Here are ten ectopic pregnancy symptoms you should not ignore.

1. Vaginal spotting or bleeding: One of the first warning signs of an ectopic pregnancy is spotting or bleeding. Although bleeding in early pregnancy does not always mean there is something wrong with the pregnancy, if you have spotting or bleeding you should report this to your doctor. Some other causes of spotting during pregnancy are implantation bleeding, subchorionic hematoma, irritation of the cervix, or miscarriage.

2. Slow rising hCG levels: Your doctor may run a quantitative hCG test in early pregnancy if you are having vaginal spotting or if he suspects ectopic pregnancy. Slow rising hCG levels can be an indicator of an ectopic pregnancy. During a normal pregnancy, hCG levels will double every two to three days in early pregnancy. With an ectopic pregnancy, hCG levels may rise but they tend to go up very slowly and not double like they should. If your hCG levels are low or not doubling your doctor may order more blood work or an ultrasound to rule out ectopic pregnancy or other complications.

3. Cramping: Mild cramping during early pregnancy is normal, but severe cramping or cramping accompanied with spotting, is not normal and could be a sign of an ectopic pregnancy. Cramping may be on one side or may feel like menstrual cramps.

4. Dizziness: Dizziness is another sign of an ectopic pregnancy. Dizziness may be a result of internal bleeding. Dizziness can also be caused by not eating enough, anemia, or not getting enough sleep.

5. Pain on one side: Pain on one side is something that you should alert your doctor about. Women may notice mild to severe abdominal pain located on one side. Not all women with ectopic pregnancies will notice pain. Once the tube has ruptured the pain will become more severe.

6: Rectal pressure, gas pain, or feeling constipated: Sometimes the pain from an ectopic can be mistaken for gas pain or constipation. If internal bleeding has occurred, this can put pressure on the rectal area and can be mistaken for gas pain or constipation. If you are having severe gas pain during early pregnancy don’t dismiss this. Call your doctor.

7. Low blood pressure: If the ectopic pregnancy goes undiagnosed and there is internal bleeding, this can cause a woman’s blood pressure to drop. She may feel short of breath, tired, or have a drop in blood pressure.

8. Shoulder pain: Shoulder pain may result after the ectopic pregnancy has ruptured. The internal bleeding caused from the rupturing may cause irritation of the nerves which results in shoulder pain. Shoulder pain is an indicator that the tube has already ruptured and if you notice shoulder pain, especially if it is accompanied with other ectopic pregnancy symptoms, you should get immediate medical attention.

9. Nausea: Nausea is also a symptom of ectopic pregnancy. Since morning sickness is very common during early pregnancy, this symptom may be hard to distinguish from normal pregnancy symptoms.

10. Shock: If the fallopian tube ruptures, a woman will have internal bleeding and may go into shock from all of the bleeding. Ectopic pregnancies can be life threatening. A ruptured tube will require hospitalization, surgery, and possibly a blood transfusion. If you have any symptoms of shock such as cold clammy skin, anxiety, dizziness, sweating, feeling weak, fainting, or having a rapid but weak pulse you should call 911 immediately.