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ALL about Symptoms of Ectopic Pregnancy

I know when you think about symptoms of ectopic pregnancy as a woman you may be either apprehensive or scared.

African lady reading a paper and sipping a drink, ectopic pregnancy can happen in a woman of child bearing age.
Abnormal Pregnancy Symptoms may be a very early clue


How can you tell if it's an ectopic? When should you worry? When do ectopic pregnancy symptoms start?

Well, let's have a look at just what ectopic pregnancy symptoms are in this article.


Meaning of Ectopic Pregnancy

Ectopic pregnancy means a 'misplaced' pregnancy.

In other words, if you get pregnant and the pregnancy is located outside the womb, this is an ectopic pregnancy.

But why should you worry about it and when do symptoms of the condition begin?

This is because if not detected early, it could cause loss or damage to your reproductive organ like the fallopian tube.

Or it could contribute to problems having children in future.

In severe cases, it could cause death.

In this article, we talk more about how it can happen.

Any woman of reproductive age can have an ectopic pregnancy though it is more common in women aged 29 years and older.

In lower and middle-income countries like Nigeria, about 1-3% of pregnancies are located outside the womb.

This is according to a study from Southern Nigeria looking at cases of ectopic pregnancy seen in a teaching hospital over a five-year period.


List of Ectopic Pregnancy Symptoms

In some cases, there are no symptoms.

But after it has grown to an extent, it will cause certain symptoms such as:

  • a sudden sharp low abdominal pain to one side - but it may also start as mild pain and get worse from day to day.

  • You may have a feeling of dizziness, fainting or being lightheaded.

  • Bleeding from the vagina, or a brown discharge may happen. It may be light or quite heavy.

  • Pain in your lower abdomen when going to the toilet for a poo or to wee.

  • Pain to your shoulder tip; usually on the side where the ectopic pregnancy is growing.
    • This suggests internal bleeding: blood leaking into the abdomen and irritating the muscle (diaphragm) at the top.


Graphic on Ectopic Pregnancy Symptoms
1-3% of Pregnancies in Nigeria are Ectopic

...And what causes them?

When the pregnancy is located in the womb, it continues to grow and increase in size, supported by hormones and blood from the womb.

However, if the pregnancy is growing in your tube, it does not get this support.

Your womb is very muscular and has lots of blood supply. Your tubes do not.

So as the pregnancy grows in your tube, it puts pressure on the tube.

This causes the pain you may experience.

The pressure also causes pain when you go to wee or open your bowels.

The abnormal location of the pregnancy can also cause abnormal vaginal bleeding or discharge which could be a clue that something is not right.


So, are Ectopic pregnancy symptoms the same as a Normal pregnancy?

The ectopic pregnancy means you may continue to have pregnancy symptoms like feeling sick or breast pain - but for a short period.

Early pregnancy symptoms like these happen because of the hormones produced by the ovaries and placenta.

This is interrupted by the fact the pregnancy is located outside the womb.

As it grows, it will eventually burst your tube causing bleeding.

The bleeding may be within your abdomen and may pass through the vagina.

If it is very heavy bleeding, it could may you feel light-headed or dizzy.

In severe cases, it could cause collapse, a medical emergency.

If not immediately treated, this could cause death. In all cases, a pregnancy outside the womb cannot survive.


What are Tubal Pregnancy Symptoms?

Tubal Pregnancy means an ectopic pregnancy inside your (fallopian) tube.

It is the most common location for a pregnancy outside the womb.

The symptoms are similar to what would happen in pregnancy located anywhere else outside the womb.


Some of the risks of ectopic pregnancy
Some factors that make women at risk of Ectopic Pregnancy

More Reading - Pregnancy and Your Heart - Risks you should know

Can Ectopic Pregnancy have NO symptoms?

This might seem like a strange question. But actually it is quite important.

Because yes, it is possible to have a pregnancy located outside the womb and show no symptoms.

This could be during the period when the embryo is still very small.

So it is not yet able to cause you to have pressure symptoms that could lead to pain or burst the tube.

This is why a lot of cases are diagnosed with an ultrasound scan.

By doing so, it is possible to see the empty womb and the pregnancy located in an abnormal location.


When do Ectopic Pregnancy Symptoms begin?

So this brings us to when you can expect symptoms to show if the embryo is growing outside the womb.

If you have a regular period, by the time it is 2 weeks after your missed period, you are already about 6 weeks pregnant.

This is the stage at which many women may begin to experience abnormal symptoms.

However, some women may experience symptoms later; while others may do so earlier.

Therefore, you should know that these symptoms may occur from about 4 weeks to 12 weeks of pregnancy.

For a woman, it is important to know when abnormal symptoms may start in order to seek medical advice early on.


Women at Risk

The chance of an ectopic pregnancy is greater in any of the following instances:

  • A woman who has had a PID (Pelvic Inflammatory Disease) - this is a womb infection that develops most often following a sexually transmitted infection.
  • Being of an older age at pregnancy - from age 35-40 years.
  • Smoking.
  • Having an ectopic pregnancy before makes you more likely to have one again.
    • The risk increases if you have had two previous ectopic pregnancies.
  • Women who are undergoing IVF - This happens from taking drugs which stimulates the release of the eggs from the ovary.
  • Having had surgery to the fallopian tube before - such as after sterilisation.
  • Falling pregnant while using a 'coil' - Copper coil (IntraUterine Device) or IUS (Intrauterine System like Mirena or Jadelle).
    • These are very effective at preventing pregnancy - but on the RARE occasion you fall pregnant while using the coil, you may be at an increased risk of having an ectopic pregnancy.
  • If you have a condition like endometriosis that causes inflammation of the womb or surrounding areas.
    • The inflammation increases the risk of scars forming, and makes it likely for an ectopic pregnancy to happen.


Conclusion

Early diagnosis and treatment of ectopic pregnancy increases the chance of saving the fallopian tube, and reducing any complications to your fertility.

If it is not treated, there is a risk of a lot more serious illness or death.

This is why it is important to learn all about the symptoms and when they may happen.

Read here to know more about how ectopic pregnancy is treated and diagnosed.


References

Odunvbun WO. Ectopic pregnancy: A 5-year review of cases in a secondary health facility in Delta State, Nigeria. Port Harcourt Med J 2019;13:53-7

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