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Ectopic Pregnancy

Table of Contents

Ectopic Pregnancy

Abdominal Pregnancy; Cervical Pregnancy; Extrauterine Pregnancy; Tubal Pregnancy

An ectopic pregnancy happens when a fertilized egg settles and grows in a place other than your uterus. Most happen in the fallopian tube, but can happen in the ovary, cervix, or abdominal cavity. Ectopic pregnancy is a dangerous condition that must receive prompt medical treatment. Know the symptoms to watch for.

Tubal Pregnancy with embryo

Image by Ed Uthman, MD

About

Reproductive system - Ectopic pregnancy

Image by Laboratoires Servier/Wikimedia

Reproductive system - Ectopic pregnancy

Ectopic pregnancy

Image by Laboratoires Servier/Wikimedia

What Is an Ectopic Pregnancy?

The uterus, or womb, is the place where a baby grows when a woman is pregnant. If you have an ectopic pregnancy, the fertilized egg grows in the wrong place, outside the uterus, usually in the fallopian tubes. The result is usually a miscarriage.

Ectopic pregnancy can be a medical emergency if it ruptures. Signs of ectopic pregnancy include

Abdominal pain
Shoulder pain
Vaginal bleeding
Feeling dizzy or faint

Get medical care right away if you have these signs. Doctors use drugs or surgery to remove the ectopic tissue so it doesn't damage your organs. Many women who have had ectopic pregnancies go on to have healthy pregnancies later.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (14)

Ectopic Pregnancy

Ectopic Pregnancy. This is an edited version of the source image made for use in the "Anatomist" iOS and Android app and shared here under the terms of the source image's Share Alike Creative Commons license.

Image by BruceBlaus/Wikimedia

Ectopic pregnancy. Eight week embryo with placenta is in the left Fallopian tube

Watercolor illustration of ectopic pregnancy. Eight week embryo with placenta is in the left Fallopian tube.

Image by Bonnie Urquhart Gruenberg

Ectopic pregnancy

Transvaginal ultrasonography of an ectopic pregnancy, showing the field of view in the following image.

Image by Mikael Haggstrom, from original by BruceBlaus

Tubal Pregnancy with embryo

This photo of an opened oviduct with an ectopic pregnancy features a spectacularly well preserved 10-millimeter embryo. It is uncommon to see any embryo at all in an ectopic, and for one to be this well preserved (and undisturbed by the prosector's knife) is quite unusual. Even an embryo this tiny shows very distinct anatomic features, including tail, limb buds, heart (which actually protrudes from the chest), eye cups, cornea/lens, brain, and prominent segmentation into somites. The gestational sac is surrounded by myriad chorionic villi resembling elongated party balloons. This embryo is about five weeks old (or seven weeks in the biologically misleading but eminently practical dating system used in obstetrics).

Image by Ed Uthman, MD

Ectopic pregnancy

Ectopic / Tubal Pregnancy : This is a diagram of an Ectopic pregnancy, showing the fetus in the fallopian tube.

Image by Takatakatakumi

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Human Embryo -found in a ruptured ectopic pregnancy case.

An intact human embryo at 6-week embryonic age (or 8-week gestational age), found in a ruptured ectopic pregnancy case.

Image by Dr. Vilas Gayakwad/Wikimedia

Ectopic pregnancy

Video by Osmosis/YouTube

Ectopic Pregnancy Overview

Video by eMedTV/YouTube

Ectopic Pregnancy

Video by Nils Grønningsæter/YouTube

What is Ectopic Pregnancy?

Video by Cleveland Clinic/YouTube

Medical Videos - Ectopic Pregnancy - Obstetrics and Gynecology

Video by darsh Mm/YouTube

Ectopic Pregnancy - What You Need To Know

Video by Rehealthify/YouTube

Ectopic Pregnancy, Animation

Video by Alila Medical Media/YouTube

Ectopic Pregnancy - Overview (pathophysiology, signs and symptoms, treatment, investigations)

Video by Armando Hasudungan/YouTube

Ectopic Pregnancy

BruceBlaus/Wikimedia

Ectopic pregnancy. Eight week embryo with placenta is in the left Fallopian tube

Bonnie Urquhart Gruenberg

Ectopic pregnancy

Mikael Haggstrom, from original by BruceBlaus

Tubal Pregnancy with embryo

Ed Uthman, MD

Ectopic pregnancy

Takatakatakumi

Sensitive content

This media may include sensitive content

Human Embryo -found in a ruptured ectopic pregnancy case.

Dr. Vilas Gayakwad/Wikimedia

5:40

Ectopic pregnancy

Osmosis/YouTube

1:24

Ectopic Pregnancy Overview

eMedTV/YouTube

1:06

Ectopic Pregnancy

Nils Grønningsæter/YouTube

1:57

What is Ectopic Pregnancy?

Cleveland Clinic/YouTube

1:31

Medical Videos - Ectopic Pregnancy - Obstetrics and Gynecology

darsh Mm/YouTube

1:31

Ectopic Pregnancy - What You Need To Know

Rehealthify/YouTube

3:46

Ectopic Pregnancy, Animation

Alila Medical Media/YouTube

10:37

Ectopic Pregnancy - Overview (pathophysiology, signs and symptoms, treatment, investigations)

Armando Hasudungan/YouTube

What Is an Ectopic Pregnancy?

Ectopic pregnancy

Image by Takatakatakumi

Ectopic pregnancy

Ectopic / Tubal Pregnancy : This is a diagram of an Ectopic pregnancy, showing the fetus in the fallopian tube.

