Ectopic pregnancies are diagnosed considering a variety of factors. Using ultrasound for ectopic pregnancy diagnosis is common.

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The word “ectopic” comes from a Latin word meaning “the presence of tissue or cells in an abnormal place.” When it comes to pregnancy, “ectopic” means that an embryo has implanted outside the uterine cavity, like on a fallopian tube, an ovary, or the cervix.

Ectopic pregnancies can’t proceed normally since the uterus is the only place for a developing baby to grow. Therefore, this type of pregnancy must be removed from a woman’s body.

But before it can be removed, an ectopic pregnancy must be diagnosed. This is often done with the use of ultrasound technology.

Read on to discover how ultrasound is used to detect ectopic pregnancies.

If your doctor suspects your pregnancy could be ectopic, they may begin with a pelvic exam to identify where you’re experiencing pain or have a mass. From there, you’ll likely have blood tests and, possibly, an ultrasound.

An ultrasound can be used for a definitive diagnosis of ectopic pregnancy but is typically not the only means of diagnosis. More often, a patient’s history combined with blood levels of serial quantitative β-hCG (the so-called “pregnancy hormone”) is enough to confirm this type of pregnancy.

Still, ultrasound is a useful tool for detecting ectopic pregnancy since it helps identify exactly where an embryo has implanted.

This imaging test may be performed either transvaginally or transabdominally (or sometimes both).

Transvaginal ultrasound

A transvaginal ultrasound is performed by inserting an ultrasound wand into the vagina. This wand uses sound-wave technology to capture images of your pelvic area, including the uterus, fallopian tubes, cervix, ovaries, and bladder.

While a good ultrasound technician will make every effort to make you comfortable during a transvaginal ultrasound, you can expect some discomfort from this procedure. That said, it’s a highly effective diagnostic tool.

Because a transvaginal ultrasound can look more closely than an abdominal ultrasound at the organs involved in pregnancy, it can more accurately detect when an embryo has implanted anywhere it shouldn’t — like on a fallopian tube, in the cervix, or even in a scar from a previous Caesarian section.

Transabdominal ultrasound

In addition to a transvaginal ultrasound, your doctor may also order a transabdominal ultrasound.

This is the kind you probably think of when you envision a pregnancy ultrasound. During this type of ultrasound, a wand slides over your belly, taking images of what’s inside.

A transabdominal ultrasound provides a wider overview of what’s happening within your abdomen. It’s especially useful for its ability to identify internal bleeding.

Ectopic pregnancies are typically diagnosed within the first trimester (before 13 weeks’ gestation).

The earliest that ectopic pregnancy can be detected with ultrasound depends partly on the size of the embryo. By 6 weeks’ gestation, an embryo is often large enough to be identified with ultrasound technology.

Prior to 6 weeks, though, it’s harder to spot. In such an early stage, an embryo or yolk sac may not be visible, and a buildup of fluid can be mistaken for an ectopic pregnancy (or for a normal pregnancy inside the uterus).

When an ultrasound tech performs a transvaginal or transabdominal ultrasound to identify an ectopic pregnancy, they’re looking for specific indicators.

An empty uterine cavity — but with elevated levels of serial quantitative β-hCG — is one clear sign that an embryo has implanted in a place where it can’t continue to grow.

Even though your hormone levels may indicate pregnancy, you’re likely experiencing an ectopic pregnancy if your uterus doesn’t contain an embryo and yolk sac.

Other evidence of ectopic pregnancy is called a decidual cast. This is a large, intact piece of tissue sloughed off from the endometrial lining. Though it’s often associated with ectopic pregnancy, more research is needed to determine exactly why.

Additionally, a buildup of blood or a mass at the site of ectopic implantation may be visible on an ultrasound. Extra fluid in the peritoneal cavity (the abdominal space that contains the liver, intestines, and stomach) can also be a sign that an ectopic pregnancy has occurred.

If you’re curious to know exactly what was identified on a transvaginal or transabdominal ultrasound, don’t hesitate to ask your doctor. For some people, having more information can be helpful for emotional healing after this type of loss.

Because an ectopic pregnancy occurs at implantation, its signs and symptoms are most likely to show up early in your pregnancy. In your first trimester, the following may indicate that the embryo has implanted outside the uterus:

  • abnormal vaginal bleeding
  • low back pain
  • mild pain in your pelvic or abdominal area
  • cramping on one side of your pelvis

If an ectopic pregnancy goes undetected, it can eventually cause a rupture in your fallopian tube (the most common site of implantation outside the uterus). When this happens, you might have symptoms like:

  • sudden, severe pain in the abdomen or pelvis
  • weakness
  • dizziness
  • fainting

In pregnancy, symptoms like pelvic cramps or low back pain can indicate various things, many of them totally normal and harmless. Still, any signs that could point to an ectopic pregnancy should be taken seriously.

If you’re experiencing any of the symptoms above (especially in combination), it’s important to see your doctor as soon as possible.

Meanwhile, if you’re pregnant and experience severe pelvic pain, shoulder pain, or unusual weakness, dizziness, or fainting, go to the ER immediately. If left untreated, a ruptured fallopian tube can cause life threatening internal bleeding.

Even if you simply feel something is “off” in your pregnancy, you can always reach out to your OB/GYN or other pregnancy healthcare professional for peace of mind.

Discovering your pregnancy is ectopic is never good news — but if you’re having symptoms, it’s best to get to the bottom of their cause as soon as possible.

Using ultrasound technology and other diagnostics, your doctor can determine whether you’re experiencing an ectopic pregnancy and what steps to take from there.