You finally got that BFP (big fat positive) on a pregnancy test, and you’re so excited about the changes ahead — but your body is telling you something’s not right. Based on your symptoms, your OB/GYN wants you to be seen for a possible ectopic pregnancy. Thoughts are swirling in your mind, like “How soon can I be seen for an ectopic pregnancy ultrasound?”

In this article, we share what to expect if you’re experiencing this type of pregnancy. Read about how it’s diagnosed, including when you can get seen for an ultrasound, and how to recover from treatment.  

woman staring out a window

What is an ectopic pregnancy?

After conception — and during the agonizing days of the two-week wait — your body works hard to support a budding pregnancy. After about 10-14 days past ovulation, the fertilized egg attaches itself to the inner lining of the uterus, where it will grow and develop throughout pregnancy. This process is known as implantation. 

In some cases, one in every 50 pregnancies to be exact, the embryo implants somewhere outside of the uterus. This phenomenon is called an ectopic pregnancy, meaning “in an abnormal place.” The most common location is in a fallopian tube, which accounts for 90% of ectopic pregnancies. They can also occur in an ovary, cervix, or abdominal cavity. 

Because the uterus is the only place a baby can grow, ectopic pregnancies are not viable. If you think you’re having one, talk to your doctor about getting seen. Pregnancies that continue to grow in the wrong place can cause a tube to rupture and cause internal bleeding — a medical emergency that requires immediate attention. 

What are ectopic pregnancy symptoms?

Ectopic pregnancies often start off feeling like any other pregnancy. You may experience typical pregnancy symptoms like nausea or food aversions, heightened smell, and breast tenderness. Your body also begins making the pregnancy hormone hCG, the hormone detected on home pregnancy tests. But as the pregnancy grows in a location outside of the uterus, it can cause abnormal symptoms, such as: 

  • Side pain

  • Low back pain

  • Mild pain in the low belly

  • Abnormal vaginal bleeding

If the pregnancy causes a fallopian tube to burst, severe symptoms occur — and they need to be treated right away. The warning signs of a ruptured tube include: 

  • Shoulder pain

  • Dizziness, weakness, or fainting

  • Sudden, severe pain in the abdomen or pelvis

If you have a positive pregnancy test and experience any of these symptoms (especially a combination), report them to your OB/GYN. A healthcare provider can direct you to the next course of action, such as an ultrasound for ectopic pregnancy. 

woman rubbing her shoulder

Are ultrasounds necessary for ectopic pregnancies?

To diagnose an ectopic pregnancy, your doctor may perform a pelvic exam and run tests. During a pelvic exam, your doctor palpates internal organs to try to locate the ectopic mass. This helps confirm the location of the pregnancy and determine the next steps. However, it’s estimated that over half of the time, OB/GYNs are unable to feel an ectopic mass during a pelvic exam.  

For this reason, an ultrasound is the preferred diagnostic imaging study for ectopic pregnancy. Imaging can either be done using a transabdominal (over the belly) or transvaginal (through the vagina) ultrasound. This test uses sound waves to provide a visual of internal structures. 

To confirm the diagnosis, your doctor may also measure blood hCG levels. Hormones are expected to increase as the pregnancy progresses, so trending the numbers over time can provide more information about the status of the pregnancy.

How early can you get an ectopic pregnancy ultrasound?

You may start having signs of ectopic pregnancy at four weeks — around the time of a missed period — and before you know about the pregnancy. This can make symptoms hard to differentiate from menstrual cramps, implantation bleeding, or other pregnancy symptoms. It’s important to trust your instincts and report any abnormal findings to your doctor during pregnancy. 

Your doctor will determine when you can get an ultrasound based on how far along you are. In general, an ultrasound for ectopic pregnancy usually takes place five to six weeks after conception. Timing depends on factors like your symptoms and past medical history. 

Try to have the following information ready for the nurse or doctor at your OB/GYN office:

  • The first day of your last menstrual period

  • Date of conception if you know it (for example, the date of an IUI procedure or IVF transfer)

  • The symptoms you’re experiencing and when they started

  • Any ectopic pregnancy risk factors you may have, such as previous pelvic surgeries, endometriosis, or pelvic inflammatory disease

If it’s too early for an ultrasound, your doctor will monitor hCG levels every few days until it’s determined that an ultrasound is appropriate.

What to expect during an ectopic pregnancy ultrasound 

During an ultrasound for ectopic pregnancy, your doctor or ultrasound tech will likely do a transvaginal ultrasound, which helps see the uterus, ovaries, tubes, and cervix. During this test, a wand-like device is placed into the vagina. While it may cause a little discomfort, it’s the preferred way to locate the pregnancy.

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Alternatively, you can have an abdominal ultrasound, which also provides a visual of internal organs and checks for internal bleeding. For this type of scan, you can expect to feel cold gel and a little pressure over your belly while the healthcare provider does the imaging. 

How are ectopic pregnancies treated?

Ectopic pregnancy ultrasound findings can help inform the next steps in your treatment plan. They’re either treated with medication or surgery. The standard medical treatment is methotrexate, which stops cells from growing and allows your body to absorb the pregnancy over the course of four to six weeks. Your doctor will monitor hCG levels to ensure the treatment is effective.

Ectopic pregnancy surgery is necessary if there’s a risk of a ruptured tube. Surgery is performed laparoscopically through one of the following methods:

  • Salpingostomy, where the ectopic tissue is removed

  • Salpingectomy, where the ectopic tissue is removed along with the tube

doctor consulting with a patient about ectopic pregnancy

Taking care of yourself after an ectopic pregnancy 

Getting an ectopic pregnancy ultrasound is an important step in getting the correct diagnosis and treatment. Everyone’s path to recovery after an ectopic pregnancy is different — and it’s important to heal in a way that works for you. 

Physical recovery can take time as your body returns to its pre-pregnancy state. As hormones fluctuate, it can also take a few cycles for your menstrual cycle to get back to normal. For many women, the emotional recovery is significant. You may experience a whirlwind of emotions, from sadness to anger, and even confusion. Allow yourself to grieve and elicit the support of family, friends, and professional help as you navigate pregnancy loss. 

*Medical Disclaimer: The content in this article is provided for informational purposes only. It is not intended to prevent, diagnose, treat, or cure any health conditions. It’s not a substitute for professional medical advice or consultation. Talk to your doctor before making changes to your healthcare regimen.

Alexa Davidson is a registered nurse and freelance health writer. She’s written for various women’s health companies, covering topics like natural hormone balance, fertility, and disease prevention. On her own fertility journey, Alexa has experienced profound loss and is passionate about supporting others with similar experiences. When she’s not researching or writing, Alexa can be found in the kitchen, where her specialty is making healthy versions of comfort foods. Nashville Hot Tofu, anyone?