Image by Takatakatakumi

What Is an Ectopic Pregnancy?

During ovulation, an egg (ovum) is released from one of the ovaries. Conception occurs when the egg meets a sperm in the fallopian tube. Normally, the fertilised egg moves down the fallopian tube and into the uterus (womb) to implant in the uterine lining (endometrium).

Ectopic pregnancy is a pregnancy that develops outside the uterus, usually in one of the fallopian tubes. In almost all cases, the embryo dies. The developing placenta cannot access a rich blood supply and the fallopian tube is not large enough to support the growing embryo.

In around 15 per cent of cases, the tube ruptures, causing pain, internal bleeding and shock. This is a medical emergency needing immediate surgery and, in some cases, a blood transfusion. In an emergency, call triple zero (000) for an ambulance or go immediately to the nearest hospital emergency department.

An ectopic pregnancy can also develop in the cervix (entrance to the womb), the abdominal cavity and the ovary itself, but these cases are rare. Around 5 in 1,000 pregnancies are ectopic.

Source: Department of Health, State Government of Victoria, Australia

Risk Factors

Around 1 in 50 pregnancies are ectopic

Image by StoryMD

Around 1 in 50 pregnancies are ectopic

Ectopic pregnancies occur when the fertilized egg implants and develops outside of the uterus. This almost always happens in one of the fallopian tubes (a tubal pregnancy), but it may also implant in the cervix, ovary, or even the abdomen.

Image by StoryMD

What Are the Risk Factors for Ectopic Pregnancy?

Ectopic pregnancy is caused by a fertilised egg not being able to move through the fallopian tube. This can be caused by a blockage in the tube or because the tiny hairs inside the tube are not able to sweep the fertilised egg towards the uterus.

Factors that can increase a woman’s risk of having an ectopic pregnancy include:

successful reversal of a tubal sterilisation
endometriosis
past infection with PID or salpingitis (inflammation of the fallopian tubes) and associated scarring
defects of the fallopian tube
use of assisted reproductive technologies
past ectopic pregnancy
damage to the fallopian tube caused by a ruptured appendix.

Source: Department of Health, State Government of Victoria, Australia

Causes

Intrauterine device

Image by Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436

Intrauterine device

X Intrauterine Device (IUD)

Image by Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436

What Causes Ectopic Pregnancy?

The contraceptives currently available in Australia do not increase the risk of ectopic pregnancy. However, of pregnancies that occur while using contraception, a percentage are ectopic. These include around:

5 per cent in women using copper IUDs or progestogen-only pills (mini pills)
10 per cent in women using the contraceptive implant
up to 50 per cent in women using hormone-releasing IUDs.

If a pregnancy occurs as a result of a failed tubal sterilisation, there is also a higher risk that it will be ectopic, but the percentage is unknown.

Because implants and IUDs are extremely effective methods of contraception and pregnancy is highly unlikely, these methods can be used in women with a past history of ectopic pregnancy. The progestogen-only pill can also be considered. Women who use these forms of contraception need to be aware of the symptoms of ectopic pregnancy.

Source: Department of Health, State Government of Victoria, Australia

Symptoms

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Female Experiencing Pelvic Pain

Image by TheVisualMD

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Female Experiencing Pelvic Pain

Three-dimensional visualization reconstructed from scanned human data. Lateral view of seated female figure holding abdomen as a result of pelvic pain, with bones, uterus, and vagina visible. Pelvic pain can result from problems such as uterine fibroids (benign muscular tumors of the uterine wall), endometriosis (the uterine lining grows outside of the uterus), vaginismus (uncontrolled spasming of the outer vagina), and dyspareunia, or pain during sex. Dysparenunia is one of the three most common forms of female sexual dysfunction, along with lack of interest in sex and inability to achieve orgasm. The most common form of dyspareunia is vulvar vestibulitis syndrome (VVS), where women are extremely sensitive to sensation on the vulva or surrounding glands, and particularly to penetration.

Image by TheVisualMD

What Are Signs and Symptoms of Ectopic Pregnancy?

The symptoms of ectopic pregnancy can mimic miscarriage or the symptoms of other reproductive disorders, such as pelvic inflammatory disease (PID) or endometriosis. An ectopic pregnancy can first appear as a normal pregnancy.

The symptoms of ectopic pregnancy can include:

the usual signs of pregnancy, such as amenorrhoea (missed period), morning sickness and breast tenderness
pain in the lower abdomen
pain in the lower back
cramps on one side of the pelvis
vaginal bleeding or spotting
sudden and severe pain in the lower abdomen (if the fallopian tube ruptures).

Source: Department of Health, State Government of Victoria, Australia

Diagnosis

Cervical pregnancy

Image by Mikael Haggstrom

Cervical pregnancy

Cervical pregnancy

Image by Mikael Haggstrom

How Is Ectopic Pregnancy Diagnosed?

Around 15 per cent of cases of ectopic pregnancy are diagnosed in the emergency room after the fallopian tube has ruptured. In most cases, ectopic pregnancy can be diagnosed using a range of tests, some of which are standard medical procedures for all pregnant women, including:

pelvic examination
blood tests
ultrasound
laparoscopy (‘keyhole’ surgery).

Source: Department of Health, State Government of Victoria, Australia

Pelvic Exam

Pelvic Exam

Also called: Pelvic Examination, Gynecological Exam

A pelvic exam is a doctor's visual and physical examination of a woman's reproductive organs. The exam may be performed as part of a regular checkup or can be done to investigate symptoms such as abnormal bleeding, unusual vaginal discharge, or pain. Pelvic exams are also done during pregnancy check-ups.

