Welcome to Laurie’s Big Blog – February 2023

Every month we will identify the most commonly asked questions about ectopic pregnancy and answer them. If you have any further questions which you cannot find answers to on the website, please can you contact us.

Does the shoulder pain from an ectopic pregnancy occur in the right or left shoulders?

Shoulder tip pain is the result of blood in the abdomen tracking down behind the diaphragm causing irritation and referred pain to the shoulder tip. It may be either right, left or even both.

Why does an ectopic pregnancy cause shoulder pain?

Shoulder tip  pain occurs when the diaphragm is irritated and it occurs when there is intra-abdominal bleeding from a leaking or ruptured ectopic pregnancy. This is known as referred pain due to the development of the human foetus.  It is an important and serious  symptom in ectopic pregnancy.
A leaking or ruptured ectopic pregnancy causes intra-abdominal blood loss which is not visible externally. The body tries to compensate by increasing heart rate to maintain blood pressure, eventually the blood pressure falls and loss of consciousness can occur and if left untreated this  hypovolemic shock results in cardiac arrest and death. This can occur quickly.
Any woman of reproductive age who reports shoulder tip pain should be seen and assessed by a gynaecologist.
A case that I was involved in was a patient referred to me who reported an inability to lie flat due to pain. I diagnosed a ruptured ectopic and at operation she was found to have a ruptured ectopic pregnancy with 2 litres of blood in her abdomen.  View the Cornual Ectopic video here.

What are the long term effects of an ectopic pregnancy?

The long term effects of surgery for ectopic pregnancy may depend on what type of surgery was performed. Laparoscopic surgeons ( key hole )  results in a shorter hospital stay with less family disruption also the time taken for recovery and return to normal activities is shorter than with open ( laparotomy surgery)  takes longer and the woman has a scar in the bikini line which may result in adhesions and abdominal and pelvic discomfort or painful.

Does having Covid-19 affect my chances of having an ectopic pregnancy?

There is no strong evidence that having a covid infection increases your chances of developing an ectopic pregnancy.

After an ectopic pregnancy, when is it safe to try and conceive again?

There is no good evidence as to when you should try for another pregnancy after a previous ectopic pregnancy. This will however depend on when you and you partner are psychologically ready any comfortable to proceed.