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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessment online. A doctor can judge how urgent your symptoms are; diagnosis and treatment need a scan and blood tests in hospital.
- What it is: a pregnancy that implants outside the womb, usually in a fallopian tube. It cannot continue, and it cannot be moved into the womb.
- How common: about 1 in 90 pregnancies in the UK, around 11,000 a year. Symptoms usually start between weeks 4 and 12.
- Typical signs: pain low down on one side, bleeding or a brown watery discharge, shoulder tip pain, and discomfort when peeing or pooing.
- Emergency: call 112 for sudden, severe tummy pain, fainting or feeling very dizzy, or looking very pale: the tube may have ruptured.
Do not book a video appointment if you have sudden, sharp, severe tummy pain, you feel very dizzy or faint, you look very pale, or you have shoulder tip pain and feel unwell: call 112. If you might be pregnant and have pain on one side or bleeding, get checked promptly, even if you have not had a positive test.
Can an online doctor help with a suspected ectopic pregnancy?
With the first assessment, yes. An ectopic pregnancy is diagnosed with a transvaginal scan and blood tests for the pregnancy hormone hCG, and it is treated in hospital, so it cannot be confirmed or managed over video. A doctor by video can go through your symptoms and dates, recognise the pattern that needs a scan, tell you how urgently and where to go, and support you after treatment and in your next pregnancy. Severe pain, fainting or collapse is an emergency.
How an online consultation helps with a suspected ectopic pregnancy
- Urgency judged: Which symptoms mean 112, and which mean an early pregnancy unit within hours rather than days.
- The right service: An early pregnancy unit, a gynaecology emergency service or an emergency department.
- Support after treatment: What to expect after medicine or surgery, and why the follow-up blood tests matter.
- Your next pregnancy: When to try again, contraception in the meantime, and an early scan next time.
What the doctor checks in an online assessment for a suspected ectopic pregnancy
The doctor puts your symptoms together with your dates, because an ectopic pregnancy usually shows itself between weeks 4 and 12. The doctor asks about:
- Warning signs: sudden severe pain, fainting, dizziness, looking pale, or pain in the tip of the shoulder.
- Your dates: the first day of your last period, whether that period was normal, and when you had a positive test.
- The pain: where it is, whether it is on one side, how it started, and whether it is getting worse.
- Bleeding: how much, what colour, and whether it starts and stops or looks watery and dark brown.
- Toilet symptoms: pain when peeing, pain or pressure in your bottom when pooing, or diarrhoea.
- Risk factors: a previous ectopic pregnancy, surgery on the fallopian tubes, a pelvic infection, fertility treatment, or a pregnancy with a coil in place.
Before the call, note the date of your last period and of any positive test, and how your symptoms have changed.
What is an ectopic pregnancy?
An ectopic pregnancy is a pregnancy that implants outside the womb, most often in one of the fallopian tubes. It cannot develop into a baby, it cannot be moved into the womb, and it needs monitoring, medicine or surgery.
About 95% of ectopic pregnancies are in a fallopian tube. Around 3% are interstitial, where the tube passes into the wall of the womb, and less than 1% each implant in a caesarean section scar, the cervix, an ovary or the abdomen. Very rarely, a pregnancy in the womb and an ectopic pregnancy happen at the same time, called a heterotopic pregnancy.
How common is ectopic pregnancy?
About 1 in 90 pregnancies in the UK is ectopic, around 11,000 a year. The Ectopic Pregnancy Trust puts it at about 1 in 80, with nearly 12,000 diagnosed each year in the 2024 MBRRACE-UK report. A rupture is uncommon and treatable when it is dealt with quickly, and deaths are rare, but ectopic pregnancy remains the most frequent cause of maternal death in early pregnancy. That is why its warning signs matter.
Is an ectopic pregnancy a miscarriage?
No, although both are the loss of an early pregnancy. A miscarriage is the loss of a pregnancy in the womb, while an ectopic pregnancy grows in the wrong place and has to be treated. The grief after either can be just as real. See miscarriage.
What are the symptoms of an ectopic pregnancy?
Pain low down on one side of the tummy, vaginal bleeding or a brown watery discharge, pain in the tip of the shoulder, and discomfort when peeing or pooing, with a missed period or a positive test. Some ectopic pregnancies cause no symptoms and are found on a routine scan.
Symptoms often come in combination, and each one can have another cause, such as a stomach bug, trapped wind or a urine infection. That is why the combination, together with your dates, decides how quickly you need a scan.
When do ectopic pregnancy symptoms start?