Pelvic Exam

Also called: Pelvic Examination, Gynecological Exam

A pelvic exam is a doctor's visual and physical examination of a woman's reproductive organs. The exam may be performed as part of a regular checkup or can be done to investigate symptoms such as abnormal bleeding, unusual vaginal discharge, or pain. Pelvic exams are also done during pregnancy check-ups.

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Use the slider below to see how your results affect your health.
Your result is Normal.
A normal result means that the uterus and ovaries are normal in size and location. The uterus can be moved slightly without causing pain. The vulva, vagina, and cervix look normal with no signs of infection, inflammation, or other abnormalities.
Related conditions
1. Pelvic Exam. NCI's Dictionary of Cancer Terms [accessed on Oct 03, 2021]
2. Pelvic Exam: Preparation, Process, and More. Healthline. [accessed on Oct 03, 2021]
3. What Is a Pelvic Exam? | Questions About Gynecology Exams. Planned Parenthood. [accessed on Jan 15, 2022]
4. Pelvic Exam | Michigan Medicine [accessed on Jan 15, 2022]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (10)

A cervical screening test - What can you expect?

Video by Healthchanneltv / cherishyourhealthtv/YouTube

How can I deal with the fear of getting a pelvic exam in the doctor's office?

Video by IntermountainMoms/YouTube

Dr. Doe's Pelvic Exam

Video by sexplanations/YouTube

Pelvic Exam Illustration

Line drawing showing pelvic exam procedure.

Image by National Cancer Institute / Unknown Illustrator

Pelvic Exam

Leopold maneuvers

Image by Christian Gerhard Leopold

Screening for Cancer

Common Screening Tests and American Cancer Society Recommendations Breast cancer Mammography: Women 40 and older should have a mammogram every year. Clinical breast exam (breast exam performed by a medical professional): Women age 20-40 should have one every 3 years. Women 40 and older should have one every year. Breast self-exam: Women age 20 and older should perform one each month (considered optional). If you have a family history of breast cancer, talk to your healthcare professional about what type of screening you should have, and how often.

Image by TheVisualMD

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Healthy Cervix

The cervix is the lower portion of the uterus where it joins with the top of the vagina. The opening of the the cervix into the vagina is called the external os, and can vary in appearance from a small, circular opening in women who have not given birth, to a wider, more slit-like opening in women who have had children. Human papillomavirus (HPV) is associated with an increased risk of cervical cancer. Women should be screened for cellular changes of the cervix with a pap smear as part of a regular pelvic exam. Human papillomavirus (HPV) is a large group of related viruses that are often sexually transmitted. Most infections clear up quickly and cause few problems, though HPV can cause genital warts. Infection by certain types of HPV, however, can lead to cervical cancer. In 2006, the FDA approved an HPV vaccine (Gardisil) that protects against viral types that cause most cases of cervical cancer as well as genital warts. Public health experts recommend routine vaccination for girls ages 11-12 to ensure vaccine effectiveness.

Image by TheVisualMD

Uterus and Ovaries in Ultrasound

Ovarian cancer is the deadliest of gynecologic cancers. More than 21,000 new cases of ovarian cancer are diagnosed each year, with more than 15,000 deaths; less than 20% of cases are found at an early stage, when treatment is most effective. When ovarian cancer is suspected, a doctor will typically perform a pelvic exam to check for masses or growths on the ovaries. Other diagnostic tests include a transvaginal ultrasound, which produce detailed images of the ovaries and other reproductive organs.

Image by TheVisualMD

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Pap Test: Pap Smear (Pap Test)

A Pap smear, also called a Pap test, is a procedure to test for cervical cancer as well as a number of different types of infections. The test involves collecting cells from the cervix. A speculum is inserted into the vagina, and samples of cervical cells are collected and examined under a microscope for abnormalities. Detecting cervical cancer early with a Pap smear gives women a greater chance of being cured. A Pap smear can also detect changes in cervical cells that suggest cancer may develop in the future. The Pap smear is usually done in conjunction with a pelvic exam. In women over 30, the Pap smear may be combined with a test for human papillomavirus (HPV), a common sexually transmitted infection that may cause cervical cancer in some women.

Image by TheVisualMD

Women's Health Checkup

Doctors Examining Pregnant Woman

Image by Israel Defense Forces

2:13

A cervical screening test - What can you expect?

Healthchanneltv / cherishyourhealthtv/YouTube

2:21

How can I deal with the fear of getting a pelvic exam in the doctor's office?

IntermountainMoms/YouTube

5:45

Dr. Doe's Pelvic Exam

sexplanations/YouTube

Pelvic Exam Illustration

National Cancer Institute / Unknown Illustrator

Pelvic Exam

Christian Gerhard Leopold

Screening for Cancer

TheVisualMD

Sensitive content

This media may include sensitive content

Healthy Cervix

TheVisualMD

Uterus and Ovaries in Ultrasound

TheVisualMD

Sensitive content

This media may include sensitive content

Pap Test: Pap Smear (Pap Test)

TheVisualMD

Women's Health Checkup

Israel Defense Forces

Ultrasound

Pelvic Ultrasound - Female

Also called: Gynecological Scan, Gynecologic Ultrasound, Female Pelvic Scan, Female Pelvic Sonography, Transabdominal Female Pelvic Ultrasound, Transvaginal Ultrasound, Endovaginal Ultrasound

A female pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a woman’s pelvis, including the uterus, cervix, fallopian tubes, ovaries, vagina, and bladder.

