Shoulders cause pain when we are stressed because we hold ourselves more rigidly and muscles in the back and neck go in to spasm or you may have slept in an awkward position – this is most likely not shoulder tip pain related to an ectopic pregnancy. You know when you have it because it is a very weird pain you have probably never experienced before. If you look to the left over your shoulder and then cast your eyes down, the tip of your shoulder is where your shoulder ends and your arm starts. Shoulder tip pain is exactly where it says – not the neck or the back but the tip of your shoulder. This is why, if you have symptoms and a surprisingly negative urine pregnancy test, it is better to be seen at the hospital. Your GP can do this test, but it will take a few days to get the result, while the hospital and EPU will have the result in a few hours. Blood tests can identify the exact hCG level in the blood. HCG is commonly detected in urine by using a urinary pregnancy test, which can show as positive or negative. The blood test that doctors would perform is for hCG which is a hormone produced in pregnancy. If you are in pain and/or bleeding and your home pregnancy test is negative, but you think it should be positive, ensure you are seen by a doctor urgently by attending your local Accident & Emergency department or by contacting your specialist Early Pregnancy Unit. If it is still negative and you still think you are pregnant, your doctor can do a blood test to measure the hCG (pregnancy hormone) levels accurately. If you do a pregnancy test and are surprised by a negative result, repeat the test perhaps with a different pregnancy test kit. This is usually because the hormone level is low. Very rarely a pregnancy test can give a falsely negative result. It is sensible to perform the test in the morning when urine contains the most pregnancy hormone (Human Chorionic Gonadotropin or hCG). They can be positive before you have missed your period. Pregnancy test kits that are available now are very sensitive. You can also view all the options for gaining professional help here. You can contact your out-of-hours doctor/GP service if your normal surgery is closed or go to your local Accident and Emergency department (A&E) or Urgent Care Centre. You can also call the NHS Direct 111 service by dialling 111 or access the NHS GP at Hand service. If you are experiencing any of the following ectopic pregnancy symptoms, please contact your doctor/GP or your local Early Pregnancy Unit. Please do be vigilant and take any pain that concerns you seriously until absolutely proven otherwise. If your instincts are screaming at you that something does not feel right, it is OK to trust them and ask for reassessment at any time. See the reasons for an ectopic pregnancy page for more information. In addition, although there are a number of recognised risk factors, in over 50% of women diagnosed with an ectopic pregnancy, there are no identifiable risk factors. The diagnosis of ectopic pregnancy may sometimes be difficult, and symptoms may occur from as early as 4 weeks pregnant and up to 12 weeks or even later. Some experience symptoms that are similar to other conditions such as gastroenteritis (tummy bug), urinary tract infection (UTI), pelvic inflammatory disease (PID) and miscarriage, which are the most common ways to misdiagnose an ectopic pregnancy. If not diagnosed and treated quickly an ectopic pregnancy can lead to internal bleeding and a medical emergency. It is however very important that an ectopic pregnancy as the cause is excluded. Lower tummy/abdominal pain and/or bleeding during pregnancy may be due to a number of causes.
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