Psychological distress after ectopic pregnancy in adolescents: a narrative review of the evidence and UK support pathways

Ectopic pregnancy is an early pregnancy loss that can kill, and it arrives as four things at once: an emergency, a surgical or medical intervention, a bereavement, and a question about future fertility. Prospective cohorts recruited in UK early pregnancy units show that around one in five women meets the criteria for probable post-traumatic stress nine months afterwards, with anxiety and depression persisting in a substantial minority. Those cohorts excluded anybody under eighteen. Adolescents have therefore not been studied as a distinct group in this literature, and no adolescent-specific prevalence figure exists to be cited.What can be assembled instead is the adjacent evidence, and it points one way. Adolescent early pregnancy loss and adolescent pregnancy are both associated with grief, depressive symptoms, low self-esteem and suicidal thoughts, which suggests that teenagers are at least as vulnerable as adults and possibly more so. Psychosocial intervention reduces depression, anxiety and grief after perinatal loss, and structured support reduces distress in pregnant adolescents. So the problem is not that nothing works.In the UK, support after ectopic pregnancy rests on general practice follow-up, NHS counselling and the voluntary sector. For a young person, reaching any of it is shaped by confidentiality, waiting times and fragmented pathways. This review sets out what the evidence supports, what it cannot yet support, and four things that could be done now: routine psychological screening after ectopic pregnancy in young people, prompt age-appropriate follow-up, a defined route between early pregnancy services and adolescent mental health care, and prospective UK studies of the group nobody has measured.