Pelvic Ultrasound - Female

Also called: Gynecological Scan, Gynecologic Ultrasound, Female Pelvic Scan, Female Pelvic Sonography, Transabdominal Female Pelvic Ultrasound, Transvaginal Ultrasound, Endovaginal Ultrasound

A female pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a woman’s pelvis, including the uterus, cervix, fallopian tubes, ovaries, vagina, and bladder.

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Use the slider below to see how your results affect your health.
Your result is Normal.
This means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.
Related conditions
Your doctor may want to order a female pelvic ultrasound to diagnose and assist in the treatment of a wide variety of conditions, such as:
- Abnormalities in the structure of the uterus and endometrium (lining of the uterus)
- Abnormalities in the structure of the ovaries
- Growths such as fibroid tumors, cysts, and other types of tumors within the pelvis
- Pelvic inflammatory disease (PID, which is an infection of your uterus, fallopian tubes, or ovaries)
- Ectopic pregnancy (pregnancy that occurs outside of the uterus)
- Abnormal bleeding or pelvic pain
- Postmenopausal bleeding
- Find an intrauterine contraceptive device (IUD)
- As part of the work-up for infertility and assisted reproduction techniques
A normal result means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.
An abnormal result indicates that a problem was detected, including but not limited to:
- Fibroid tumors
- Cysts
- Ovarian torsion
- Pelvic masses
- Pelvic inflammatory disease
- Ectopic pregnancy
- Miscarriage
- Free liquid in the pelvic cavity
- Endometrial hyperplasia, which is a thickening of the endometrium
1. Pelvic Ultrasound: Purpose, Procedure, Risks, Results [accessed on Dec 27, 2018]
2. Pelvic Ultrasound [accessed on Dec 27, 2018]
3. Pelvic Ultrasound | Johns Hopkins Medicine Health Library [accessed on Dec 27, 2018]
4. Transvaginal Ultrasound: Purpose, Procedure, and Results [accessed on Dec 27, 2018]
5. Pelvic Ultrasound - StatPearls - NCBI Bookshelf [accessed on Dec 27, 2018]
6. HEM Ultrasound | Female Pelvic Ultrasound [accessed on Dec 27, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (1)

What to Expect From a Female Pelvic Ultrasound Exam

Video by RAYUS Radiology™/YouTube

2:19

What to Expect From a Female Pelvic Ultrasound Exam

RAYUS Radiology™/YouTube

hCG Blood Test

Pregnancy Test

Also called: Human Chorionic Gonadotropin Test, HCG Test, HCG total OB

A pregnancy test can tell whether you're pregnant by checking a urine or blood sample for hCG, a hormone made during pregnancy. HCG levels can first be detected by a blood test about 11 days after conception and about 14 days after conception by a urine test.

Pregnancy Test

Also called: Human Chorionic Gonadotropin Test, HCG Test, HCG total OB

A pregnancy test can tell whether you're pregnant by checking a urine or blood sample for hCG, a hormone made during pregnancy. HCG levels can first be detected by a blood test about 11 days after conception and about 14 days after conception by a urine test.

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Use the slider below to see how your results affect your health.
(mi.U.)/mL
5
25
Your result is Negative.
Normal levels of the hCG hormone in women who are not pregnant.
Related conditions
{"label":"hCG (urine) reference range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"If you have a negative result, you should consider these results to be uncertain, as they may indicate a false negative. Until you can be sure that you\u2019re not pregnant, you should be cautious and avoid doing anything that could hurt a developing fetus.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"If you have a positive result, it means that the test detected hCG in your urine. Your next step should be to consult your doctor. They can confirm pregnancy with an exam and additional testing, if necessary.","conditions":["Pregnancy"]}],"value":0.5,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your health.
Your result is Negative.
If you have a negative result, you should consider these results to be uncertain, as they may indicate a false negative. Until you can be sure that you’re not pregnant, you should be cautious and avoid doing anything that could hurt a developing fetus.
Related conditions
You may need this test if you think you're pregnant. Symptoms of pregnancy vary from person to person. The most common sign of early pregnancy is a missed period. Other common signs of early pregnancy may include:
- Swollen, tender breasts
- Fatigue
- Frequent need to urinate (pee)
- Nausea and vomiting (also called morning sickness)
- Feeling bloated or swollen in your abdomen (belly) or body
If you need to have medical treatment that could harm an unborn baby, you may also need a pregnancy test to make sure that you aren't pregnant.
Home pregnancy tests are quick and easy to use. You can buy a home pregnancy test kit without a prescription. The kits include test sticks or strips that react to hCG in your urine. The steps for doing a test depend on the brand, so it's very important to follow the instructions that come with your test. For most test kits, you'll either:
- Hold the test stick or strip in your urine stream
- Collect your urine in a cup and dip the test stick or strip into the cup
After waiting a certain number of minutes, you'll check your results on the test stick or strip. The instructions will tell you what to look for. In general, to get the most accurate results with any home pregnancy test, you'll need to:
- Check the expiration date before you use the test.
- Test your first morning urine. Morning urine usually has more hCG than urine later in the day.
- Use a timer. If you guess the timing, your results may not be accurate.
Blood tests are done at your provider's office or a lab. A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This process usually takes less than five minutes.
Most pregnancy tests simply measure whether or not you have hCG in your sample. But certain pregnancy tests also measure how much hCG you have. These tests are called quantitative hCG tests, and they're usually done on blood samples.
The amount of hCG in your body can give your provider important information about your pregnancy and the health of your unborn baby. Quantitative hCG tests are sometimes used to help:
- Find out the age of the fetus if you're very early in your pregnancy
- Monitor your pregnancy if you have a high risk of miscarriage
- Check for certain problems, such as:
  Ectopic pregnancy, which is a fertilized egg that tries to grow outside of the uterus. The egg cannot grow into a baby when it's in the wrong place. It must be removed to avoid damage to your organs. This can be a medical emergency.
  Molar pregnancy (hydatidiform mole), which is an abnormal growth of tissue in the uterus. It's caused by a fertilized egg with such severe genetic problems that it cannot become a baby. The growth can turn into cancer and must be removed.
  Problems in the unborn baby, including Down syndrome, other chromosome problems, and certain birth defects (hCG testing is usually part of a group of prenatal screening tests called a "triple" or "quadruple" screen test.)
Your provider may also order a quantitative hCG blood test to help diagnose or monitor health conditions that aren't related to pregnancy. These include ovarian and testicular cancer along with other conditions that can increase hCG levels.
1. Pregnancy Test: MedlinePlus Medical Test [accessed on Feb 29, 2024]
2. Quest Diagnostics: hCG, Total, Quantitative [accessed on Sep 12, 2018]
3. Possible Meanings of a High hCG Level in Pregnancy [accessed on Sep 12, 2018]
4. American Pregnancy: Human Chorionic Gonadotropin (hCG): The Pregnancy Hormone [accessed on Sep 12, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (41)

