Can you have tubal pregnancy without bleeding

It is not known exactly why shoulder tip pain occurs, but it usually occurs when you are lying down and is a sign that the ectopic pregnancy is causing internal bleeding. The bleeding is thought to irritate the phrenic nerve, which is found in your diaphragm the muscle used during breathing that separates your chest cavity from your abdomen.

The irritation to the phrenic nerve causes referred pain pain that is felt elsewhere in the shoulder blade. Diarrhoea and vomiting — an ectopic pregnancy can cause similar symptoms to a gastrointestinal disease and is often associated with diarrhoea and vomiting.

It can be difficult to diagnose an ectopic pregnancy from the symptoms alone, as they can be similar to other conditions. If an ectopic pregnancy is detected at an early stage, a medication called methotrexate is sometimes needed to stop the egg developing. The pregnancy tissue is then absorbed into the woman's body. Methotrexate is not always needed, as in around half of cases the egg dies before it can grow larger.

Ectopic pregnancies detected at a more advanced stage will require surgery to remove the pregnancy sac. If an ectopic pregnancy is left to develop, there is a risk that the fertilised egg could continue to grow and cause the fallopian tube to split open rupture , which can cause life-threatening internal bleeding.

A ruptured fallopian tube is a medical emergency. If you think that you or someone in your care has experienced this complication, call and ask for an ambulance. In a normal pregnancy an egg is fertilised by sperm in one of the fallopian tubes, which connect the ovaries to the womb. The fertilised egg then moves into the womb and implants itself into the womb lining endometrium , where it grows and develops. An ectopic pregnancy occurs when a fertilised egg implants itself outside the womb.

It most commonly occurs in a fallopian tube this is known as a tubal pregnancy , often as the result of damage to the fallopian tube or the tube not working properly. Less commonly in around 2 in cases , an ectopic pregnancy can occur in an ovary, in the abdominal space or in the cervix neck of the womb.

In many cases, it's not clear why a woman has an ectopic pregnancy. Sometimes it happens when there's a problem with the fallopian tubes, such as them being narrow or blocked. The loss of your pregnancy at any stage can have a huge impact on you and your partner. One day you are pregnant and planning your future life with your child, and then within a short time, your pregnancy ends. The ending of an ectopic pregnancy is a form of miscarriage — and the feelings that a woman and her partner may experience can be similarly difficult.

It is not uncommon for feelings of grief and bereavement to last for 6 to 12 months, although these feelings usually improve with time. Pregnancy, Birth and Baby offers free and confidential support and counselling to women, their partners, friends and relatives. Call on Many women affected by a miscarriage benefit from counselling. SANDS miscarriage, stillborn and neonatal death support provide support groups for parents and their family whose baby has died through stillbirth , miscarriage , ectopic pregnancy and medically advised termination.

It is normally recommended that you wait for at least 2 menstrual cycles before trying for another pregnancy, as this will allow time for your fallopian tubes to recover if treated with methotrexate, you will need to wait at least 3 to 4 months. However, many women are not emotionally ready to try for another pregnancy so soon. Your chances of having a successful pregnancy will depend on the underlying health of your fallopian tubes. If you cannot conceive in the normal way then fertility treatment such as in-vitro fertilisation IVF may be an option.

Some pain is likely in the first few days after the injection, but this can usually be controlled with paracetamol. Certain substances should be avoided during treatment, including: [3]. Good to know: Apart from being used as a medication for ectopic pregnancy, methotrexate is a chemotherapy drug and immune system suppressant used to treat a variety of other conditions. It can cause significant side-effects. However, the dose to treat ectopic pregnancy is much lower and is unlikely to cause severe problems.

There are two possible aims for surgical management, which will be decided depending on damage to the affected fallopian tube and the condition of the other tube. These are: [12] [13]. Total salpingectomy: This involves removal of the tube containing the ectopic pregnancy and is normally recommended for people who either do not want to have any children in future, who have had another ectopic pregnancy in the same fallopian tube, or who have severely damaged tubes. This reduces the risk of a persistent ectopic pregnancy, in which some ectopic cells are left behind and continue to grow, or further ectopic pregnancies.

Total salpingectomy may also be chosen in cases of uncontrolled bleeding and abnormal blood pressure. Linear salpingostomy: This is a more conservative approach, involving a surgical incision into a fallopian tube, which aims to remove the ectopic pregnancy without removing the tube.

This is normally recommended for people who have an unruptured ectopic pregnancy in the ampullary middle portion of the tube. This may also be chosen if the person only has one tube, or their other tube does not seem to be healthy.

It carries a higher risk of future ectopic pregnancy and persistent ectopic pregnancy, but still leaves the possibility of a future uterine pregnancy. However, salpingostomy is not always possible. Laparoscopy: This is keyhole surgery involving minimal incisions. Recovery is about two to four weeks, though this varies from person to person. Laparotomy: This is open surgery, which is used if severe internal bleeding is suspected. It involves a larger incision in the lower abdomen.