Usually between the 4th and 12th week of pregnancy. Many women first notice symptoms around week 6, about 2 weeks after a missed period, and most ectopic pregnancies are suspected between weeks 6 and 10.
What does ectopic pregnancy pain feel like?
It is typically low down on one side. It can develop suddenly or gradually, and it may be persistent or come and go. Pain in the tip of the shoulder, felt where the shoulder ends and the arm begins, can mean internal bleeding and needs medical advice straight away. Sharp, sudden, intense pain with dizziness or fainting can mean the tube has ruptured, which needs emergency surgery.
What does the bleeding look like?
It tends to be different from a normal period: it often starts and stops, and it may be watery and dark brown. Light bleeding in early pregnancy has many causes, including implantation bleeding, but with one-sided pain it needs checking. See also bleeding in pregnancy.
Does an ectopic pregnancy show on a pregnancy test?
Yes. An ectopic pregnancy produces the pregnancy hormone hCG, so a home pregnancy test is usually positive. A positive test cannot show where the pregnancy is: only a scan and blood tests can.
If a urine pregnancy test is negative, symptoms are very unlikely to be caused by an ectopic pregnancy. If you have the symptoms and might be pregnant, get advice even before you have done a test.
What causes an ectopic pregnancy?
Often there is no clear cause. Damage, narrowing or blockage of a fallopian tube can stop the fertilised egg moving along to the womb. The risk is higher with:
- pelvic inflammatory disease, usually caused by a sexually transmitted infection such as chlamydia
- a previous ectopic pregnancy
- previous surgery on the fallopian tubes, including a sterilisation that did not work
- fertility treatment, such as IVF, including medicine to stimulate ovulation
- becoming pregnant with a coil (IUD or IUS) in place, which is rare but more likely to be ectopic
- smoking
- increasing age, with the highest risk over 35
Using condoms when you are not trying for a baby lowers the risk of the infections that can damage the tubes, and stopping smoking lowers the risk too.
How is an ectopic pregnancy diagnosed?
At an early pregnancy unit or a hospital gynaecology service, the diagnosis is made with:
- A transvaginal ultrasound scan, more accurate than a scan through the tummy; a repeat scan after a few days is sometimes needed.
- hCG blood tests, usually repeated 48 hours apart. In a pregnancy in the womb, hCG rises by about 63% over 48 hours; in an ectopic pregnancy it is usually lower, and it rises more slowly or stays flat.
- Keyhole surgery (laparoscopy), occasionally, when the diagnosis is still unclear.
What is a pregnancy of unknown location?
A positive pregnancy test with no pregnancy seen on the scan. It can be a very early pregnancy in the womb, a miscarriage or an ectopic pregnancy, so repeat hCG blood tests decide what happens next. It can take a week or more before the answer is clear.
How is an ectopic pregnancy treated?
With one of three options: careful monitoring while the pregnancy dissolves by itself, an injection of methotrexate to stop it growing, or keyhole surgery to remove it, usually with the affected tube. The choice depends on your symptoms, the scan and your hCG level.
Swipe sideways to compare →
| Treatment | When it is usually offered | What it involves |
|---|---|---|
| Expectant management | Stable and pain free, an ectopic smaller than 35 mm with no heartbeat, hCG of 1,000 IU/L or less, and able to come back for tests | Repeat hCG blood tests until the hormone is gone; treatment if it stays the same or rises |
| Methotrexate injection | No significant pain, no rupture, an ectopic smaller than 35 mm with no heartbeat, and hCG below 1,500 IU/L | A single injection, no hospital stay; follow-up blood tests, a second dose in about 15 in 100, and surgery later in about 7 in 100 |
| Surgery | Significant pain, an ectopic of 35 mm or larger, a visible heartbeat, hCG of 5,000 IU/L or more, or not able to come back for follow-up | Keyhole surgery under general anaesthetic, usually removing the affected tube; full recovery in 4 to 6 weeks |
Can an ectopic pregnancy be saved or moved into the womb?
No. It is not possible to move an ectopic pregnancy into the lining of the womb, and it cannot continue. Treatment protects your health and future fertility.
After methotrexate
Tummy pain, usually mild and passing within a day or two, feeling or being sick, dizziness and diarrhoea are common. Use reliable contraception for at least 3 months, because methotrexate can harm a baby, and avoid alcohol until you are told it is safe. Keep every follow-up blood test until hCG is back to normal.
Surgery and anti-D
If the other tube looks healthy, the affected tube is usually removed, which is the most effective treatment and is not thought to reduce the chance of a future pregnancy. If the other tube is missing or unhealthy, the surgeon may remove the pregnancy and keep the tube. If you are RhD negative, you may be offered an anti-D injection after treatment, to protect future pregnancies.
