Becoming a mother may be one of the most beautiful moments in a woman’s life. But pregnancy itself can be a difficult time for many women.

For example, having abdominal cramps is considered to be normal during the later stages of pregnancy, but in some instances it can be an indication of something more serious like an ectopic pregnancy.

Ectopic pregnancy is a life-threatening emergency in the first trimester of pregnancy – however, most women are unaware of this condition. 

We asked Dr Archana Nirula, a gynaecologist associated with myUpchar, to tell us the early signs of ectopic pregnancy that can be noticed by any pregnant woman. Edited excerpts from an interview:

Q: What is an Ectopic pregnancy?

A: In a normal pregnancy, the egg fuses with a sperm in the fallopian tube and then travels to the uterus, where it attaches and grows to become a foetus.

In case of an ectopic pregnancy, also known as an extrauterine pregnancy, the egg fuses with a sperm and attaches somewhere other than the wall of the uterus – 97% of the extrauterine pregnancies occur in the fallopian tube and the remaining 3% occur in the cervix, ovary, peritoneal cavity, or in uterine scars.

Q: What are the early signs of an Ectopic pregnancy?

A: Women who have an ectopic pregnancy will typically experience a triad of symptoms – abdominal pain, loss of menses (amenorrhea), and irregular abnormal vaginal bleeding where the discharge is generally dark red or brown in colour. All three symptoms must be present together – even if one is missing, the triad is incomplete.

Of course, all women stop menstruating once they conceive – there might be light spotting, but that is normal. In an ectopic pregnancy, amenorrhea is accompanied by brownish-red vaginal discharge and abdominal pain.

Now, abdominal pain is okay in the latter part of the pregnancy, when the foetus is growing and stretching the mom’s stomach to take up space. But in the early months, there shouldn’t be stomach pain as the foetus is still very small.

The pain may be localized to the right or the left pelvic area but sometimes may present over the entire abdomen or lower back.

These symptoms may vary from person to person. On pelvic examination, gynaecologists may see cervical tenderness which is another sign of ectopic pregnancy.

Q: What are the tests to confirm this?

A: About 75% of ectopic pregnancies can be detected by transvaginal ultrasonography – a pelvic ultrasound. If not detected in time, it can rupture and even become fatal.

Q: Are there any signs one should watch out for?

A: A ruptured ectopic pregnancy may present with notable symptoms like sharp, unilateral abdominal pain, large palpable mass in the pelvic region, referred shoulder pain due to blood pooling under the diaphragm, peritonitis (inflammation of the inner wall of the abdomen) and Cullen’s sign, a bluish discolouration of the umbilical area that may indicate pooling of blood in the peritoneal cavity.

Due to rapid blood loss, the woman may undergo syncope (fainting) or even shock.

Q: What are the risk factors for an ectopic pregnancy? Who is at risk?

A: Any woman can have an ectopic pregnancy but there are some risk factors that may increase the chances in some women.

  • Women who have already had one ectopic pregnancy are at risk of developing it again.

  • Women conceiving at or after 35 years of age have a much higher risk of having an ectopic pregnancy.

  • Women with a history of pelvic surgery, abdominal surgery, or multiple abortions are also at risk.

  • Women with pelvic inflammatory disease are at risk of having an ectopic pregnancy. Pelvic inflammatory disease is an inflammation of female reproductive organs.

  • Women with a history of endometriosis, a painful condition where similar tissue that lines the inner wall of the uterus, starts to grow outside the uterus, are at risk.

  • Women who conceived, despite tubal ligation or intrauterine device (IUD).

  • Women with a history of having any sexually transmitted disease, such as gonorrhoea and chlamydia, are at a greater risk.

  • Women with structural abnormalities in the fallopian tubes may have an ectopic pregnancy because it might get hard for the egg to travel down to the uterus.

This article was written by, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health. For more information, please watch our video on Ectopic Pregnancy: Causes, Symptoms, Treatment.

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