Ectopic pregnancy abdominal pain symptoms

Written by Liu Wei Jie
Obstetrics
Updated on March 16, 2025
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Let's first discuss what an ectopic pregnancy is. An ectopic pregnancy occurs when the fertilized egg implants outside of the uterus, such as in any part of the fallopian tubes, the corners of the uterus, or the abdominal cavity. Due to the different implantation sites, the symptoms of abdominal pain vary. A very small number of people feel no symptoms at all, experiencing only vaginal bleeding. Additionally, some people may feel severe discomfort in the abdomen. The last type involves severe, intense abdominal pain, resembling a tearing sensation, accompanied by nausea, vomiting, and hypotension shock.

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Ectopic pregnancy characteristics

Lower unilateral abdominal pain, irregular vaginal bleeding, and even after 50 days of pregnancy, the ultrasound still does not show the gestational sac implanted in the uterine cavity. An ultrasound can be used to understand the size and location of the gestational sac. The symptoms of an ectopic pregnancy are often atypical. Some patients may experience shock due to heavy bleeding, with pale complexion and a drop in blood pressure. It is important to hospitalize timely for the treatment of ectopic pregnancy to prevent life-threatening severe bleeding. In cases of ectopic pregnancy, blood hCG levels may not increase.

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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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What should I do about an ectopic pregnancy?

Ectopic pregnancy, as the name suggests, refers to the implantation of the gestational sac outside the uterine cavity, with the more common types including tubal pregnancy, ovarian pregnancy, and abdominal pregnancy. Ectopic pregnancy is mainly diagnosed through ultrasound and blood tests. If an ectopic pregnancy is confirmed or highly suspected, treatment should begin, primarily choosing between conservative medication treatment or surgical treatment based on the severity of the condition. 1. If the condition is mild, with HCG levels less than 1000 U/L and the mass volume smaller than 3 cm, conservative medication treatment can be chosen. 2. If the condition is severe, with a larger mass volume and significantly elevated HCG levels, surgical treatment is recommended. Currently, with the advancement of minimally invasive surgery, the majority of ectopic pregnancies can be treated using laparoscopy.

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Can an ectopic pregnancy cause a fever?

Ectopic pregnancy generally does not cause fever symptoms unless there is an infection. The typical signs of an ectopic pregnancy include a history of missed menstruation, minor vaginal bleeding, and abdominal pain. When the ectopic pregnancy in the fallopian tube has not ruptured, the pain is characterized by swelling pain in the lower abdomen. If the fallopian tube pregnancy ruptures, there will be tearing pain, followed by tenderness in the lower abdomen, rebound pain, and abdominal muscle tension, and then fainting and shock can occur. During a gynecological examination, it is possible to feel a mass in the abdomen. Ectopic pregnancies generally require surgical treatment. After surgery, there might be a temporary fever known as "absorption fever," but this type of fever is short-lived and the body temperature does not exceed 38 degrees Celsius. This is a normal physiological reaction after surgery and is not considered a pathological fever.

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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.