Your healthcare provider will need to perform a gentle tummy and internal examination if they think you have an ectopic pregnancy. Your healthcare provider will also check your blood pressure and heart rate and decide what investigations are needed.
If you have lower abdominal pain and vaginal bleeding, a pregnancy test should be performed even if you're taking contraception and don’t feel pregnant.
- A urine test is usually done to check for pregnancy and can easily be done by your healthcare provider.
- If the urine pregnancy test is positive then a pregnancy test is done with a blood test. This will measure the amount of a pregnancy hormone called beta-hCG.
- At the same time, your healthcare provider may also do the routine pregnancy blood tests that are performed at the beginning of a pregnancy.
Ultrasound is the best way to identify where a pregnancy is located. A pregnancy inside your uterus can usually be seen by a putting a narrow ultrasound probe into your vagina from 5 weeks after your last period. If your periods are irregular or you’re not sure how pregnant you are, the beta-hCG level can be used to estimate how far on the pregnancy should be.
Sometimes even though you have a positive pregnancy test (raised beta-hCG), an ultrasound scan might not identify a pregnancy. In this case it’s referred to as a pregnancy of unknown location (PUL). This means it could be either an early pregnancy in your uterus or an early ectopic. Because it could still be an ectopic pregnancy, close follow-up with further investigations over time are usually recommended until it’s clear whether it’s growing in your uterus or not.
If your healthcare provider is concerned that you might have an ectopic pregnancy, but decides to wait until they can be sure, it’s important that you have an emergency phone number you can call at any time and that you're not too far from a hospital. This is in case you develop light-headedness, increased pain or bleeding.