You may not notice any symptoms at first. However, some women who have an ectopic pregnancy have the usual early signs or symptoms of pregnancy — a missed period, breast tenderness and nausea. If you take a pregnancy test, the result will be positive. Still, an ectopic pregnancy can’t continue as normal.

Pain on one side of the lower tummy (abdomen). It may develop sharply, or may slowly get worse over several days. It can become severe. Vaginal bleeding often occurs but not always.

Shoulder tip pain: This is a common sign of internal bleeding. The bleeding may irritate the phrenic nerve, and this leads to pain in the shoulder. Pain when passing urine or feces: This may also indicate an ectopic pregnancy.

At first, an ectopic pregnancy may feel like a typical pregnancy. Aside from a missed menstrual period, you may have tender breasts, an upset stomach or nausea. You may also notice some other symptoms, such as abnormal vaginal bleeding, low back pain, rectal pressure, or pain or cramping on one side of your pelvis.

A pregnancy that’s ectopic is usually diagnosed at about four to six weeks into pregnancy. Ectopic pregnancy tests and diagnosis often include: A pelvic exam.

Since ectopic pregnancies still produce the hormone hCG, they’ll register as a positive home pregnancy test. Women with ectopic pregnancies will also experience early pregnancy symptoms like sore breasts, nausea, spotting, and more.

Approximately 1% of ectopic pregnancies will have a negative urine pregnancy test and a β-hCG level of less than 20 mIU/mL. The emergency physician must remain cognizant of this potential diagnosis in the setting of unexplained intraabdominal hemorrhage or severe pelvic pain with a negative urine pregnancy test [2, 4].