How Do I Know If I've Had a Miscarriage?

Could It Be an Ectopic Pregnancy?

In some cases, vaginal bleeding in early pregnancy may be a sign of another form of pregnancy loss called an ectopic pregnancy (or tubal pregnancy). This occurs when a fertilized egg implants outside the uterus, usually in a fallopian tube. It can also implant in an ovary or in the abdominal cavity. This type of pregnancy loss can be identified using an ultrasound.
Ectopic pregnancies are serious and potentially life-threatening. The growing embryo can rupture a fallopian tube, resulting in internal bleeding, infections, and even death. Although they are not very common (occurring in about 2 out of every 100 pregnancies), ectopic pregnancies are a leading cause of pregnancy-related death during the first trimester in the United States.
It can be difficult to know early on if your pregnancy is ectopic. In many cases, ectopic pregnancies seem like normal pregnancies, with you having a missed period, breast tenderness, fatigue, and nausea. However, as the pregnancy continues, you may develop symptoms such as:
  • Cramps and spotting
  • Severe abdominal (stomach) pain on one side of the body
  • Vaginal bleeding
  • Shoulder pain
  • Fainting spells or dizziness
  • Nausea and vomiting.
If you are pregnant and have severe pain or bleeding, get to the emergency room immediately. The earlier an ectopic pregnancy is diagnosed and treated, the better your chances of not developing a life-threatening complication.
Treatment for an ectopic pregnancy may involve medicine or surgery. A medicine called methotrexate can be used to end an ectopic pregnancy. In some cases, surgery (called a salpingectomy) may be necessary to remove the tube with the pregnancy. Talk to your healthcare provider about which treatment is best for your situation.
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