hCG testing for pregnancy

Diagram of typical immunoassay home pregnancy test which detects human chorionic gonadotropin (hCG). (A) A urine sample is applied to the stick. If pregnant, this should contain hCG. (B) As the sample is absorbed into the stick it goes through free dye-labeled antibodies that recognize and stick to hCG. (C) An anchored set of antibodies stick to and capture hCG molecules (and the attached dye-labeled antibodies), creating the first line. In the "not pregnant" sample no hCG is attached to the dye-labeled antibodies, so they wash past this point and no line appears. (D) A second anchored set of antibodies captures the dye-labeled antibodies, providing a positive control to indicate that the test is working properly.

Image by Madprime

Human Chorionic Gonadotropin (hCG): hCG Levels Increase Over Time

hCG testing for pregnancy is available to women of child-bearing age. The \"quad\" screen, of which hCG is a component, is especially recommended for women with higher-risk pregnancies as indicated by factors such as maternal age, family history, and disease history. Levels can first be detected by a blood test about 11 days after conception and about 12-14 days after conception by a urine test. In general the hCG levels will double every 72 hours. The level will reach its peak in the first 8-11 weeks of pregnancy and then will decline and level off for the remainder of the pregnancy.

Image by TheVisualMD

PAPP-A: PAPP-A Screening Tests

The PAPP-A screen is administered as a first-trimester screen integrated with an hCG test and nuchal translucency (NT) ultrasound. The test screens for chromosomal abnormalities such as Down syndrome and trisomy 18. The image featured here shows an ultrasound image of a fetus suspected to have down syndrome. The areas of concern are highlighted in yellow.

Image by TheVisualMD

Human Chorionic Gonadotropin (hCG)

In the very earliest stages of pregnancy, a developing placenta begins to secrete human chorionic gonadotropin (hCG). The hormone enters maternal circulation once an embryo is implanted in the endometrium, shown in this image. hCG testing is used widely to detect pregnancy. Because hCG levels begin to rise immediately after conception, the test enables accurate, early detection.

Image by TheVisualMD

Hormonal Regulation of Growth

Image by OpenStax College

How do pregnancy tests work? - Tien Nguyen

Video by TED-Ed/YouTube

How Pregnancy Tests Work (Pregnancy Health Guru)

Video by Healthguru/YouTube

How to Take a Clear Blue Pregnancy Test | Parents

Video by Parents/YouTube

How Accurate are Pregnancy Tests? | Pregnancy Questions | Parents

Video by Parents/YouTube

Focus on Health: Quad Screen

Video by Virginia Women's Center/YouTube

Graph of the levels of estrogen, progesterone, beta-hcg throughout pregnancy

Graph of the levels of estrogen, progesterone, beta-hcg throughout pregnancy

Image by osmosis

Fallopian Tube and Ovary - Upon fertilization, the egg secretes a hormone called human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick uterine lining of the womb.

Fallopian Tube and Ovary: Medical visualization of a cross-section of the ovary, as well as the associated fallopian tube; seen inside the cross-section are a developing follicle, corpus luteum, and corpus albicans. The ovaries are the site of egg production and maturation within the human female. Each month, an oocyte is ejected from a mature follicle to the surface of one of the two ovaries. This event is called ovulation. The finger-like projections of the fallopian tube (fimbriae) sweep up the oocyte into the duct where it awaits fertilization. The remains of the ruptured follicle in the ovary are transformed into a structure called the corpus luteum. Upon fertilization, the egg secretes a hormone called human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick uterine lining of the womb. If fertilization does not occur, the corpus luteum degenerates into a corpus albicans, which is essentially scar tissue and is mostly comprised of collagen.

Image by TheVisualMD

Sensitive content

This media may include sensitive content

Ooctye Erupting from Ovary

Visualization of an oocyte erupting from the surface of the ovary. The ovary, which is suspended by the ovarian ligament, is seen in cross section. Revealed are the ovarian follicles which are oocytes in various stages of maturation. Each month, one of the mature follicles ejects it's oocyte through the surface of the ovary. This event is called ovulation. The finger-like projections of the fallopian tube sweep up the oocyte into the duct where it awaits fertilization. Meanwhile, the remains of the ruptured follicle in the ovary are transformed into a structure called the corpus luteum which eventually degenerates if fertilization does not occur. If fertilized, however, the egg secretes the a hormone called human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick uterine lining of the womb.

