Symptoms of Ectopic Pregnancy
The symptoms of ectopic pregnancy usually appear between the 4th and 12th week of pregnancy. In the early stages, they may seem identical to those of a normal pregnancy—making the condition hard to detect without medical evaluation. Recognising the symptoms of ectopic pregnancy quickly can be life-saving.
The first sign is often a missed period, followed by a positive pregnancy test. However, unlike a normal pregnancy, the woman may also experience:
Sharp, stabbing pain in the lower abdomen or pelvis
Vaginal bleeding or spotting, which may be lighter or darker than a normal period
Shoulder-tip pain, a sign of internal bleeding irritating the diaphragm
Dizziness or fainting, caused by blood loss and low blood pressure
Rectal pressure or pain during bowel movements
The pain may come and go, or it may be constant. It can be felt on one side or both sides of the abdomen. As the ectopic pregnancy grows, it may rupture the fallopian tube, causing heavy internal bleeding and shock. This is a medical emergency.
Symptoms of a ruptured ectopic pregnancy include:
Sudden, severe abdominal pain
Heavy vaginal bleeding
Cold, clammy skin
Rapid heartbeat
Loss of consciousness
These symptoms require immediate emergency care. In South Africa, delays in seeking care—especially in rural areas—can be fatal. Many women do not suspect anything is wrong until the condition becomes critical.
Symptoms of Ectopic Pregnancy
It’s also worth noting that some ectopic pregnancies show very few symptoms in the early stages. This is why routine early ultrasound scans and blood tests for pregnancy hormone levels (hCG) are important. In ectopic pregnancy, hCG levels may rise more slowly than expected.
Any woman who is pregnant and experiences unusual bleeding, pelvic pain, or fainting should be assessed urgently. Even if the pain feels manageable, it should never be ignored—especially in the first trimester.
Recognising the symptoms of ectopic pregnancy early can prevent complications, reduce the need for major surgery, and protect the woman’s future fertility. Timely diagnosis and treatment save lives.
[Next: Diagnosis of Ectopic Pregnancy→]