Recovery and trying again after an ectopic pregnancy
Most women leave hospital within a few days of surgery, and full recovery can take 4 to 6 weeks. Grief after the loss of a pregnancy is common and can last several months; it usually eases over time, and counselling helps many people. Partners can be affected too.
- When to try again: wait at least until you have had 2 periods after treatment, and at least 3 months after methotrexate.
- Fertility: most women can conceive again, even with one tube; some need fertility treatment such as IVF.
- Another ectopic pregnancy: the risk is about 7 to 10 in 100, higher than in a first pregnancy but still small.
- Next time: tell a doctor as soon as you know you are pregnant, so an early scan at 6 to 8 weeks can check where the pregnancy is.
- Contraception: if you do not want to be pregnant yet, ask which method suits you after treatment.
What might the doctor recommend for a suspected ectopic pregnancy?
What happens next depends on your symptoms, your dates and how you are feeling. This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Sudden severe pain, fainting, dizziness or looking very pale | Emergency surgery may be needed | No | Call 112 now |
| Shoulder tip pain with a positive test | Urgent assessment for internal bleeding | No | Emergency department or early pregnancy unit now |
| One-sided pain or bleeding with a positive test | A scan and hCG blood tests | Yes, to assess urgency | Early pregnancy unit promptly |
| Light spotting without pain around the time of a period | Going through your dates and symptoms | Yes | A scan if pain or more bleeding starts |
| After treatment for an ectopic pregnancy | Recovery, contraception and planning the next pregnancy | Yes | Follow-up blood tests at the hospital |
Mild pain or spotting in early pregnancy? A doctor can go through your symptoms and tell you how urgently to be seen in one consultation.
See available times →Special situations
Pregnant with a coil in place
Pregnancy with a coil in place is rare, but when it happens it is more likely to be ectopic, so a positive test with a coil needs prompt medical advice.
After IVF or fertility treatment
Fertility treatment raises the risk. Report pain or bleeding to your fertility clinic or an early pregnancy unit promptly, without waiting for a scheduled scan.
A previous ectopic pregnancy
Tell a doctor as soon as your test is positive, so an early scan can be arranged.
Waiting for a diagnosis
While a pregnancy of unknown location is being monitored, keep every blood test appointment and know the emergency signs: sudden severe pain, shoulder tip pain, dizziness or fainting mean 112.
When ectopic pregnancy is assessed online, and when you need in-person care
Assessed online: mild symptoms in early pregnancy, judging how urgently you need a scan and where, questions while you wait for results, recovery after treatment, contraception and planning the next pregnancy.
In-person care: the scan and hCG blood tests, every treatment, severe or worsening pain, shoulder tip pain, and any sign of a rupture.
When to get in-person care
Call 112 now for:
- sudden, sharp and intense pain in your tummy
- feeling very dizzy, fainting or collapsing
- looking very pale, or feeling sick with severe pain
- shoulder tip pain with feeling faint or unwell
Get medical advice the same day for:
- pain low down on one side when you might be pregnant
- bleeding or a dark brown watery discharge in early pregnancy
- pain when peeing or pooing, or diarrhoea, with a positive test and tummy pain
- new pain or bleeding after treatment for an ectopic pregnancy
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your symptoms: say the date of your last period, when your test was positive, and where the pain is.
- Leave with a plan: how urgently to be seen and where, what the tests will show, and which signs mean 112. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
If you have any warning sign listed on this page, call 112 now. Otherwise, tick every symptom you have to see each page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Miscarriage can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about ectopic pregnancy
What is an ectopic pregnancy?
A pregnancy that implants outside the womb, usually in a fallopian tube. It cannot continue or be moved into the womb, and it needs monitoring, medicine or surgery.
When do ectopic pregnancy symptoms start?
Ectopic pregnancy symptoms usually start between weeks 4 and 12 of pregnancy, most often around week 6, about 2 weeks after a missed period, with pain low down on one side, bleeding or a brown watery discharge; some women have no symptoms and the ectopic pregnancy is found on an early scan. A positive test with one-sided pain, shoulder tip pain or feeling faint needs urgent assessment at any stage.
What does ectopic pregnancy pain feel like?
Ectopic pregnancy pain is typically low down on one side, sudden or gradual, constant or coming and going. Shoulder tip pain can mean internal bleeding, and sudden intense pain with dizziness or fainting is an emergency.
Does an ectopic pregnancy show on a pregnancy test?
