Symptoms of ectopic pregnancy

Written by Tang Mei Xiang
Obstetrics and Gynecology
Updated on September 27, 2024
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The symptoms of an ectopic pregnancy depend on the location of the implantation of the fertilized egg, whether there has been a rupture or miscarriage, and the amount and duration of bleeding if there has been a rupture or miscarriage. Generally, there may be no symptoms in the early stages. If a miscarriage or rupture occurs, symptoms similar to those of threatened miscarriage or early pregnancy might appear. Typically, the manifestations of ectopic pregnancy include missed periods, usually about six to eight weeks of amenorrhea. The second is abdominal pain, which is the most common symptom in patients with tubal pregnancies, accounting for about 95%. Third, there is a small amount of vaginal bleeding, which does not correlate proportionally with internal bleeding and is generally less than a normal menstrual period. Fourth, fainting and shock can occur if there is significant internal bleeding. Fifth, a mass may be palpable in the abdomen.

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Written by Du Rui Xia
Obstetrics
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How many days can an ectopic pregnancy be detected?

Generally around six weeks after a missed period, an ectopic pregnancy can be detected through an ultrasound examination. For women with regular menstrual cycles, if menstruation is delayed by a week and a pregnancy test shows a positive result, it indicates pregnancy. At this time, it is necessary to visit the hospital for an ultrasound to ascertain the implantation site of the gestational sac. In the case of an ectopic pregnancy, it is normal that no gestational sac is visible within the uterine cavity during an ultrasound. The ultrasound might reveal irregular echo areas in the adnexal area, which includes the fallopian tubes or ovaries, possibly indicating thickened fallopian tubes or enlarged ovaries. At this point, one should be vigilant about the possibility of an ectopic pregnancy and seek timely treatment.

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Written by Liu Qin
Obstetrics and Gynecology
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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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Written by Zhao Li Li
Obstetrics
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Can an ectopic pregnancy be treated with medication abortion?

Ectopic pregnancy refers to the condition where the embryo implants outside the uterine cavity, most commonly in the fallopian tubes. A normal pregnancy test may still show a positive result in cases of an ectopic pregnancy. However, around 40 days after missed menstruation, no normal gestational sac can be seen inside the uterine cavity. Diagnosis generally requires a combination of blood HCG level monitoring and ultrasonographic examination. Once an ectopic pregnancy is confirmed, medical abortion is not viable, as it cannot expel the embryo from the body. Other surgical interventions are necessary for treatment.

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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.

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Written by Tang Mei Xiang
Obstetrics and Gynecology
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What are the early signs of ectopic pregnancy?

Ectopic pregnancy is a common term for what is known as a displaced pregnancy; that is, a condition where the fertilized egg implants outside of the uterine cavity. Therefore, ectopic pregnancy and intrauterine pregnancy are different. In the early stages of an ectopic pregnancy, if there is no splitting of the pregnancy sac or bleeding, there generally are no symptoms. However, the condition can be understood and assessed through some auxiliary examinations. For example, after the cessation of menstruation, an ectopic pregnancy might be accompanied by a small amount of vaginal bleeding, and blood tests for HCG might show that the HCG levels do not double as expected. Or, at a certain gestational week, such as six or seven weeks, an ultrasound might not reveal a pregnancy sac. These are all precursors to an ectopic pregnancy, and if these signs appear, the likelihood of an ectopic pregnancy is very high.