Symptoms typically develop around the 6th week of pregnancy. This is about 2 weeks after a missed period if you have regular periods. However, symptoms may develop anytime between 4 and 10 weeks of pregnancy. You may not be aware that you are pregnant. For example, your periods may not be regular, or you may be using contraception and not realise it has failed. Also, symptoms may start about the time a period is due. At first you may think the symptoms are just a late period. Symptoms include one or more of the following.

• Pain on one side of the lower abdomen. It may develop sharply, or may slowly get worse over several days. It can become severe.
• Vaginal bleeding often occurs, but not always. It is often different to the bleeding of a period. For example, the bleeding may be heavier or lighter than a normal period. The blood may look darker. However, you may think the bleeding is a late period.
• Other symptoms may occur such as diarrhoea, feeling faint, or pain on passing faeces (stools).
• Shoulder-tip pain may develop. This is due to some blood leaking into the abdomen and irritating the diaphragm (the muscle used to breathe).
• If the fallopian tube ruptures and causes internal bleeding, you may develop severe pain or 'collapse'. This is an emergency as the bleeding is heavy.
• Sometimes there are no warning symptoms (such as pain) before the tube ruptures. Therefore 'collapse' due to sudden heavy internal bleeding is sometimes the first sign of an ectopic pregnancy.

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