How long does it take for an ectopic pregnancy to bleed?

Written by Zhang Lu
Obstetrics
Updated on March 04, 2025
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Ectopic pregnancy test strips indicate that the gestational sac is implanted outside the uterine cavity, with the most common type being a tubal pregnancy. The bleeding caused by a tubal pregnancy includes two types: vaginal bleeding and intra-abdominal bleeding.

Firstly, the vaginal bleeding caused by an ectopic pregnancy mainly occurs because the gestational sac lacks a normal developmental environment, with relatively low levels of estrogen and progesterone. This leads to insufficient endometrial proliferation, resulting in regressive bleeding. Typically, vaginal bleeding appears around the fifth week of an ectopic pregnancy, but the amount of bleeding is generally small.

Secondly, if the gestational sac in an ectopic pregnancy is relatively large, it can cause the local rupture of the fallopian tube, leading to intra-abdominal bleeding. This usually occurs around the seventh to eighth week of pregnancy. If the gestational sac is too small, even if there is mild abdominal pain, it will not cause intra-abdominal bleeding.

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Written by Tang Mei Xiang
Obstetrics and Gynecology
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Symptoms of ectopic pregnancy

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 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 Du Rui Xia
Obstetrics
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What is the best treatment for ectopic pregnancy?

In cases where an ectopic pregnancy is diagnosed, timely treatment is necessary. Generally, around 50 days into the pregnancy, there is a possibility of the ectopic pregnancy rupturing, so early treatment is crucial. If it is discovered before rupture, conservative treatment can be an option. However, if an ectopic rupture has already occurred, surgical treatment is required. The type of surgery depends on the specific situation; women who wish to preserve their fertility may undergo a salpingostomy, whereas those without fertility needs may undergo salpingectomy.

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Written by Zhang Lu
Obstetrics
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Ectopic pregnancy starts to cause abdominal pain at how many weeks?

Ectopic pregnancy refers to the implantation of the gestational sac outside the uterus, with over 95% of ectopic pregnancies being tubal pregnancies. Symptoms of ectopic pregnancy include lower abdominal pain, vaginal spotting, and shock. In many cases, there are no obvious clinical symptoms in the early stages of an ectopic pregnancy. This is because the gestational sac is relatively small, causing less irritation locally and not leading to significant abdominal pain. However, if the ectopic pregnancy grows significantly, it can irritate the fallopian tube and also stimulate the peritoneum, causing abdominal pain. Around five weeks, significant pain can be felt, but as the pregnancy progresses, this pain can increase in severity and may lead to rupture of the tubal pregnancy, causing hemorrhagic shock, which then necessitates emergency medical intervention.

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Written by Du Rui Xia
Obstetrics
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Does an ectopic pregnancy hurt?

Ectopic pregnancy is an abnormal pregnancy state where the fertilized egg implants outside the uterine cavity. As the pregnancy sac grows, there is a possibility of rupture and bleeding at the implantation site, which can lead to abdominal pain. In the early stages of an ectopic pregnancy, women generally do not exhibit any specific symptoms and are unaware of the condition. Symptoms are only felt when rupture occurs, causing pain in the lower abdomen. If rupture occurs, the pain often feels like tearing in the lower abdomen and is frequently accompanied by nausea and vomiting. It is recommended to promptly visit a hospital for an ultrasound and actively pursue surgical treatment.