Ectopic pregnancy can you have a negative test

Lower tummy/abdominal pain and/or bleeding during pregnancy may be due to a number of causes. It is however very important that an ectopic pregnancy as the cause is excluded. If not diagnosed and treated quickly an ectopic pregnancy can lead to internal bleeding and a medical emergency.

Some experience symptoms that are similar to other conditions such as gastroenteritis (tummy bug), urinary tract infection (UTI), pelvic inflammatory disease (PID) and miscarriage, which are the most common ways to misdiagnose an ectopic pregnancy. Not all experience symptoms.

When ectopic pregnancy symptoms start

The diagnosis of ectopic pregnancy may sometimes be difficult, and symptoms may occur from as early as 4 weeks pregnant and up to 12 weeks or even later. In addition, although there are a number of recognised risk factors, in over 50% of women diagnosed with an ectopic pregnancy, there are no identifiable risk factors. See the reasons for an ectopic pregnancy page for more information.

If your instincts are screaming at you that something does not feel right, it is OK to trust them and ask for reassessment at any time. Please do be vigilant and take any pain that concerns you seriously until absolutely proven otherwise.

If you are experiencing any of the following ectopic pregnancy symptoms, please contact your doctor/GP or your local Early Pregnancy Unit. You can also call the NHS Direct 111 service by dialling 111 or access the NHS GP at Hand service. You can contact your out-of-hours doctor/GP service if your normal surgery is closed or go to your local Accident and Emergency department (A&E) or Urgent Care Centre.

You can also view all the options for gaining professional help here.

What does ectopic pregnancy pain feel like?

Ectopic pregnancy pain can be on one side of the tummy, or lower abdomen, or in the pelvic area, or at the tip of the shoulder. Experiencing these pains during early pregnancy may mean that you could be experiencing ectopic pregnancy. Consult an emergency healthcare professional immediately.

What are the chances of a woman or pregnant person having an ectopic pregnancy?

The risk of ectopic pregnancy is not uncommon – around 1 in 80 pregnancies are ectopic. This is when the fertilised egg implants itself outside of the womb, most commonly in a Fallopian tube, but other sites can be on an ovary, within a Caesarean section scar, or in the cervix.

Deciding whether your symptoms are getting worse

It can be difficult to know which symptoms are concerning. Are they symptoms of an ectopic pregnancy or normal pregnancy sensations? If you are at worried, you should seek medical advice. Contact your doctor/GP or local Early Pregnancy Unit for advice. Your GP will likely refer you to your local Early Pregnancy Unit for an assessment by a healthcare professional. This may involve a blood test to check hormone levels and/or an ultrasound scan depending on how many weeks pregnant you are and your symptoms.

It is important to remember that normal pregnancy symptoms are common and that not everyone experiencing such symptoms will have an ectopic pregnancy. It could still be a viable, healthy pregnancy. However, it is important to be vigilant. If in doubt, seek medical attention and advice from healthcare professionals.

Ectopic Pregnancy Symptoms Checker

A normal, healthy pregnancy develops in a person's uterus. But around 2% of the time, an embryo implants somewhere else—usually in the fallopian tubes, but sometimes in the ovaries, abdomen, cervix, or previous C-section scar. This is called an ectopic pregnancy.

Left untreated, ectopic pregnancies could cause ruptured fallopian tubes, internal bleeding, and maternal death, according to Mark D. Levie, M.D., professor of OB-GYN and women's health at the Albert Einstein College of Medicine. With speedy diagnosis and treatment, however, a person probably won't have any complications. Here's what you need to know about the tests used to diagnose an ectopic pregnancy.

Would an Ectopic Pregnancy Show Up on a Home Pregnancy Test?

Since ectopic pregnancies still produce the hormone hCG, they'll register as a positive home pregnancy test. People with ectopic pregnancies will also experience early pregnancy symptoms like sore breasts, nausea, spotting, and more. The telltale symptoms of ectopic pregnancy(bleeding and abdominal pain) typically appear around 6-8 weeks, says Dr. Levie.

Ectopic Pregnancy Testing and Diagnosis

If you experience abdominal pain or bleeding during the first trimester, you should see a doctor to rule out ectopic pregnancy. This is especially important as an ectopic pregnancy progresses, which may cause lightheadedness, weakness, shoulder pain, fainting, and more. Getting a diagnosis early reduces the risk of complications like fallopian tube rupture and internal bleeding. Keep in mind that the probability of ectopic pregnancy is low, even with pain and bleeding, but it's best to have a high index of suspicion to rule it out.

Confirming the Pregnancy

Many people visit their doctor for abdominal pain and bleeding without knowing the cause. If the doctor thinks you may be pregnant, they'll test your blood or urine for human chorionic gonadotropin (hCG). Levels of hCG can be detected within 10 days of ovulation—although sometimes an increase can be detected earlier, sometimes even before you miss your period.

Pelvic Exam

Your doctor might also conduct a pelvic exam. If they notice painful areas or a tender mass in the fallopian tube, they might suspect ectopic pregnancy. More testing is necessary to confirm the diagnosis. Pelvic exams could also rule out other causes of abdominal pain and vaginal bleeding.

Ultrasound

"We usually do an ultrasound to see if the pregnancy is in the uterus or outside the uterus," says Tracy Anderson, M.D., a Kaiser Permanente OB-GYN based in Lakewood, Colorado. Doctors may use an abdominal ultrasound or transvaginal ultrasound (a device placed into the vagina that creates images through sound waves). However, Dr. Anderson notes that pregnancy in the fallopian tube might have inconclusive ultrasound results, leading to the next ectopic pregnancy test.

Quantitative hCG Test

Your health care provider may have already tested hCG levels to confirm a pregnancy. But according to Dr. Levie, they might also do a quantitative hCG test, which measures the exact level of hCG in the blood. Usually during pregnancy, hormone levels increase 40-100% every 48 hours, he says. "If this doesn't happen, then it could signal an ectopic pregnancy." What's more, hCG levels tend to be lower overall in an ectopic pregnancy. You may need to test hCG levels over a few days for definite results.

Note that if ectopic pregnancy symptoms are severe (intense pain, heavy bleeding, etc.) the doctor may immediately treat the ectopic pregnancy. Waiting for a diagnosis could put the pregnant person's health at risk.

Positive Ectopic Pregnancy Tests: Now What?

If a doctor confirms ectopic pregnancy in the early stages, they will probably prescribe methotrexate to stop cell growth, says Dr. Anderson. But if the ectopic pregnancy is advanced or ruptured, surgery may be necessary to remove it.

Dr. Levie stresses the importance of early diagnosis of ectopic pregnancy. "Get to the doctor early in the pregnancy to confirm it's in the right place" if you have pain or bleeding, he says, adding that most pregnant people are unlikely to suffer complications with proper treatment.

Naturally, people have concerns about treating ectopic pregnancy after Roe v. Wade was overturned by the Supreme Court. Current state abortion laws allow exemptions for life-saving procedures, such as ectopic pregnancies—but given the new restrictions, some providers might be unsure how to legally treat them. Speak with your doctor about any concerns you may have.

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