Ectopic Pregnancy

Basics

Description

  • Implantation of fertilized ovum outside of uterus:
    • Most commonly fallopian tube (93–97%)
  • Abdominal and peritoneal implantations:
    • Associated with higher morbidity
    • Difficult to diagnose
    • Tendency to bleed
  • Occurs in ∼2% of pregnancies
  • Accounts for 6% of all maternal deaths (leading cause of first-trimester pregnancy-related death)
  • 60% of women with ectopic pregnancy are subsequently able to have a normal pregnancy

Etiology

  • Risk factors include:
    • Woman >35 yr old
    • African American
    • Previous fallopian tube damage from infections, such as pelvic inflammatory disease (PID)
    • Previous tubal surgery (i.e., tubal ligation)
    • Previous ectopic pregnancy
    • Intrauterine device (IUD) use:
      • 25–50% of pregnancies with IUD are ectopic
    • Diethylstilbestrol (DES) exposure
    • In vitro fertilizations
    • Being a current smoker
  • More than half of women with ectopic pregnancies have no risk factors

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