[darksnape]

1. As an emergency. Suddenly, without warning a woman is very unwell, collapses and is taken to hospital. A positive pregnancy test is found and she is transferred to theatre PDQ and a ruptured ectopic is found with bleeding into the abdomen.

2. The second group are known to be at risk of an ectopic pregnancy, for example she may have had an ectopic previously, may have undergone tubal surgery or assisted conception (such as IVF). Early detection of ectopics are high in this group of women as we routinely check that the pregnancy is where it should be fairly early on. Less than 20% of ectopics present this way.

3. Finally, the most common presentation is with a missed period, positive pregnancy test, some abdominal pain (usually to one side), and some irregular vaginal bleeding. Some women report fainting or shoulder-tip pain.