August 21, 2026

Ectopic pregnancy: symptoms, causes and when to go to A&E

If you’ve heard the word “ectopic” at an appointment or you’ve had unusual spotting with pain on one side and you’re not sure what’s normal, I understand how worrying it feels ❤️. Let me walk you through what an ectopic pregnancy is, why it happens, what signs to watch for and when to get urgent medical help.

Ectopic pregnancy symptoms

What is an ectopic pregnancy and where does it happen?

In a typical pregnancy the fertilised egg travels along the fallopian tube into the uterus, where it implants and starts to grow. In an ectopic pregnancy it implants outside the uterus and cannot continue to term.

Most often (around 90% of cases) it stays in one of the fallopian tubes — a tubal pregnancy — but, much less commonly, it can implant in the ovary, in the scar of a previous caesarean or in the abdominal cavity.

Fallopian tubes are very narrow and are not designed to host a growing embryo. If the pregnancy continues it can stretch and damage the tube, with a risk of rupture and internal bleeding. That’s why it is always a medical emergency that your doctor needs to assess.

Risk factors

There is rarely a single cause, and sometimes it happens without any known risk factor. These are the factors most linked to an ectopic pregnancy:

Previous ectopic pregnancy: the risk of recurrence is higher.
Tubal surgery (tubal ligation or reversal surgery to try for pregnancy again).
Pelvic inflammatory disease (PID) or untreated sexually transmitted infections that can scar the tubes.
Endometriosis and pelvic adhesions.
Smoking: nicotine affects the cilia that move the egg towards the uterus.
Age 35-44 and assisted reproduction treatments such as IVF.
Intrauterine device (IUD): the IUD is very effective at preventing pregnancy; in the very unlikely event that a pregnancy occurs with an IUD in place, it is more likely to be ectopic.
Congenital tube defects and other anatomical variations.

Having one of these factors does not mean you will have an ectopic pregnancy — it just means you should tell your doctor about it at your first visit.

Warning signs and symptoms

At first an ectopic can feel just like any early pregnancy: missed period, tender breasts, nausea or fatigue. That’s why it can be hard to tell apart early on. If you’ve had a positive test you can take our free online pregnancy test to reflect on your symptoms while you book an appointment — and if you fancy a distraction, try our finger pregnancy test game: it’s just a gam