What’s the First Step After a Positive Pregnancy Test?

It’s a positive pregnancy test, now what?

That positive pregnancy test is just the beginning – there is more information you need to have before deciding what you want to do in regards to your pregnancy. A limited sonogram will determine if the gestational sac (or pregnancy) is inside the uterus, how far along your pregnancy currently is, and if the pregnancy is viable or a fetal heartbeat is present. Without this information, a decision may be made regarding the future of your pregnancy that is not necessary.

An ectopic pregnancy is occurs when a fertilized egg grows outside the uterus. Since it is not in the uterus, an ectopic pregnancy cannot grow as it should and must be treated. As the pregnancy progresses, it can cause the fallopian tube to rupture or burst. If this happens, major internal bleeding may occur. This can be life threatening to the mother and needs to be treated with surgery.  If the tube has not yet ruptured, it can be treated in some instances with medication or repaired. Any woman who wants to have children will want to keep her fallopian tube so she can have a family in the future. If the tube has already ruptured, it may need to be removed. The remaining tube will be the sole means for possible pregnancies in the future. Early intervention via ultrasound is important to determine if the pregnancy is inside the uterus or to rule out ectopic pregnancy.

There are factors that increase the chance of an ectopic pregnancy occurring for women. However, any woman of childbearing age is at risk. Approximately 1 in 50 pregnancies is ectopic. Any woman with abnormal fallopian tubes is at an increased risk. These may be caused by pelvic inflammatory disease, history of ectopic pregnancies, history of sexually transmitted infection(s), pelvic or abdominal surgery, endometriosis, infertility, or prior tubal surgery (such as tubal sterilization or ligation). Some of these conditions may produce scar tissue in the tubes which can prevent the fertilized egg from reaching the uterus. Other risk factors include cigarette smoking, increased age or exposure to the drug DES (diethylstilbestrol) during her mother’s pregnancy.

An ultrasound will also determine the gestational age of a pregnancy (how far along the pregnancy currently is). It can also determine if the pregnancy is viable (a fetal heartbeat is present). Approximately 15-20% of pregnancies end in miscarriage. The majority of miscarriages occur in the first 13 weeks of pregnancy. There are many reasons a miscarriage may occur. Some miscarriages can be attributed to chromosomal abnormalities, which often happen by chance and are not likely to occur again in a later pregnancy. Another factor that may contribute to a miscarriage is an infection of the uterus, mother’s chronic disease (for example, uncontrolled diabetes), problems with the uterus or cervix, and lifestyle factors of the mother (for example, smoking, heavy alcohol use, or illegal drug use).

There are a few warning signals for miscarriage. Please contact your doctor or go to the Emergency Department if you are pregnant and experience spotting or bleeding without pain, heavy or persistent bleeding accompanied by abdominal pain or cramping, gush of fluid but no pain or bleeding, or you have passed fetal tissue. It is important to be evaluated and examined in each of these circumstances by a medical professional for a medical diagnosis and to determine if and when treatment is needed.

Before making any decision regarding your pregnancy, an ultrasound is absolutely crucial.


If you have taken a pregnancy test and it is positive, but you don’t know where to turn for the next steps, let us help. We offer medical-grade pregnancy testing, limited sonograms, and additional resources.

You don’t have to be alone through this!

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Sources for this article:
www.aium.org     American Institute of Ultrasound in Medicine
www.acog.org      American Congress of Obstetricians and Gynecologists
See also ACOG’s brochures on “Early Pregnancy Loss: Miscarriage and Molar Pregnancy” and “Ectopic Pregnancy”