Ectopic Pregnancy: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Ectopic Pregnancy?
An obstetrician-gynecologist (OB-GYN), a doctor who cares for pregnancy and the female reproductive system, treats ectopic pregnancy. Emergency care is needed if the pregnancy bursts. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is an ectopic pregnancy?
An ectopic pregnancy is a pregnancy that occurs outside the womb (uterus). The fertilized egg grows in the wrong place. It usually happens in a fallopian tube, a tube that carries eggs from the ovaries to the uterus. Less often, it happens in an ovary, the belly cavity, or the cervix.
An ectopic pregnancy cannot end in a healthy pregnancy because the egg cannot grow. If the pregnancy continues, the fallopian tube can burst. This can cause internal bleeding, which can be a life-threatening emergency that needs immediate surgery.
Symptoms
You may not notice any symptoms at first. You may have usual signs of pregnancy, such as a missed period, breast tenderness, or nausea. Early signs of an ectopic pregnancy may be light vaginal bleeding and pelvic pain. Other signs can include:
- Mild cramping on one side of the pelvis.
- Pain in the lower belly or pelvic area.
- Pain in the shoulder area.
- A brown, watery discharge from the vagina.
If the area around the pregnancy bursts and bleeds, symptoms can get worse. They may include severe, sharp, and sudden pain in the lower belly, fainting, and intense pressure in the rectum.
Causes and who gets it
In most pregnancies, the fertilized egg travels through the fallopian tube to the uterus. If the egg is blocked or slowed in the tube, it can lead to an ectopic pregnancy. Sometimes the cause is not known. Hormones may play a role.
Causes can include a birth defect in the fallopian tubes and endometriosis. Scarring from a ruptured appendix, past infections, or surgery of the female organs can also cause it.
Other things raise the risk as well:
- Being older than 35.
- Getting pregnant while using an IUD, or after having your tubes tied.
- Past surgery to untie the tubes to become pregnant.
- Infections spread by sex (STIs), including pelvic inflammatory disease.
- Some infertility treatments.
- Smoking.
An ectopic pregnancy can happen even if you use birth control.
How doctors diagnose it
A doctor will do a pelvic exam, which may show tenderness in the pelvic area. A pregnancy test and a vaginal ultrasound will also be done. An ectopic pregnancy cannot be diagnosed without blood tests and an ultrasound.
The hormone hCG is made during pregnancy. When hCG levels are above a certain value, a pregnancy sac in the uterus should show on ultrasound. If the sac is not seen, an ectopic pregnancy may be present.
Treatment
An ectopic pregnancy needs treatment to stop damage to your organs. The pregnancy cannot continue to birth. Treatment uses either medicine to end the pregnancy or surgery to remove it.
If the pregnancy has not burst, you may get surgery. Or you may get medicine that ends the pregnancy, with close monitoring by your doctor. The medicine is an injection of methotrexate.
Keyhole surgery uses small cuts and general anesthesia. It removes the pregnancy, usually along with the affected fallopian tube. If the pregnancy has burst, surgery is done to stop the blood loss and remove the pregnancy.
After methotrexate, you are usually told to wait at least 3 months before getting pregnant. The medicine could harm a baby. Treatment works very well if the problem is caught early. Losing a pregnancy can be devastating. It may help to talk with your doctor or a counselor.
When to see a doctor
Get medical care right away if you have belly or pelvic pain, shoulder pain, or vaginal bleeding. Also call your doctor if you think you might be pregnant.
Call 911 or go to the emergency room if you have severe, sharp, and sudden pain in the lower belly. Do the same if you faint, feel suddenly dizzy or weak, or have bleeding that will not stop. Also go if you feel intense pressure in the rectum. These can be signs that the pregnancy has burst, which needs emergency help.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can order a pregnancy test and send you to an OB-GYN or emergency care quickly. They can also check on your recovery afterward and help you find counseling.
Common questions
Can an ectopic pregnancy be saved?
No. An ectopic pregnancy cannot end in a healthy pregnancy because the egg cannot grow. It usually has to be removed with medicine or an operation.
Is an ectopic pregnancy an emergency?
It can be. If the fallopian tube bursts, internal bleeding can be life-threatening and need immediate surgery. Get medical care right away if you have belly pain, shoulder pain, or vaginal bleeding.
Can I get pregnant again after an ectopic pregnancy?
Yes, many women can. Many women who have had an ectopic pregnancy go on to have healthy pregnancies later. Most can get pregnant again even if a fallopian tube was removed. The chance of another ectopic pregnancy is higher, but the risk is still small.
Sources
- MedlinePlus - Ectopic pregnancy (Medical Encyclopedia)
- MedlinePlus - Ectopic Pregnancy
- NHS - Ectopic pregnancy
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
