Q&A: I am concerned I have signs of an ectopic pregnancy because of early pain.

There are many innocent explanations for pain in early pregnancy. "Growing pains," usually nothing more than mild uterine contractions against the expanding pregnancy, are normal. Ligament pain, which occurs as the ligaments that hold the uterus in place are stretched, can be particularly uncomfortable, but are harmless. A bladder infection, which pregnant patients are prone to, can mimic almost any type of lower abdominal pain. A threatened miscarriage can feel like growing pains, but is generally also associated with bleeding.

An ectopic pregnancy, usually a pregnancy in one of your fallopian tubes, will distend the tube, causing localized tenderness. If it outgrows the elasticity of the tube, the tube can split and bleeding into the abdomen can occur. This will cause a vague burning tenderness throughout the abdomen. Generally by the time this happens, there is vaginal bleeding as well. This is a surgical emergency.

Women at risk for ectopic pregnancy are those who have suffered damage to their tubes from previous problems. Infections of the tubes (salpingitis) from sexually transmitted diseases are the usual culprits, leaving a scarred path for the fertilized egg to try to navigate on its way to the inside of the uterus for implantation.

You should report any pains to your healthcare provider during your normal prenatal office visit, but if you have any bleeding or severe pain, call your provider right away.