Image by TheVisualMD

Pregnancy-associated plasma protein A

PAPP-A Screening Tests : The PAPP-A screen is administered as a first-trimester screen integrated with an hCG test and nuchal translucency (NT) ultrasound. The test screens for chromosomal abnormalities such as Down syndrome and trisomy 18. The image featured here shows an ultrasound image of a fetus suspected to have down syndrome. The areas of concern are highlighted in yellow.

Image by TheVisualMD

Ectopic pregnancy

Human Embryo (7th week of pregnancy, 5th week p.o.) This photo of an opened oviduct with an ectopic pregnancy features a spectacularly well preserved 10-millimeter embryo. It is uncommon to see any embryo at all in an ectopic, and for one to be this well preserved (and undisturbed by the prosector's knife) is quite unusual. Even an embryo this tiny shows very distinct anatomic features, including tail, limb buds, heart (which actually protrudes from the chest), eye cups, cornea/lens, brain, and prominent segmentation into somites. The gestational sac is surrounded by myriad chorionic villi resembling elongated party balloons. This embryo is about five weeks old (or seven weeks in the biologically misleading but eminently practical dating system used in obstetrics). The photo was taken on Kodak Elite 200 slide film, with a Minolta X-370 camera and 100mm f/4 Rokkor bellows lens at near-full extension. The formalin-fixed specimen was immersed in tap-water and pinned to a tray lined with black velvet. The exposure was 1/4 second at f/8.

Image by Ed Uthman, MD

Ectopic pregnancy

Schematic drawing of various types of ectopic pregnancy. N=normal nidation a=peritoneal (abdominal) pregnancy b=cornual pregnancy c=isthmic tubal pregnancy d=ampullar tubal pregnancy e=fimbric tubal pregnancy f=ovarial pregnancy g=cervical pregnancy h=intramural pregnancy

Image by Hic et nunc

Ectopic pregnancy

Transvaginal ultrasonography of an ectopic pregnancy, showing the field of view in the following image.

Image by Mikael Haggstrom, from original by BruceBlaus

Pre-Embryonic Cleavages

Pre-embryonic cleavages make use of the abundant cytoplasm of the conceptus as the cells rapidly divide without changing the total volume.

Image by CNX Openstax

Pre-Embryonic Development

Ovulation, fertilization, pre-embryonic development, and implantation occur at specific locations within the female reproductive system in a time span of approximately 1 week.

Image by CNX Openstax

Development of the Embryonic Disc

Formation of the embryonic disc leaves spaces on either side that develop into the amniotic cavity and the yolk sac.

Image by CNX Openstax

Germ Layers

Formation of the three primary germ layers occurs during the first 2 weeks of development. The embryo at this stage is only a few millimeters in length.

Image by CNX Openstax

Fates of Germ Layers in Embryo

Following gastrulation of the embryo in the third week, embryonic cells of the ectoderm, mesoderm, and endoderm begin to migrate and differentiate into the cell lineages that will give rise to mature organs and organ systems in the infant.

Image by CNX Openstax

Cross-Section of the Placenta

In the placenta, maternal and fetal blood components are conducted through the surface of the chorionic villi, but maternal and fetal bloodstreams never mix directly.

Image by CNX Openstax

Newborn

A single fertilized egg develops over the span of nine months into an infant consisting of trillions of cells and capable of surviving outside the womb. (credit: “Seattleye”/flickr.com)

Image by CNX Openstax (credit: “Seattleye”/flickr.com)

Placenta Previa

An embryo that implants too close to the opening of the cervix can lead to placenta previa, a condition in which the placenta partially or completely covers the cervix.

Image by CNX Openstax

Fallopian Tube and Ovary

Medical visualization of a cross-section of the ovary, as well as the associated fallopian tube; seen inside the cross-section are a developing follicle, corpus luteum, and corpus albicans. The ovaries are the site of egg production and maturation within the human female. Each month, an oocyte is ejected from a mature follicle to the surface of one of the two ovaries. This event is called ovulation. The finger-like projections of the fallopian tube (fimbriae) sweep up the oocyte into the duct where it awaits fertilization. The remains of the ruptured follicle in the ovary are transformed into a structure called the corpus luteum. Upon fertilization, the egg secretes a hormone called human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick uterine lining of the womb. If fertilization does not occur, the corpus luteum degenerates into a corpus albicans, which is essentially scar tissue and is mostly comprised of collagen.

Image by TheVisualMD

Choragon (HCG) 5000 IUs

Image by Ferring Pharmaceuticals Inc.

Prepregnancy - Stages of Pregnancy Uterus, amniotic sac and Fetal Growth 1

12 Weeks Stages of Pregnancy Uterus, amniotic sac and Fetal Growth 2

16 Weeks Stages of Pregnancy Uterus, amniotic sac and Fetal Growth 3

24 Weeks Stages of Pregnancy Uterus, amniotic sac and Fetal Growth 4

40 Weeks Stages of Pregnancy Uterus, amniotic sac and Fetal Growth 5

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2

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5

Prepregnancy / 12 Weeks / 16 Weeks / 24 Weeks / 40 Weeks

Prepregnancy - Stages of Pregnancy _ Uterus, amniotic sac and Fetal Growth 12 Weeks Stages of Pregnancy _ Uterus, amniotic sac and Fetal Growth_2 16 Weeks Stages of Pregnancy _ Uterus, amniotic sac and Fetal Growth_3 24 Weeks Stages of Pregnancy _ Uterus, amniotic sac and Fetal Growth_4 40 Weeks Stages of Pregnancy _ Uterus, amniotic sac and Fetal Growth_5

Interactive by TheVisualMD

How To Inject Low-Dose hCG | Fertility Treatment | CVS Specialty®

Video by CVS Health/YouTube

How To Inject Pregnyl® (hCG) Subcutaneously | Fertility Treatment | CVS Specialty®

Video by CVS Health/YouTube

How To Inject Pregnyl® (hCG) Intramuscularly | Fertility Treatment | CVS Specialty®

Video by CVS Health/YouTube

How high should my HCG levels be at the beginning of pregnancy?

