What are the symptoms of an ectopic pregnancy?

Written by Yue Hua
Obstetrics and Gynecology
Updated on September 26, 2024
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Ectopic pregnancy initially presents with a lack of menstruation, specifically in women of childbearing age who miss their expected period and then discover they are pregnant. A few days later, they might experience light vaginal bleeding, which is usually scanty and in drips. Additionally, about 95% of affected individuals will feel pain in the lower abdomen, which typically presents as a faint cramping pain before the ectopic pregnancy ruptures. If a rupture occurs, it can lead to very severe, tearing-like intense pain. If the pain leads to internal bleeding, severe cases may result in symptoms of shock.

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Early symptoms of ectopic pregnancy

The early symptoms of an ectopic pregnancy, where the pregnancy test shows implantation outside the uterine cavity, indicate an ectopic pregnancy. Depending on the type of ectopic pregnancy, whether there is a miscarriage at the site where the fertilized egg attaches, or whether there is a rupture, as well as the timing, duration, and volume of bleeding, the clinical manifestations can vary. In early tubal pregnancies, if there is no miscarriage or rupture, there are generally no specific clinical symptoms, meaning there is neither abdominal pain nor vaginal bleeding. However, as the condition progresses, some typical symptoms may appear, beginning with the cessation of menstruation. Then, abdominal pain may occur. If there is no rupture, the pain or soreness is typically localized to one side of the lower abdomen. If a rupture occurs, tearing pain will be followed by lower abdominal pain, abdominal tenderness, and rebound pain, potentially leading to a shock state.

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Does an ectopic pregnancy hurt in the early stages?

Ectopic pregnancy refers to the implantation of the gestational sac outside the uterine cavity, with common implantation sites including the fallopian tubes, ovaries, and pelvic cavity. Early ectopic pregnancy can also cause some pain, with common reasons for the pain including the following: First, the main reason is the enlargement of the uterus under the stimulation of estrogen and progesterone in the body, which pulls on the surrounding tissues and ligaments, such as the round ligament of the uterus, uterosacral ligaments, or bilateral adnexa, causing lower abdominal traction pain. This presents as a feeling of heaviness or menstrual-like sensation. This pain is a normal physiological manifestation during early pregnancy and is present in both intrauterine and ectopic pregnancies. Second, in early ectopic pregnancy, sometimes the gestational sac can cause mild irritation and pressure on local tissues, leading to mild localized pain, which is often not very noticeable.

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How is an ectopic pregnancy treated?

If symptoms of an ectopic pregnancy are confirmed, further examinations are necessary before symptomatic treatment can be administered. Normally, it is essential to first determine the specific status of the ectopic pregnancy, whether there is any rupture, whether the patient's vital signs are stable, and whether there is significant internal bleeding in the abdominal cavity. If the symptoms are not severe and there is no rupture, localized conservative medicinal treatment can be administered. However, if the symptoms are severe, accompanied by hemorrhagic shock or substantial internal bleeding in the abdomen, emergency surgical treatment is required.

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Ectopic pregnancy signs

Normally, if menstruation does not occur at the expected time and there is irregular, light bleeding, the first step is to go to the hospital for an early pregnancy test. If the test shows two lines, this indicates pregnancy. Pregnancy includes intrauterine pregnancy and ectopic pregnancy. In cases of ectopic pregnancy, there is generally also irregular bleeding and abdominal pain. Therefore, if the early pregnancy test is positive with two lines and there is irregular bleeding and abdominal pain, one must be alert for the occurrence of an ectopic pregnancy. At this time, you can go to the hospital for blood tests to check the HCG levels and progesterone, along with an ultrasound to comprehensively determine the situation. If there is no gestational sac within the uterine cavity and an abnormal mass is found outside the uterus, then hospitalization and appropriate treatment for the ectopic pregnancy are needed.

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How to Self-Diagnose an Ectopic Pregnancy

Generally, ectopic pregnancy can be ruled out through one's own symptoms and signs. Firstly, through one's own clinical symptoms, if pregnancy has been confirmed by a urinary pregnancy test and the patient does not experience abdominal pain, abnormal vaginal bleeding, or other such conditions, but does experience significant early pregnancy reactions like nausea and vomiting, the likelihood of an ectopic pregnancy is small. It can generally be judged to be an intrauterine pregnancy. However, self-diagnosis is not very accurate, and ultimately, it depends on an ultrasound to see the intrauterine gestational sac to confirm whether it is an intrauterine pregnancy. Therefore, the most scientific method is to go to the hospital for an ultrasound and have a blood test for HCG. This method is more scientifically accurate. If an ectopic pregnancy is confirmed, surgical treatment must be pursued immediately as it can be life-threatening.