Ectopic-Tubal Pregnancy

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  • The pain may have begun suddenly, but not always

Shoulder tip pain

  • The pain may have begun suddenly
  • It tends to develop after you have been aware of feeling unwell or having other symptoms of vaginal bleeding and pain

It is caused by internal bleeding irritating the diaphragm (the muscle in your chest which helps you to breathe) when you breathe in and out. Shoulder tip pain is exactly where it says – not the neck or the back but the tip of your shoulder. If you look to the left over your shoulder and then cast your eyes down, the tip of your shoulder is where your shoulder ends and your arm starts.Shoulders cause pain when we are stressed because we hold ourselves more rigidly and muscles in the back and neck go in to spasm – this is not shoulder tip pain; Shoulder tip pain is very distinctive. You know when you have it because it is a very ‘weird’ pain you have probably never experienced before.If you take two paracetamol, which are known to be safe in pregnancy providing you have taken this medicine in the past without problems, apply a cold pack to your shoulder for 10 minutes and 30 minutes later your shoulder pain has eased, that is unlikely to be ectopic related shoulder pain. However, if in any doubt consult your doctor about it. Bladder or Bowel Problems

  • Diarrhoea
  • Pain when you have your bowels open (go for a poo)
  • Pain when you pass water (have a wee)

Some pain and a change in your normal bladder and bowel pattern are features of a normal pregnancy for some women. All the same, if you present at your GP or hospital Pregnancy Unit with such symptoms, it would be reasonable to have an early pregnancy assessment.Collapse

  • Feeling light-headed or faint, or actually fainting
  • Often accompanied by sickness and looking pale
  • Increasing pulse rate or falling blood pressure may also be present

Pregnancy TestThis may be positive but not always. Specialised hCG blood tests performed by your doctor are sometimes required to confirm this. Human Chorionic Gonadotropin (hCG) is a hormone produced by a fertilised egg after conception.Abnormal bleeding

  • Bleeding is often dark and ‘prune juice’ like (i.e. a brownish colour)
  • Some women do report spotting and bleeding of redder blood

If you don’t know whether you are pregnant but find yourself having an unusual period, it may be due to a number of causes, one of which might be an ectopic pregnancy, particularly if you have had a coil (IUCD) fitted. If your bleeding is heavier or lighter than usual and prolonged or if, unlike your normal monthly period, this bleeding is slight, dark and watery, you should tell your doctor as soon as possible.You should be aware of any change in the bleeding you are experiencing.  If it becomes very heavy, causing you to soak a pad in less than an hour, or if you soak a pad in two hours with this level of flow continuing for more than 4 hours, you should have this checked out.Bleeding in early pregnancy is thought to occur in about 30% of all pregnancies, of which only 1 to 2% will be ectopic.A missed or late periodIf you have missed one or more periods, the most likely reason is that you have a normal pregnancy. However, the fact that you may experience normal pregnancy symptoms, such as nausea, painful breasts or a swollen abdomen but no bleeding, does not completely rule out an ectopic pregnancy.Deciding whether your symptoms are getting worseTrying to decide whether your symptoms are getting worse can be really tricky but, as a general rule, if you aren’t sure something is wrong then you are probably OK to wait for half an hour and continue to make your own assessment. The difficulty is, often when we feel worried about our pregnancy, when no one can be precise about a diagnosis and there isn’t a doctor on hand to ask, stress can, naturally, cause us to become very concerned and confused.Probably the single most useful thing to do if you aren’t sure if things are getting worse is to take yourself in to a quiet space, sit or lie and relax by breathing in deeply and out again in the same way, two or three times with your eyes shut and then ask yourself the question, “right here, right now, do I feel OK?” If the reply you get back is “yes I am OK” or “mmm I am not sure” then you should give yourself half an hour of relaxation and quiet time, take paracetamol for the pain as directed on the packet unless your doctor has given you reasons of why you cannot take paracetamol, and then reassess yourself in half an hour.When considering pain, it can be helpful to give yourself a pain scale, with zero being no pain at all and ten being the worst pain you have ever had in your life multiplied by ten. One way to test the pain would be to take two paracetamol, as directed on the pack, then rescore the pain about 45 minutes later. If the pain has eased at all, then it’s unlikely that the pain you have is related to a deteriorating ectopic pregnancy. It doesn’t necessarily mean that you don’t have an ectopic pregnancy though, just that it is more likely to be stable. 

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