Video by IntermountainMoms/YouTube

What level of blood Beta HCG confirms pregnancy? - Dr. Phani Madhuri

Video by Doctors' Circle - World's Largest Health Platform/YouTube

I've had positive, faint positive, and negative pregnancy tests. Do HCG levels fluctuate?

Video by IntermountainMoms/YouTube

hCG in Early Pregnancy, Explained - How Much Is Normal? - Pregnancy Q&A

Video by What To Expect/YouTube

Embryo and Fetus Development

Embryo and Fetus Development, placenta and amniotic sac

Image by TheVisualMD

Embryos at 4 to 8 Weeks

Rapid differentiation of cells and an astounding rate of growth characterize the first weeks of embryonic development. At 4 weeks, the embryo is the size of a grain of rice. Its heart has already begun to beat, and the early divisions of what will be the heart's four chambers are apparent. At 6 weeks, the embryo may be half an inch (10-14 mm) long and is starting to acquire a human face, although it is impossible to differentiate male from female embryos at this stage. An 8-week-old embryo may measure over an inch (28-30 mm) in length, and all of the body's parts-cells, tissues, organs, systems-have been differentiated.

Image by TheVisualMD

Embryo at 6 Weeks

At 6 weeks, the embryo is only about half an inch (10-14 mm) long and weighs less than a paper clip. It's possible to see the tiny embryonic heart beating. The embryo is starting to acquire a human face. The folds of the eyelids and the jaws form, and the tip of the nose can be clearly seen. Ears are developing inside and out: internally, the semicircular canals are laid down, while externally mounds of tissue erupt where the whorls of the ears will grow. The eyes become pigmented and continue their extremely complex development, as delicate eye muscles begin to form and nerve cells appear in the retina. At this point male and female fetuses look identical both internally and externally. External genital development consists of an indifferent penis, which will either form into a penis and scrotum or clitoris and labia.

Image by TheVisualMD

Positive Pregnancy Test Result

The urine is placed on the tip of the pregnancy test where it will travel up to the test region. The HCG hormone first binds to, cultured and placed, anti-HCG monoclonal antibodies with attached enzymes that will trigger a color change. Then the bonded HCG and anti-HCG antibodies will encounter another set of monoclonal anti-HCG antibodies and bind. This will cause the first color change of the test that will indicate the user is pregnant. Finally, any remaining anti-HCG monoclonal antibodies will bind to monoclonal HCG antibodies and trigger the second color change. This second color change is the control test that indicates the pregnancy test is working correctly.

Image by Melo20179

HCG and Pregnancy

HCG and Pregnancy

Image by TheVisualMD

Pregnant Woman with Fetus after Conception 0 Months three quarter view

Pregnant Woman with Fetus at 3 Months three quarter view

Pregnant Woman with Fetus at 4 Months

Pregnant Woman with Fetus at 6 Months three quarter view

Pregnant Woman with Fetus at 9 Months three quarter view

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Pregnant Woman with Fetus - 0 Months, 3 Month, 4 Month 5 Month, 9 Month

0 Months three quarter view 3 Month Pregnant Woman with Fetus 4 Month Pregnant Woman with Fetus 5 Month Pregnant Woman with Fetus 9 Month Pregnant Woman with Fetus

Interactive by TheVisualMD

hCG testing for pregnancy

Madprime

Human Chorionic Gonadotropin (hCG): hCG Levels Increase Over Time

TheVisualMD

PAPP-A: PAPP-A Screening Tests

TheVisualMD

Human Chorionic Gonadotropin (hCG)

TheVisualMD

Hormonal Regulation of Growth

OpenStax College

4:34

How do pregnancy tests work? - Tien Nguyen

TED-Ed/YouTube

2:42

How Pregnancy Tests Work (Pregnancy Health Guru)

Healthguru/YouTube

1:49

How to Take a Clear Blue Pregnancy Test | Parents

Parents/YouTube

1:48

How Accurate are Pregnancy Tests? | Pregnancy Questions | Parents

Parents/YouTube

3:08

Focus on Health: Quad Screen

Virginia Women's Center/YouTube

Graph of the levels of estrogen, progesterone, beta-hcg throughout pregnancy

osmosis

Fallopian Tube and Ovary - Upon fertilization, the egg secretes a hormone called human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick uterine lining of the womb.

TheVisualMD

Sensitive content

This media may include sensitive content

Ooctye Erupting from Ovary

TheVisualMD

Pregnancy-associated plasma protein A

TheVisualMD

Ectopic pregnancy

Ed Uthman, MD

Ectopic pregnancy

Hic et nunc

Ectopic pregnancy

Mikael Haggstrom, from original by BruceBlaus

Pre-Embryonic Cleavages

CNX Openstax

Pre-Embryonic Development

CNX Openstax

Development of the Embryonic Disc

CNX Openstax

Germ Layers

CNX Openstax

Fates of Germ Layers in Embryo

CNX Openstax

Cross-Section of the Placenta

CNX Openstax

Newborn

CNX Openstax (credit: “Seattleye”/flickr.com)

Placenta Previa

CNX Openstax

Fallopian Tube and Ovary

TheVisualMD

Choragon (HCG) 5000 IUs

Ferring Pharmaceuticals Inc.

