24/08/2026
🚨 ECTOPIC PREGNANCY: WHEN A PREGNANCY DEVELOPS OUTSIDE THE WOMB
The pregnancy test is positive. The woman is excited because she believes she is pregnant.
But there is one important question that must be answered:
Where is the pregnancy located?
An ectopic pregnancy occurs when a fertilised egg implants outside the normal cavity of the uterus. Approximately 90–95% of ectopic pregnancies occur in the fallopian tube, although implantation can occur in other locations.
The image above demonstrates an ectopic pregnancy within a fallopian tube.
🩺 Why is this dangerous?
The fallopian tube is not designed to accommodate a growing pregnancy.
As the pregnancy develops, the tube can become stretched and eventually rupture, resulting in potentially severe internal bleeding into the abdomen.
This is a medical emergency and can be fatal if treatment is delayed.
⚠️ What symptoms should you look out for?
An ectopic pregnancy may initially have very few symptoms. However, a woman in early pregnancy should seek medical attention if she develops:
• Lower abdominal or pelvic pain, particularly pain that is more pronounced on one side
• Vaginal bleeding or spotting
• Shoulder-tip pain, especially when associated with abdominal pain or bleeding
• Dizziness, weakness or fainting
• Sudden, severe abdominal pain
• Collapse
Severe pain, fainting, marked weakness or collapse in a woman who may be pregnant should be treated as an emergency.
🔬 How is ectopic pregnancy diagnosed?
A positive pregnancy test alone cannot tell us where the pregnancy is located.
Assessment may involve:
1. Pregnancy testing and quantitative β-hCG
Serial measurements may be required depending on the clinical situation.
2. Ultrasound examination
A transvaginal ultrasound is particularly useful in determining whether a pregnancy is located within the uterus and in identifying features suggestive of an ectopic pregnancy.
3. Clinical assessment
The woman’s symptoms, examination findings, gestational age and haemodynamic status are extremely important.
💊 How is it treated?
Treatment depends on several factors, including the woman’s clinical condition, ultrasound findings, β-hCG level, presence or absence of fetal cardiac activity, and the location and size of the ectopic pregnancy.
Management may include:
• Expectant management in carefully selected patients
• Medical treatment with methotrexate in appropriately selected cases
• Surgical treatment, particularly when there is rupture, significant internal bleeding, haemodynamic instability or other contraindications to medical management
An ectopic pregnancy cannot develop normally into a viable pregnancy outside the uterine cavity, and it cannot simply be transferred into the uterus.
❤️ A message to every woman
If you have a positive pregnancy test and develop abdominal pain or vaginal bleeding in early pregnancy, please do not ignore it.
Do not assume that every pain or bleeding episode is simply a “normal pregnancy symptom.”
Early assessment can make the difference between a treatable condition and a life-threatening emergency.
If you are experiencing severe abdominal pain, dizziness, fainting or collapse, seek emergency medical care immediately.
👨🏽⚕️ Medical education saves lives. Share this information with someone who may need it.