How to check for an ectopic pregnancy?

Written by Liu Wen Li
Obstetrics
Updated on June 10, 2025
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The examination for an ectopic pregnancy is divided into two steps, the first step is to confirm whether one is pregnant. Then, pregnancy can be detected either by a pregnancy test strip or the most accurate method, which is through a blood test. Once pregnancy is confirmed, the second step involves an ultrasound examination. A blood test only indicates whether or not one is pregnant, but an ultrasound can specifically determine whether it is an intrauterine pregnancy or an ectopic pregnancy. If it is an intrauterine pregnancy, the pregnancy can simply continue. If it is an ectopic pregnancy, surgical or medical treatment is necessary. On an ultrasound, an ectopic pregnancy is indicated by the absence of a gestational sac within the uterine cavity, but a gestational sac or mass is found outside the uterus, which confirms the diagnosis of an ectopic pregnancy.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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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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Written by Su Wen
Obstetrics and Gynecology
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Early symptoms of ectopic pregnancy

Ectopic pregnancy, also known as extrauterine pregnancy, refers to the implantation of the gestational sac outside the uterine cavity. For example, in the fallopian tubes, ovaries, or the cornual region, etc., leading to a series of symptoms known as ectopic pregnancy. Typically, symptoms of an ectopic pregnancy include a history of amenorrhea, where most individuals have a long or short history of missed periods. The second symptom is bleeding, which can be irregular, minor vaginal bleeding or significant bleeding, as well as bleeding within the abdominal cavity, which can lead to hemorrhagic shock in severe cases. Additionally, abdominal pain may occur, manifesting as sudden, tearing-like lower abdominal pain, or irregular referred pain.

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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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How is an ectopic pregnancy caused?

Ectopic pregnancy refers to the implantation of a fertilized egg outside the uterine cavity. A pregnancy located outside the uterine cavity is commonly known as an ectopic pregnancy. The most common type of ectopic pregnancy is a tubal pregnancy, though less common types include abdominal, ovarian, and cervical pregnancies. How does an ectopic pregnancy occur? Inflammation is the most common cause, as it can lead to adhesions in the fallopian tubes or pelvic area, causing abnormal transport in the fallopian tubes. Additionally, ectopic pregnancies can result from scarring after surgeries, such as pregnancies in cesarean section scars, and from anomalies of the uterus, like pregnancies in a remaining part of the uterus.

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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.