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Ectopic Pregnancy at 5 Weeks: Symptoms, Causes, Rates, Rupture Signs

By: Author Dr Akatakpo Dunn, MBBS, PG Dip Ultrasound, Prof Dip O&G (RCPI) Medical Director & Lead Obstetrician/Ultrasonologist, Verah Clinic & Maternity

Posted on Last updated:

Question: What are the causes, rates, risk factors, symptoms and ruptured signs of ectopic pregnancy at 5 weeks?

If you are now pregnant, you must be wondering if there is any chance you will have a miscarriage, ectopic pregnancy or sudden loss of your baby.

It’s possible you may experience complications in the first months of pregnancy, and in fact, the first trimester is usually a time when a miscarriage and ectopic pregnancy commonly occurs.

While a miscarriage can affect some pregnancies, it may easily be confused for an ectopic pregnancy because they have similar symptoms (bleeding and pain).

What’s an ectopic pregnancy?

An ectopic pregnancy means your baby is growing outside your womb (most commonly in the fallopian tube) instead of inside the uterus. This kind of pregnancy cannot continue normally and can become life-threatening if it ruptures and causes internal bleeding. ACOG+1

If you are five weeks pregnant, it’s possible you may have an ectopic pregnancy. The chances are even higher if you’ve had trichomoniasis, gonorrhea and chlamydia infections in the past without informing your doctor for advice and treatment (especially chlamydia and gonorrhea, which are strongly linked to pelvic inflammatory disease and tubal damage). MedlinePlus+1

The truth is, these sexually transmitted diseases will sometimes be in your body without you knowing. More than 50 percent of women with STDs like chlamydia will not be symptomatic, though they may still end up in the future with long-term complications.

If you’ve had sexual contact with someone in the past without use of a condom, STDs could have been gotten through this act.

Other risk factors are a surgical procedure on your fallopian tubes or if you’ve asked your doctor to tie your tubes while trying to prevent pregnancy (tubal ligation).

If you are pregnant, at five weeks, your period is now delayed for about a week. At this time, it’s possible you won’t even have symptoms of an ectopic pregnancy. But you may feel pregnant.

Symptoms of pregnancy vary among women, though commonly, you may start feeling breast tenderness, weakness, excessive vaginal discharge, back pain and mood swings.

Worldwide, ectopic pregnancy affects about 1–2 percent of pregnancies and is one of the leading causes of pregnancy-related deaths in the first three months of pregnancy (roughly 6–13 percent of early pregnancy deaths). Wikipedia Signs you will experience are vaginal bleeding and abdominal or pelvic pain.

This article explains the causes, signs, and symptoms of ectopic pregnancy at 5 weeks.

What causes ectopic pregnancy at 5 weeks?

While it is sometimes believed that ectopic pregnancy results from a previous abortion, this is not considered a major cause on its own in modern studies. Many women with ectopic pregnancy have no clear cause.

In fact, more than 30 percent of women that develop an ectopic pregnancy might not exactly have any recognizable cause. With that in mind, there are well-known causes and risk factors for ectopic pregnancy. They are:

1. Tubal damage

The female reproductive tract is divided into the upper and lower parts.

The uterus (that functions to keep your baby during pregnancy) has ovaries on both sides connected by the fallopian tube.

The fallopian tube, also called the oviduct, is a 10-centimeter tube that plays important function during reproduction and its malfunction may result to an ectopic pregnancy in women.

Within the fallopian tube are ciliated cells that aid the backward transport of the embryo (formed after fertilization of the male’s sperm and female egg) to the uterus for implantation.

Any damage to the fallopian tube may cause the embryo to be attached inside the fallopian tube and develop within the tube. This will result in an ectopic pregnancy.

A possible reason for a damaged tube is a pelvic inflammatory disease that occurs when untreated infections (especially chlamydia and gonorrhea) ascend upwards through the reproductive tracts and damage the epithelial lining and ciliated cells of the fallopian tubes. MedlinePlus+1

Smoking, previous ectopic pregnancy, and some fertility treatments are also known to increase risk. NCBI+1

2. Tubal ligation

It is common that women, especially those that are through with childbearing, take actions to prevent an unplanned pregnancy. Usually, these actions could be birth control pills or subdermal implant attached to your arm.

However, some women may prefer the ligation of the fallopian tube to prevent sperm transport to the fallopian tube (where fertilization occurs). If this fails and pregnancy still happens, it’s possible you may have an ectopic pregnancy, because any pregnancy after tubal ligation has a higher chance of being ectopic. MedlinePlus+1

Also, it’s possible you’ve changed your mind later on and asked your doctor to reverse a tubal ligation. This usually comes with a risk of an ectopic pregnancy.

