Early symptoms of ectopic pregnancy

Written by Tang Mei Xiang
Obstetrics and Gynecology
Updated on March 21, 2025
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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 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 Liu Wei Jie
Obstetrics
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Ectopic pregnancy abdominal pain symptoms

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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Written by Tang Mei Xiang
Obstetrics and Gynecology
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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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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 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.