Ectopic pregnancy and miscarriage: diagnosis and initial management | finding-out-whats-wrong-at-your-gp-surgery | Information for the public | NICE
Next Finding out what s wrong at your GP surgery Signs and symptoms of early pregnancy problems, including ectopic pregnancy If your GP tells you to wait Finding out what's wrong at your GP surgery Signs and symptoms of early pregnancy problems, including ectopic pregnancy
If you are having signs and symptoms of early pregnancy problems, your doctor will want to find out what is causing them. For example, it may mean you are having a miscarriage or have an ectopic pregnancy.
An ectopic pregnancy is where the baby develops outside of the womb, usually in the fallopian tubes (which lie between the womb and the ovaries). It is very important to make an accurate diagnosis of an ectopic pregnancy because if left untreated it can rupture and cause serious complications. Ectopic pregnancy can be mistaken for other conditions because the symptoms are sometimes similar – for example, a stomach upset or urinary infection. But in the case of an ectopic pregnancy, there will be a positive pregnancy test. Therefore, if you have gone to see your GP with symptoms and you haven't taken a pregnancy test recently, your GP may offer you one because they want to rule out an ectopic pregnancy. Common signs and symptoms of an ectopic pregnancy can include pain or tenderness (or both) in the abdomen or pelvis, 1 or more missed periods and vaginal bleeding. Other symptoms can include a fast heartbeat (over 100 beats a minute), dizziness or fainting.
If you have pelvic tenderness or pain and abdominal tenderness and your GP thinks you may have an ectopic pregnancy, he or she should refer you straight away to an early pregnancy assessment service for further tests. If it is outside of working hours and the service is closed you should be able to go to an out-of-hours gynaecology service, such as a hospital gynaecology ward. There is more information on early pregnancy assessment services in Finding out what's wrong at an early pregnancy assessment service.
You may also be offered an appointment at an early pregnancy assessment service if you have symptoms suggesting early pregnancy problems and you are at least 6 weeks pregnant or it's not clear how long you have been pregnant.
If you are offered an appointment at an early pregnancy assessment service you should be told why, and what to expect when you get there.
If you have symptoms or signs of early pregnancy problems when you visit an accident and emergency department or antenatal service, the doctor, midwife or nurse will also be able to refer you to an early pregnancy assessment service.
You may need to go straight to an accident and emergency department if your blood pressure is very low or your GP is very concerned about the level of pain or bleeding. If your GP tells you to wait
It is often difficult to know how the pregnancy is going to progress if you identify problems before 6 weeks. Therefore, if you are bleeding but not in pain your GP should advise you to take a home pregnancy test after 7–10 days. You should return if the test shows that you are pregnant, or your symptoms continue. If symptoms get worse you will need to return sooner. If you return to your GP and he or she thinks you may have an ectopic pregnancy or are having a miscarriage, you should be referred to an early pregnancy assessment service. A negative pregnancy test means that the pregnancy has miscarried. If you have had a miscarriage you should be given information on where to get support and help from counselling services.
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