Prepregnancy / 12 Weeks / 16 Weeks / 24 Weeks / 40 Weeks

TheVisualMD

5:46

How To Inject Low-Dose hCG | Fertility Treatment | CVS Specialty®

CVS Health/YouTube

6:06

How To Inject Pregnyl® (hCG) Subcutaneously | Fertility Treatment | CVS Specialty®

CVS Health/YouTube

6:22

How To Inject Pregnyl® (hCG) Intramuscularly | Fertility Treatment | CVS Specialty®

CVS Health/YouTube

1:40

How high should my HCG levels be at the beginning of pregnancy?

IntermountainMoms/YouTube

3:54

What level of blood Beta HCG confirms pregnancy? - Dr. Phani Madhuri

Doctors' Circle - World's Largest Health Platform/YouTube

4:07

I've had positive, faint positive, and negative pregnancy tests. Do HCG levels fluctuate?

IntermountainMoms/YouTube

1:27

hCG in Early Pregnancy, Explained - How Much Is Normal? - Pregnancy Q&A

What To Expect/YouTube

Embryo and Fetus Development

TheVisualMD

Embryos at 4 to 8 Weeks

TheVisualMD

Embryo at 6 Weeks

TheVisualMD

Positive Pregnancy Test Result

Melo20179

HCG and Pregnancy

TheVisualMD

Pregnant Woman with Fetus - 0 Months, 3 Month, 4 Month 5 Month, 9 Month

TheVisualMD

Treatment

Laparoscopic Surgery (Keyhole Surgery)

Image by U.S. Navy photo by Mass Communication Specialist Seaman Paul Polach

Laparoscopic Surgery (Keyhole Surgery)

Fleet Surgical Team 5 performs laparoscopic surgery

Image by U.S. Navy photo by Mass Communication Specialist Seaman Paul Polach

How Is Ectopic Pregnancy Treated?

A ruptured fallopian tube is a medical emergency. Laparoscopic surgery is done to remove the embryo and attempts are made to repair the fallopian tube. A blood transfusion may also be needed.

For non-emergency ectopic pregnancy, medication is often successful, but sometimes surgery is still needed. Any woman thought to have or found to have an ectopic pregnancy will need careful observation. Most women who have had an ectopic pregnancy can become pregnant again, but they will need careful follow up, as their risk of ectopic pregnancy is higher.

Source: Department of Health, State Government of Victoria, Australia

Prevention

Pelvic inflammatory disease

Image by BruceBlaus

Pelvic inflammatory disease

Pelvic inflammatory disease

Image by BruceBlaus

How Can an Ectopic Pregnancy Be Prevented?

Many cases of ectopic pregnancy are caused by scarring of the fallopian tubes. Suggestions on how to reduce your risk of fallopian tube damage include:

treating any pelvic infection promptly
treating any sexually transmissible infection (STI) promptly
avoiding STIs by always using a condom when having sex if the risk of an STI is at all possible.

Source: Department of Health, State Government of Victoria, Australia

Related HealthJournals

Miscarriage

A miscarriage is an unexpected loss of pregnancy before the 20th week of pregnancy. Most miscarriages happen very early in the pregnancy, often before a woman even knows she is pregnant. Read about symptoms and how to cope if you've suffered a miscarriage.

Pregnancy Complications

Complications of pregnancy are health problems that occur during pregnancy. They can involve the mother's health, the baby's health, or both. Some women have health problems before they become pregnant that could lead to complications. Other problems arise during the pregnancy. Learn more about common pregnancy complications and how to prevent and treat it.

Ovulation

Ovulation is the release of an egg from an ovary during the menstrual cycle. It can occur anywhere between 10 and 21 days after the first day of a woman's menstrual cycle. A woman is most fertile two days before through the day of ovulation. Learn more about ovulation, how it fits into the menstrual cycle, and how to track it.

Early Embryonic Development

A developing human is referred to as an embryo during weeks 3–8. Pre-embryonic and embryonic stages of development are characterized by cell division, migration, and differentiation. By the end of the embryonic period, all of the organ systems are structured in rudimentary form.

Dilatation and Curettage

Dilatation and curettage (D&C) is a procedure to remove tissue from inside your womb (uterus). It may be done to diagnose abnormal vaginal bleeding or after a miscarriage. Find out more about D&C and when it’s done.

Abortion

An abortion is a common medical procedure to end a pregnancy. It uses medicine or surgery to remove the embryo or fetus and placenta from the uterus. Generally speaking, the earlier in pregnancy an abortion is performed the safer it is for the woman. Read more on abortion methods, its possible risks and complications.

Uterus

The uterus is the muscular organ that nourishes and supports the growing embryo

Early Pregnancy - Ovulation, Implantation and Early Embryonic Development

From ovulation and implantation, to the first beats of a tiny developing heart. Learn more about the incredible process of human development during early pregnancy.

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Ectopic Pregnancy

An ectopic pregnancy happens when a fertilized egg settles and grows in a place other than your uterus. Most happen in the fallopian tube, but can happen in the ovary, cervix, or abdominal cavity. Ectopic pregnancy is a dangerous condition that must receive prompt medical treatment. Know the symptoms to watch for.

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