) for an ambulance.

About 1 in every 100 pregnancies is an ectopic pregnancy.

Many women who have ectopic pregnancies don't have any risk factors. But there are some things that can increase your chance of an ectopic pregnancy, including:

• some fertility treatments (Opens in new tab), such as in vitro fertilisation (IVF) (Opens in new tab)
• past sexually transmitted infections (Opens in new tab) (STIs)
• damaged fallopian tubes
• previous abdominal surgery (such as a caesarean section or surgery for ovarian cysts (Opens in new tab))
• previous tubal sterilisation surgery (Opens in new tab)
• becoming pregnant while using an intrauterine device (Opens in new tab) (IUD) or a progestogen-only pill (Opens in new tab)
• being 35 years of age or older

Smoking (Opens in new tab) can also increase your chances of having an ectopic pregnancy.

If you have any of the symptoms of an ectopic pregnancy, see your doctor as soon as possible.

Your doctor will ask about your symptoms and examine (Opens in new tab) you. They will ask whether you are (or could be) pregnant.

Your doctor may recommend tests, including a:

• blood test for pregnancy hormone levels (hCG level (Opens in new tab))
• pregnancy ultrasound, which may involve a vaginal ultrasound (Opens in new tab)

Your doctor will recommend treatment depending on your situation. They may suggest to watch and wait, using medicine, or a surgical treatment.

You will need to have follow-up tests after your treatment to make sure that the pregnancy has fully ended.

Watch and wait

If it seems as though your ectopic pregnancy is miscarrying, your doctor may suggest waiting to see what happens.

Your doctor will only advise this if:

• you are well or have little pain
• the ectopic pregnancy is small and has not ruptured
• your pregnancy hormone (hCG) level is low and going down

You should go to the nearest emergency department or call triple zero (000) for an ambulance if you get symptoms such as:

• abdominal pain
• pain in your shoulder tip
• heavy vaginal bleeding
• dizziness or fainting

Medicine

Medicine to stop the pregnancy growing may be used if:

• your ectopic pregnancy is very small
• there is no sign of internal bleeding

The medicine is called methotrexate. It is given as an injection and takes time to work.

This medicine is not suitable for everyone. Some women may need another injection or surgery to remove the ectopic pregnancy.

Surgery

Surgery (Opens in new tab) may be needed to remove the ectopic pregnancy. Surgery is usually needed if you are bleeding internally or are at risk of bleeding. Surgery may also be needed if medication is not a suitable option.

Surgery for an ectopic pregnancy is usually done as keyhole surgery (Opens in new tab).

In some cases, your doctor may need to do open surgery or remove your fallopian tube. If this happens, you will need longer to recover.

Everyone is different when it comes to recovery and it depends on the treatment you received. Give yourself time to heal.

Physical recovery

The treatment you receive may affect your return to day-to-day activities:

• Exercise —you can start with gentle exercise 2 weeks after keyhole surgery and 6 weeks after open surgery.
• Driving — you may be advised not to drive for the first week after surgery. It's a good idea to start with small trips and build up.
• Return to work — you should be able to return to work within 6 weeks after surgery. This depends how you heal.
• Alcohol — you should not drink alcohol while recovering from surgery. If you were given methotrexate, don't drink alcohol for at least 3 months.

Emotional recovery

Ectopic pregnancy is a kind of early pregnancy loss (Opens in new tab). There is no 'right way' to feel about a pregnancy loss. It is normal to feel grief. Counselling (Opens in new tab) services are available to support you.

Speak to your doctor if you feel you need support. You are entitled to Medicare (Opens in new tab)-funded counselling with a psychologist if you suffer a pregnancy loss. Your doctor can help arrange this for you.

There are also community support groups — see below.

To find a psychologist near you, use the Healthdirect Service Finder (Opens in new tab) tool.

Ectopic pregnancy and its causes may impact your future fertility.

Talk to your doctor about your situation and whether your fertility is likely to have been affected.

What is my chance of having another ectopic pregnancy?

If you've had an ectopic pregnancy, you have a higher chance of having another one.

This could be because the underlying cause may still be there. Also, the ectopic pregnancy may have damaged or scarred your fallopian tube.

Talk to your doctor or healthcare team about when it is safe to have sex again and about your contraception (Opens in new tab) (birth control) options.

Before getting pregnant again, it's advised you wait:

• 2 months after surgery
• 3 to 4 months after taking methotrexate

Methotrexate takes a long time to fully leave your body and could be harmful to your next baby.

If you find out you are pregnant again, tell your doctor as early as possible. Your doctor will likely advise you have an early pregnancy ultrasound. This is to make sure that the pregnancy is in your uterus.

Sexual Health Victoria (Opens in new tab) has information and resources about what to expect with an ectopic pregnancy (Opens in new tab).

Women's & Newborn Health at Westmead Hospital (Opens in new tab) has a detailed resource about the treatment options available for an ectopic pregnancy (Opens in new tab).

Support and counselling services

You can talk to your doctor or midwife about where to get support. Your hospital may have a social worker (Opens in new tab) you can talk to.

Red Nose Grief and Loss (Opens in new tab) provides support for people affected by pregnancy loss, stillbirth, baby or child death. You can call them on 1300 308 307 – 24 hours a day, 7 days a week.

The Pink Elephants Support Network (Opens in new tab) provides information and support for people who have had a miscarriage.

Bears of hope (Opens in new tab) is a free online and in person support group for people experiencing pregnancy loss.

Grief Australia (Opens in new tab) provides support and counselling for people grieving any type of loss.

Griefline (Opens in new tab) has online support and resources to help you manage with grief and loss.

If you have experienced a miscarriage or pregnancy loss, there are many support services available to help you, your partner and your family. Find a service that is right for you (Opens in new tab).