Other risk factors for ectopic pregnancy at five weeks are infertility, tubal surgery in the past, and use of intra-uterine devices (IUDs). IUDs actually reduce your overall chance of getting pregnant, but if pregnancy does occur with an IUD in place, the chance that this pregnancy is ectopic is higher. MedlinePlus+1

Maternal age is also linked to ectopic pregnancy. Women that are more than 35 years have a higher chance of an ectopic pregnancy. MedlinePlus+1

What are the symptoms and signs of ectopic pregnancy at 5 weeks pregnant?

Sign of an ectopic pregnancy differs from woman to woman. While some women will have classical signs of an ectopic pregnancy (vaginal bleeding and abdominal pain), others may have vague symptoms like mild spotting and dull pelvic pain. Mayo Clinic+1

Usually, at the 4th or 5th week of gestation, most women will not have had obvious signs of an ectopic pregnancy. As an ectopic pregnancy grows, it may rupture and bleed into the abdomen. On average, ectopic pregnancy is diagnosed around 6–8 weeks of gestation; if it is not detected and treated, rupture can occur in this time window or sometimes earlier or later. Wikipedia+1

Symptoms of an ectopic pregnancy are:

1. Vaginal bleeding

Vaginal bleeding is a common symptom experienced by women who have an ectopic pregnancy. However, most women with a miscarriage in early pregnancy will also have vaginal bleeding.

The truth is, it’s difficult to tell if you are having a miscarriage or an ectopic pregnancy just from bleeding alone. It’s best you inform your doctor as early as possible.

Then again, some women with an ectopic pregnancy will not have any bleeding at all. The onset of a sudden sharp pain radiating to your shoulders is a sign something is wrong with your pregnancy and may suggest internal bleeding.

2. Abdominal pain

Pain in your abdomen can occur for a different reason when pregnant. Inflammation of the appendix, fallopian tube, ovarian torsion, and cyst may cause pregnant women to feel pain.

If you have an ectopic pregnancy, you will feel pain too. Pain may be very severe sometimes, especially when an ectopic pregnancy breaks open the fallopian tube and bleeds into the abdomen.

If this happens (ruptured ectopic pregnancy), you may notice any of these symptoms:

  • Sharp tummy or pelvic pain

  • Dizziness and fainting attack

  • Shoulder pain

  • Fast breathing

  • Fast heart rate

If you are pregnant, these symptoms suggest something is wrong. Talk to your doctor or go to the emergency room immediately.

(For more symptom detail, see Mayo Clinic’s ectopic pregnancy page: https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088.) Mayo Clinic+1

How is ectopic pregnancy diagnosed and treated at 5 weeks?

Ectopic pregnancy is quite common and occurs at a rate of about 1–2 percent of pregnancies. Wikipedia+1 If you’ve started having the above symptoms, it could be an ectopic pregnancy, but other conditions (like miscarriage, ovarian cysts or appendicitis) can cause similar signs. Wikipedia+1

One easy way to confirm what is going on is by notifying your doctor about how you feel. At 5–6 weeks, it’s possible for your baby to be visualized with a transvaginal ultrasound scan. Wikipedia

Your doctor will quickly check if your baby is located within the uterus and may also check your HCG (human chorionic gonadotropin) hormone level.

After implantation (either within the uterus or in the fallopian tube), your body produces HCG. This hormone signifies you are pregnant.

Doctors often use a combination of serial blood HCG levels and transvaginal ultrasound. If this hormone is present and above a certain level (sometimes called the “discriminatory zone”, often around 1500–3500 mIU/ml) but a high-quality transvaginal ultrasound still cannot visualize a pregnancy in the uterus, your doctor will be very concerned about an ectopic pregnancy or a “pregnancy of unknown location” and will arrange repeat tests, close follow-up, or treatment. NICE+1

Treatment follows once the diagnosis is made. If there is no evidence of a ruptured ectopic pregnancy and you are stable, drugs like methotrexate (a single or sometimes repeated injection) may be used in selected women, especially when the ectopic is small and HCG levels are not very high. ACOG+1

However, a laparoscopic or open abdominal surgery may be performed if your doctor feels you are not stable, if there is a rupture, or if methotrexate is not suitable. This may require a complete removal of the affected fallopian tube (salpingectomy) or, in some cases, a surgical opening and repair of the tube (salpingostomy). ACOG+1

The truth is getting pregnant after an ectopic pregnancy can sometimes take longer, and the risk that another ectopic will occur is higher than before (about 1 in 10 in future pregnancies). However, many women go on to have healthy intrauterine pregnancies after an ectopic, especially if at least one tube is still open and other fertility factors are normal. Wikipedia+1

It’s important you see your doctor for all the help you could get, including counseling about future pregnancy, timing of trying again, and early ultrasound in your next pregnancy.

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