Welcome to Laurie’s Big Blog – July 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.

What does ectopic shoulder pain feel like?

Shoulder tip pain is a sign that the ectopic pregnancy has resulted in bleeding from the ectopic pregnancy which is either leaking or has actually ruptured . The pain is due to blood irritating the diaphragm leading to referred pain in the shoulder which tends to be worse when lying flat. (See case report in the Bibliography section)

IS PTSD common after an ectopic pregnancy?

Ectopic pregnancy can be life threatening and may have a profound effect on the woman’s mental well-being. Accurate figures for this are not known and maybe under-reported . PTSD has been reported and psychological support is recommended. View our Feelings following an ectopic pregnancy page.

I have chlamydia – are my chances of an ectopic pregnancy higher?

Chlamydia is a sexually transmitted disease which is recognised as an important cause of ectopic pregnancy infection.  It may be asymptomatic with few symptoms presenting but it can result in severe tubal damage . It can cause scaring and adhesion to the Fallopian tubes. It may also damage the lining of the tube: the lining of the tube has cells which have fine hairs ( known as cilia) which beat to facilitate the embryo to travel down the tube and into the uterine cavity . If damaged there is a slower transfer and thus a higher chance that the embryo will implant in the tube resulting in an ectopic pregnancy.

Even if you have no symptoms but have any concerns that you may have chlamydia, you should visit your nearest sexual health clinic to be screened.  This involves having swabs taken – see the Risks of Ectopic Pregnancy section for more information)

What happens during an ectopic pregnancy surgery?

Surgery for an ectopic pregnancy can be either performed laparoscopically (key hole) which is the most common, or by open surgery, usually through an incision on the abdomen.

The decision on which procedure is undertaken depends on the clinical situation. Whichever approach is used the operation usually involves removal of the portion of the tube that contains the pregnancy (partial salpingectomy).  In selective cases an incision is made over the pregnancy and is removed with conservation of the Fallopian tube. This is called a linear salpingectomy. (see surgical treatment of ectopic pregnancy and also surgical videos which contains graphic images of actual surgery which could be unsuitable for those under the age of 18).

How early can an ultrasound detect an ectopic pregnancy?

Ultrasound is mainly used to exclude an ectopic pregnancy.  If an inter-uterine pregnancy has been confirmed then the chances of having an ectopic pregnancy as well (known as an heteroscopic pregnancy) is said to bee 1 in 40,000 cases . Transvaginal scan findings which are suggestive of an ectopic pregnancy include a thickened endometrium (lining of the womb), increased fluid behind the uterus (known as the pouch of Douglas) and a complex mass at the side of the uterus. It is rare to see a beating foetal heart beat outside the uterus.