Ectopic pregnancy is a serious and potentially life-threatening obstetric condition in which a fertilized egg implants outside the uterine cavity instead of within the endometrial lining of the uterus. The most common site of ectopic implantation is the fallopian tube, accounting for the majority of cases, though implantation may also occur in the ovary, cervix, interstitial portion of the tube, cesarean scar, or abdominal cavity. Because these locations cannot support normal placental development or fetal growth, ectopic pregnancies are non-viable and require prompt medical attention.

The clinical significance of ectopic pregnancy lies in its risk of rupture and internal hemorrhage. As the pregnancy grows, the surrounding tissue is unable to accommodate expansion, leading to tearing of blood vessels and potentially massive intra-abdominal bleeding. This can result in hemodynamic instability, shock, and maternal death if not diagnosed and managed early. Ectopic pregnancy remains one of the leading causes of maternal mortality in the first trimester, highlighting the importance of early detection.

Symptoms of ectopic pregnancy vary depending on gestational age and whether rupture has occurred. Early ectopic pregnancy may present with subtle or non-specific symptoms, including mild lower abdominal pain, light vaginal bleeding, or delayed menstruation. As the condition progresses, symptoms may intensify and include sharp pelvic pain, shoulder tip pain due to diaphragmatic irritation from internal bleeding, dizziness, fainting, or collapse. In ruptured ectopic pregnancy, symptoms are often sudden and severe, constituting a medical emergency.

Risk factors for ectopic pregnancy include previous ectopic pregnancy, history of pelvic inflammatory disease, tubal surgery, infertility treatment, assisted reproductive technologies, smoking, and conditions that impair normal tubal function. However, ectopic pregnancy can occur in the absence of identifiable risk factors, making vigilance essential in all early pregnancies.

Diagnosis relies on a combination of clinical assessment, measurement of pregnancy hormone levels, and imaging studies. Serial monitoring of pregnancy hormone trends is used to assess abnormal pregnancy progression, while transvaginal ultrasound helps determine the location of the pregnancy. The absence of an intrauterine pregnancy when hormone levels exceed expected thresholds raises strong suspicion for ectopic implantation.

Management of ectopic pregnancy aims to safely resolve the abnormal pregnancy while minimizing complications and preserving future fertility whenever possible. Treatment options depend on gestational age, hormone levels, clinical stability, and site of implantation. Early, unruptured ectopic pregnancies may be managed medically, while surgical intervention is required in cases of rupture, instability, or failed medical management. Delayed diagnosis increases the likelihood of tubal rupture, need for emergency surgery, blood transfusion, and long-term reproductive consequences.

With early recognition, timely intervention, and appropriate follow-up, most women recover fully from ectopic pregnancy and retain good future fertility potential. Structured post-treatment monitoring is essential to ensure complete resolution and reduce recurrence risk.