What is an ectopic pregnancy?

Written by Tang Mei Xiang
Obstetrics and Gynecology
Updated on May 25, 2025
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Ectopic pregnancy used to be commonly referred to as "宫外孕". In fact, it is known as ectopic pregnancy, which means that the fertilized egg implants outside the uterine cavity. A normal pregnancy occurs in the uterine cavity, but if it occurs outside the uterine cavity, it is called ectopic pregnancy. Ectopic pregnancy includes tubal pregnancy, ovarian pregnancy, abdominal pregnancy, broad ligament pregnancy, cervical pregnancy, cornual pregnancy, etc. These are all types of ectopic pregnancies, with tubal pregnancy being the most common clinically.

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ectopic pregnancy symptoms

Ectopic pregnancy is not a normal state of pregnancy. Normally, the gestational sac should be located in the middle of the uterine cavity. An ectopic pregnancy refers to the implantation of the gestational sac outside the uterine cavity. Common types of ectopic pregnancy include tubal pregnancy, ovarian pregnancy, and abdominal pregnancy, with over 99% of ectopic pregnancies being tubal pregnancies. The symptoms of an ectopic pregnancy include the following aspects: 1. In the early stages of an ectopic pregnancy, there are no clinical symptoms because the early gestational sac is relatively small and does not stimulate the fallopian tube or the local area, thus causing no symptoms. 2. When the gestational sac grows to a certain size, it compresses the tube cavity, causing mild abdominal pain. This pain intensifies as the gestational sac grows and can lead to tearing pain, indicating a ruptured tubal pregnancy. 3. During an ectopic pregnancy, because the gestational sac cannot develop normally, the levels of estrogen and progesterone in the body are relatively low, leading to endometrial withdrawal bleeding, which manifests as a small amount of bright red vaginal bleeding.

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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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Causes of ectopic pregnancy

Ectopic pregnancy refers to the implantation of a fertilized egg outside the uterine cavity, among which tubal pregnancy is the most common type, accounting for about 95% of ectopic pregnancies. There are many causes of ectopic pregnancy, with the main cause being inflammation of the fallopian tubes. The inflammation can cause the mucous membrane of the fallopian tube to become sticky, narrowing the lumen of the tube, or impairing the function of the cilia inside the tube, leading to obstruction of the fertilized egg's movement within the tube and resulting in implantation at that location. Other causes include surgery on the fallopian tubes, poor development or abnormal function of the fallopian tubes, further development of assisted reproductive technologies, and the use of emergency contraceptive pills, also known as contraceptive failure, among others. (The use of medications should be under the guidance of a doctor.)

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How long does it take for an ectopic pregnancy to bleed?

Ectopic pregnancy test strips indicate that the gestational sac is implanted outside the uterine cavity, with the most common type being a tubal pregnancy. The bleeding caused by a tubal pregnancy includes two types: vaginal bleeding and intra-abdominal bleeding. Firstly, the vaginal bleeding caused by an ectopic pregnancy mainly occurs because the gestational sac lacks a normal developmental environment, with relatively low levels of estrogen and progesterone. This leads to insufficient endometrial proliferation, resulting in regressive bleeding. Typically, vaginal bleeding appears around the fifth week of an ectopic pregnancy, but the amount of bleeding is generally small. Secondly, if the gestational sac in an ectopic pregnancy is relatively large, it can cause the local rupture of the fallopian tube, leading to intra-abdominal bleeding. This usually occurs around the seventh to eighth week of pregnancy. If the gestational sac is too small, even if there is mild abdominal pain, it will not cause intra-abdominal bleeding.

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What are the early signs of an ectopic pregnancy?

The precursors of an ectopic pregnancy can manifest as unilateral lower abdominal dropping pain, and there may be irregular vaginal bleeding. After 50 days of pregnancy, the gestational sac is not visible in the uterine cavity, and the symptoms of an ectopic pregnancy are atypical. Some people may experience severe bleeding and go into shock. In cases of ectopic pregnancy, it is imperative to go to the hospital for an ultrasound to determine the size and location of the gestational sac and confirm whether it is an ectopic pregnancy. Timely hospitalization and treatment are necessary if an ectopic pregnancy is confirmed.