Ectopic pregnancy starts to cause abdominal pain at how many weeks?

Written by Zhang Lu
Obstetrics
Updated on March 15, 2025
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Ectopic pregnancy refers to the implantation of the gestational sac outside the uterus, with over 95% of ectopic pregnancies being tubal pregnancies. Symptoms of ectopic pregnancy include lower abdominal pain, vaginal spotting, and shock. In many cases, there are no obvious clinical symptoms in the early stages of an ectopic pregnancy. This is because the gestational sac is relatively small, causing less irritation locally and not leading to significant abdominal pain. However, if the ectopic pregnancy grows significantly, it can irritate the fallopian tube and also stimulate the peritoneum, causing abdominal pain. Around five weeks, significant pain can be felt, but as the pregnancy progresses, this pain can increase in severity and may lead to rupture of the tubal pregnancy, causing hemorrhagic shock, which then necessitates emergency medical intervention.

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Written by Tang Mei Xiang
Obstetrics and Gynecology
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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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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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Ectopic pregnancy medical conservative treatment

Under normal circumstances, the treatment of ectopic pregnancy is generally divided into conservative treatment and surgical treatment. Conservative treatment is usually applied when the ectopic pregnancy has not ruptured, using medication for about a week. After one week, a follow-up examination is done to check blood HCG levels and an ultrasound scan. If blood HCG levels have dropped significantly, the ultrasound shows that the mass has not grown, and the symptoms of abdominal pain have decreased, it indicates that the conservative treatment was successful. The threat is only considered resolved when blood HCG returns to normal levels. Otherwise, the conservative treatment for ectopic pregnancy may fail, and surgery will be necessary to treat the ectopic pregnancy symptomatically. If there is a particularly large amount of bleeding or a rupture has occurred, surgical treatment is the only option.

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Written by Tang Mei Xiang
Obstetrics and Gynecology
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What are the symptoms of an ectopic pregnancy?

Ectopic pregnancy refers to the implantation of the fertilized egg outside the uterine cavity. Because it is not in the environment of the uterus, ectopic pregnancies often end in miscarriage or rupture. The symptoms of an ectopic pregnancy mainly depend on the location of the implantation of the fertilized egg, whether a miscarriage or rupture has occurred, the amount of bleeding, the duration of the bleeding, and whether there is a rupture or miscarriage in a tubal pregnancy. Generally, there are often no specific clinical manifestations in the early stages. If it reaches the middle to late stages, there might be symptoms such as abdominal pain and vaginal bleeding. If a tubal pregnancy ruptures, the abdominal pain follows a series of tearing pains, then progresses to generalized abdominal tenderness and rebound pain.

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Written by Yue Hua
Obstetrics and Gynecology
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ectopic pregnancy early symptoms

First, there will be a cessation of menstruation, followed by a brief period of amenorrhea, and then irregular vaginal bleeding will occur. This vaginal bleeding is usually light and droplet-like, and the color is dark red. Additionally, most women will experience pain on one side of the lower abdomen, which manifests as a distension pain. At this time, because the ectopic pregnancy in the fallopian tube has not ruptured, the enlarging embryo causes the fallopian tube to expand, leading to spasms of the tube, and thus these symptoms occur. If the condition continues to progress, the fallopian tube may rupture, resulting in acute and severe pain on one side of the lower abdomen.

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Written by Tang Mei Xiang
Obstetrics and Gynecology
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Can you have intercourse with an ectopic pregnancy?

Ectopic pregnancy and sexual intercourse often occur when the patient is unaware, specifically during the early stages when there is no bleeding, no abdominal pain, and only amenorrhea is present; intercourse might occur under these circumstances. However, if there is irregular vaginal bleeding or abdominal pain, suspecting an ectopic pregnancy, it is advised not to have intercourse. This is because intercourse can cause excitement, which might lead some ectopic pregnancy masses to rupture, potentially causing severe bleeding.