Symptoms:

• Abnormal vaginal bleeding
• Amenorrhea
• Breast tenderness
• Low back pain
• Mild cramping on one side of the pelvis
• Nausea
• Pain in the lower abdomen or pelvic area

If the area of the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include:

• Feeling faint or actually fainting
• Pain that is felt in the shoulder area
• Severe, sharp, and sudden pain in the lower abdomen

Internal bleeding due to a rupture may lead to shock. Shock is the first symptom of almost 20% of ectopic pregnancies.

Signs and tests:

The health care provider will do a pelvic exam, which may show tenderness in the pelvic area.

Tests that may be done include:

• Culdocentesis
• Hematocrit
• Pregnancy test
• Quantitative HCG blood test
• Transvaginal ultrasound or pregnancy ultrasound
• White blood count

A rise in quantitative HCG levels may help tell a normal (intrauterine) pregnancy from an ectopic pregnancy. Women with high levels should have a vaginal ultrasound to identify a normal pregnancy.

Other tests may be used to confirm the diagnosis, such as:

• D and C
• Laparoscopy
• Laparotomy

An ectopic pregnancy may affect the results of a serum progesterone test.