Yes, a home pregnancy test is usually positive in an ectopic pregnancy, because the pregnancy produces hCG wherever it has implanted, though the line can be fainter than expected. A test cannot show where the pregnancy is: only an ultrasound scan, usually through the vagina, together with blood tests tracking the hCG level, can tell an ectopic pregnancy from one in the womb.
Can an ectopic pregnancy be saved?
No. An ectopic pregnancy cannot be moved into the womb and cannot continue, because the fallopian tube cannot stretch or supply the pregnancy as it grows, and leaving it risks the tube rupturing and heavy internal bleeding. Treatment protects your health and your future fertility, and most women go on to have a healthy pregnancy afterwards.
Is an ectopic pregnancy a miscarriage?
No. Both are early pregnancy losses, but a miscarriage happens in the womb and usually completes by itself, while an ectopic pregnancy grows outside the womb, most often in a fallopian tube, and needs monitoring, medicine or surgery because it can cause dangerous internal bleeding. Grief after an ectopic pregnancy is just as real, and the same support applies.
What causes an ectopic pregnancy?
Often there is no clear cause. The risk is higher after pelvic infection, a previous ectopic pregnancy, tubal surgery, fertility treatment, pregnancy with a coil, smoking and with increasing age.
Can an ectopic pregnancy be prevented?
Not reliably, because an ectopic pregnancy often has no clear cause, but the risk can be lowered: use condoms with new partners and get tested for chlamydia, since pelvic inflammatory disease is the main avoidable cause; stop smoking, which damages the tubes; and tell your doctor about a previous ectopic pregnancy, tube surgery or fertility treatment so that an early scan at 6 to 7 weeks can check where the next pregnancy is.
How common is ectopic pregnancy?
Ectopic pregnancy affects about 1 in 90 pregnancies in the UK, around 11,000 a year, and the Ectopic Pregnancy Trust puts it at about 1 in 80. It is more common after pelvic inflammatory disease, a previous ectopic pregnancy, tube surgery, fertility treatment, or conceiving with a coil in place, but about a third of women have no known risk factor at all.
How is an ectopic pregnancy treated?
An ectopic pregnancy is treated by monitoring while it dissolves, a methotrexate injection, or keyhole surgery, usually removing the affected tube. The choice depends on your symptoms, the scan and your hCG level.
Can I get pregnant after an ectopic pregnancy?
Most women can, even with one tube. Wait for 2 periods, or 3 months after methotrexate, and ask for an early scan next time. The risk of another ectopic pregnancy is about 7 to 10 in 100.
How do I look after myself after an ectopic pregnancy?
Rest, take the painkillers you are given, and expect bleeding like a period for a week or two; after keyhole surgery avoid heavy lifting and driving until you can brake comfortably, and after methotrexate avoid alcohol, folic acid supplements and sex until the hCG blood tests reach zero, which can take several weeks. Use contraception for as long as the hospital advises, usually 3 months after methotrexate, and ask for support, because the loss and the shock of an ectopic pregnancy affect many women.
Is it an ectopic pregnancy or a miscarriage?
Both cause bleeding and pain in early pregnancy, and only a scan and blood tests can tell them apart, so neither should be judged at home. An ectopic pregnancy more often causes pain low down on one side, bleeding or a brown watery discharge that starts and stops, shoulder tip pain, and discomfort when peeing or pooing, usually between 4 and 12 weeks; a miscarriage more often brings bleeding that becomes heavier, with clots and cramps. Sudden severe pain, dizziness or fainting means 112.
Can an online doctor help with a suspected ectopic pregnancy?
Yes, with the first assessment: a doctor can judge how urgently a possible ectopic pregnancy needs a scan and where to go. The diagnosis and treatment are in hospital, and severe pain or fainting needs 112.
- Ectopic pregnancy, NHS, National Health Service (UK), reviewed 23 August 2022.
- Ectopic pregnancy: symptoms, NHS, National Health Service (UK), reviewed 23 August 2022.
- Ectopic pregnancy: treatment, NHS, National Health Service (UK), reviewed 23 August 2022.
- Ectopic pregnancy: patient information, RCOG, Royal College of Obstetricians and Gynaecologists, November 2017.
- What is an ectopic pregnancy?, The Ectopic Pregnancy Trust, reviewed 10 March 2026.
- Ectopic pregnancy and miscarriage: diagnosis and initial management (NG126), NICE, National Institute for Health and Care Excellence, 17 April 2019, updated 17 June 2026.
- Vaginal bleeding in pregnancy, NHS, National Health Service (UK), reviewed 17 February 2026.
- Stomach pain in pregnancy, NHS, National Health Service (UK), reviewed 18 November 2024.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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