For many women, two pink lines on a pregnancy test symbolise hope, love and a new chapter in their lives. It is the kind of news families celebrate quietly at first, then loudly with prayers and plans. But for some, that joy is abruptly replaced by confusion, pain and fear.
An ectopic pregnancy happens when a fertilised egg implants outside the uterus, most commonly in the fallopian tube. Instead of growing safely inside the womb, the pregnancy develops in a space that cannot support it. If left untreated, it can rupture and cause life-threatening internal bleeding.
For Piyashi Chowdhury, an ectopic pregnancy survivor, the diagnosis came as a devastating shock. “I felt shocked, scared and heartbroken after hearing that it was ectopic,” she recalled. “I was being told that my pregnancy could not continue and that it could even be life-threatening.”
The fallopian tubes are delicate passageways designed to transport the fertilised egg to the uterus. When that journey is interrupted due to damage, infection or unknown reasons, the embryo may implant in the tube itself. Rarely, implantation can also occur in the cervix, ovary, abdomen or even a previous caesarean scar.
Doctors say the exact cause is not always clear. However, certain factors increase the risk:
- History of infertility
- Assisted reproductive techniques (such as IVF)
- Previous pelvic infections
- Prior ectopic pregnancy
- Pregnancy while using an intrauterine device (IUD)
- Smoking and alcohol use
- Previous abdominal or pelvic surgery
Yet many women diagnosed with ectopic pregnancy have none of these risk factors, making awareness even more important.
Hospital-based studies in Bangladesh suggest that ectopic pregnancy occurs in roughly 1.5-3.6% of pregnancies seen in clinical settings, with variations across regions and healthcare facilities. Most patients in these studies were women in their mid-20s to early 30s.
One of the most dangerous aspects of ectopic pregnancy is how easily its early symptoms can be mistaken for a typical pregnancy.
Dr Jesmin Sultana Dina, FCPS Part 2 trainee in Gynaecology and Obstetrics at Shaheed Suhrawardy Medical College and Hospital, warns that delays are common.
“Many women mistake early warning signs for normal pregnancy discomfort,” she said. “By the time they come to the hospital, complications may already have begun.”
The initial signs often include missed period, nausea, and breast tenderness. But as the pregnancy grows in the wrong place, more alarming symptoms begin to surface. A woman may experience sharp, one-sided pain in the lower abdomen, often sudden and persistent. Light vaginal bleeding or unusual spotting may follow, sometimes mistaken for an irregular period. Many also report dizziness, weakness and a lingering ache in the lower back.
These signs should never be ignored, as they can indicate that pregnancy is developing dangerously outside the uterus.
A mother with a more prolonged gap between marriage and her first pregnancy faces a greater risk of ectopic pregnancy. The initial pregnancy can occasionally serve a similar purpose. Using tobacco and drinking alcohol may pose an additional risk. The history of infertility, especially primary infertility, was closely associated with the risk of ectopic pregnancy. Even a spontaneous miscarriage raises the likelihood of it.
Piyashi remembers the moment her body signalled that something was terribly wrong.
“I had sharp pain on one side of my lower abdomen, light bleeding and felt very weak and dizzy,” she said. “Then everything went blank. When I woke up in the hospital, my whole world had changed.”
If a fallopian tube ruptures, symptoms can escalate suddenly. This is a medical emergency that requires immediate surgery. “We face many cases every year,” Dr Jesmin added. “Many women reach us only after experiencing severe pain or internal bleeding.”
Beyond the physical danger lies another wound, the emotional one. An ectopic pregnancy means the loss of a wanted child. For many women, it also brings fear about future fertility and guilt, even though the condition is rarely preventable. If you are pregnant and experience unusual pain or bleeding, seek medical attention immediately. Do not wait. Do not dismiss it as “normal.”
Women’s health conversations must go beyond the celebration of motherhood to include awareness of its risks. Because sometimes, what begins as the happiest news of a lifetime can become a race against time and knowing the signs may be what saves a life.
