Ectopic Pregnancy

What is an Ectopic Pregnancy?

An ectopic pregnancy occurs when a fertilised egg implants outside the uterus, most commonly in the fallopian tube, but occasionally in the ovary, cervix, or abdominal cavity.

Because these locations cannot support normal pregnancy growth, an ectopic pregnancy cannot progress safely and may cause serious complications if not diagnosed early. As the pregnancy grows, it can lead to internal bleeding, rupture of the fallopian tube, and life-threatening emergencies.

Ultrasound scanning is a critical diagnostic tool used to confirm pregnancy location and guide urgent clinical management.

When ectopic pregnancy assessment is recommended

An ectopic pregnancy scan is recommended when symptoms or findings raise concern that a pregnancy may not be developing inside the uterus.

You may require urgent assessment if you:

• Have a positive pregnancy test with pelvic or abdominal pain
• Experience vaginal bleeding in early pregnancy
• Have one-sided lower abdominal pain
• Feel shoulder tip pain or dizziness
• Have fainting or collapse
• Have a history of ectopic pregnancy
• Have had previous tubal surgery or pelvic infection
• Have rising pregnancy hormone levels without a visible intrauterine pregnancy

Suspected ectopic pregnancy is a medical emergency and requires prompt evaluation.

How ectopic pregnancy is assessed

Assessment typically includes:

• Transvaginal ultrasound to locate the pregnancy
• Evaluation of the uterus for absence of intrauterine pregnancy
• Assessment of fallopian tubes and surrounding structures
• Identification of free fluid or signs of internal bleeding
• Correlation with pregnancy hormone (hCG) levels

In very early pregnancy, follow-up scans and blood tests may be required to confirm diagnosis.

Benefits of early ectopic pregnancy diagnosis

• Early detection of a potentially life-threatening condition
  Reduces risk of rupture and internal bleeding.
• Guides urgent medical or surgical treatment
  Supports safe and timely care.
• Prevents severe complications
  Including haemorrhage and shock.
• Supports fertility preservation where possible
  Early treatment may reduce tubal damage.
• Provides clarity in early pregnancy uncertainty
  Helps explain symptoms and next steps.
• Non-invasive imaging assessment
  Ultrasound does not use radiation.
• Supports safe pregnancy care planning
  Enables appropriate follow-up.
• Essential for emergency decision-making
  A key diagnostic investigation.

Understanding ectopic pregnancy scan findings

Normal intrauterine pregnancy

A gestational sac is seen inside the uterus.

Typical report:

• Intrauterine pregnancy identified

Suspected ectopic pregnancy

No pregnancy is seen in the uterus, with findings suggestive of ectopic implantation.

Typical report:

• Findings suspicious for ectopic pregnancy

Urgent medical review is required.

Confirmed ectopic pregnancy

Clear evidence of pregnancy outside the uterus, often with associated findings.

Typical report:

• Ectopic pregnancy identified

Immediate management is necessary.