Recovery is about four to six weeks, though this varies from person to person. An ectopic pregnancy may rupture the fallopian tube, leading to heavy bleeding, which can cause serious medical problems and may, occasionally, be life-threatening.

Ruptured ectopic pregnancy requires emergency, life-saving surgery. Symptoms of a rupture include: [1].

There are some possible, but very rare complications after surgery, as well as side effects from taking methotrexate. A doctor will discuss these with the person affected by ectopic pregnancy, before commencing treatment. A persistent ectopic pregnancy may occur, in which some ectopic cells are left behind and continue to grow, or further ectopic pregnancies occur.

If there is no history of diseases of the fallopian tubes, the chances of having another ectopic pregnancy may not be much higher than in a person who has not previously had an ectopic pregnancy.

If a person has some of the risk factors for ectopic pregnancy, as listed above, then the risk of problems in the future increases. Most women will make a full recovery from ectopic pregnancy and will be able to conceive normally in future. Rarely, fertility may be affected, especially in the case of ruptured ectopic pregnancy or if a fallopian tube is removed in treatment. If treatment has involved any kind of surgery, the risk of fertility problems is higher than if medical treatment or no treatment was needed.

It is normal to feel distressed after an ectopic pregnancy. It can mean coming to terms with the loss of a baby, with a potential impact on future fertility or, for some, with the thought of having nearly lost their life. In some people, these emotions can develop into depression and anxiety if left untreated. According to the Miscarriage Association, a person with ectopic pregnancy may be emotionally affected in a variety of ways, including: [15].

Shock: A person may experience shock about the diagnosis, especially in cases where there has been emergency surgery or about what might have happened without diagnosis. Counseling is available for people affected by an ectopic pregnancy. Support groups are also available and may be able to put a person in touch with others in a similar situation. A health professional will be able to provide advice on choosing the most appropriate kind of support for a person, couple or family who has experienced an ectopic pregnancy.

Q: How common is ectopic pregnancy? A: About one in 50 pregnancies are ectopic. Some ectopic pregnancies will resolve before they produce symptoms. Q: Can a person have an ectopic pregnancy with a copper coil IUD? A: IUDs ensure a very low risk of any pregnancy, either intrauterine or ectopic.

Q: Can a person have an ectopic pregnancy with IVF? A: Yes, in vitro fertilization puts a person at higher risk of ectopic pregnancy. It may increase the occurrence of unusual types of ectopic pregnancies, such as heterotopic pregnancy, in which there is simultaneous intrauterine and tubal pregnancies, and interstitial pregnancy, which occurs in the part of the fallopian tube embedded in the uterus wall. Q: Is it possible to miscarry an ectopic pregnancy? A: In the very early stages, the fetus may pass out of the cervix on its own, without the need for further treatment.

This may result in some symptoms of miscarriage being present. As the fetus develops, it becomes less likely that it will pass out of the womb on its own, and medical or surgical management will be needed to remove it.

However, the techniques used to treat ectopic pregnancy may differ from those used to treat incomplete miscarriage. See this resource on miscarriage for more information. Q: Is prevention of ectopic pregnancy possible? A: Preventing ectopic pregnancy is not normally possible.

Adequate use of contraceptives significantly reduces the risk of ectopic pregnancy. A person may be able to prevent a tubal pregnancy in the fallopian tube, if things that scar the tube, such as smoking and exposure to sexually transmitted diseases STDs , can be avoided. In some cases of ectopic pregnancy, a person may have surgery to remove the tube containing the ectopic pregnancy, which will reduce the risk of further ectopic pregnancies or persistent ectopic pregnancy.

This occurs if some ectopic cells are left behind and continue to grow, or if there are subsequent ectopic pregnancies. Accessed 27 April Accessed 26 April The Ectopic Pregnancy Trust. Accessed 15 May A classical ectopic pregnancy does not develop into a live birth.

Ectopic pregnancy can be hard to diagnose because symptoms often are like those of a normal early pregnancy. These can include missed periods, breast tenderness, nausea, vomiting, tiredness, or frequent urination peeing. Often, the first warning signs of an ectopic pregnancy are pain or vaginal bleeding. There might be pain in the pelvis, abdomen, or even the shoulder or neck if blood from a ruptured ectopic pregnancy builds up and irritates certain nerves.

The pain can range from mild and dull to severe and sharp. It might be felt on just one side of the pelvis or all over. The tube can get blocked from an infection or inflammation.

The tube can get blocked from:. If a woman might have an ectopic pregnancy, her doctor may do an ultrasound to see where the developing fetus is. How doctors treat an ectopic pregnancy depends on things like the size and location of the pregnancy. Sometimes they can treat an early ectopic pregnancy with an injection of methotrexate, which stops the growth of the embryo. If the pregnancy is farther along, doctors usually need to do surgery to remove the abnormal pregnancy.

Whatever treatment she gets, a woman will see her doctor regularly afterward to make sure her pregnancy hormone levels return to zero.